What are Panic Attacks?
By: Max Violets
Panic disorder is an anxiety disorder wherein you have panic attacks, often for no apparent reason. In order to be diagnosed, you must have recurrent panic attacks with at least one month of worry or concern about future panic attacks.
Panic attacks are the body's fight/flight response. They are a very physical thing. The exact symptoms of a panic attack are different for everyone however they will include: raised heartbeat/palpitations, hot or cold flashes, loss of feeling in extremities or limbs/tingling sensation in extremities or limbs, hyperventilating, shortness or breath, sweating, dissociation, nausea, fainting or feeling faint, shaking or trembling, a choking sensation, chest pain, dizziness, numbness, pins and needles, dry mouth, 'clammy' hands, a need to go to the toilet, ringing in your ears, and a feeling of dread. You must exhibit 4 of the above symptoms for it to be considered a panic attack.
Anyone can have a panic attack. The system is there and the process exists for survival - it's useful if you were being chased by a bear. However with panic disorder, the system is oversensitive. It's like a car alarm that goes off when a leaf brushes past whilst most people's alarms only go off when someone's smashed the windscreen and is breaking in. This causes someone with panic disorder to have panic attacks in situations when they should not: moments as minor as slight unease or a millisecond of fear can trigger a panic attack in people with panic disorder, or they may have a panic attack for no reason at all.
It is important to note that this is regardless of the person with panic disorder's actual feelings in the situation. The panic attack is a physical response and panic disorder is when the system which triggers them is oversensitive, not when the person themselves is 'oversensitive'.
This causes a variety of long-term problems; the attacks themselves are physically exhausting and highly unpleasant. This, in turn, makes them mentally exhausting and you may get very tired and burnt out after one, impacting anything you do and any decisions you make for the rest of the day after. The body is not designed to have a fight/flight response every day. You can end up physically ill as a result e.g. losing a lot of weight, digestive issues, muscle ache or deterioration, a weakened immune system.
With panic disorder, panic attacks are a very physical response as opposed to mental thoughts - you may not even know why you're panicking, which leads to feeling out of control of your own body. Panic attacks are very unpleasant, but they are very hard to prevent, (you cannot stop your body having a panic attack in the same way you cannot stop your body from sweating when it's hot) so you may go to extreme, irrational, lengths to try. This can lead to avoidance of certain situations to an unhealthy level, or when the situations cannot be avoided it can lead to some very unreasonable behaviour.
Whilst feelings of anxiety can be hidden it is very hard to hide the fact you are shaking, hyperventilating, crying, etc. This is incredibly frustrating for you and for people around you and it can severely damage relationships as people don't tend to understand how physical and uncontrollable the disorder is.
Knowing how and seeing how it affects people around you can lower self-esteem and heavily impact relationships - you feel like a nuisance, you are treated by others as if you are doing it on purpose and are called attention seeking, whilst in reality no matter how much you try not to panic it's a physical thing and you cannot stop it so this just creates further guilt and lowers self-esteem even more. It cannot be reiterated enough how confusing and awful the feeling of being out of control of your body, let alone when others do not understand or respect that.
Often people with this disorder develop agoraphobia, obsessive-compulsive disorder, generalised anxiety, or depression alongside panic disorder. Recovery becomes more complicated as you are fighting your body, not your mind. You can mentally be logical all you like however that will not stop your body from shaking. As previously mentioned the panic attacks are a physical response and occur regardless of your actual feelings - you cannot fight them with logic or 'positive thinking'.
However there is some treatment; medication may be prescribed. This may be antidepressants (usually SSRIs or tricyclic) or medications such as pregabalin or clonazepam (which are also commonly prescribed for epilepsy, interestingly). These aim to reduce the panic attacks and the physical symptoms.
Cognitive behavioural therapy or other forms of therapy can help. This is rarely effective in preventing the panic attacks themselves however it can help and aims to help with the negative feelings or treat other disorders/illnesses such as agoraphobia or depression that have developed as a result of the panic disorder. Support groups can be effective in removing some of the isolation and providing group therapy. Communication, honesty, and reassurance from friends or family is extremely comforting.
Last but not least: Awareness goes a long way. A person is more than their panic disorder and awareness can help others to understand.