Woman having a panic attack
What Are the Symptoms of a Panic Attack?
Panic attacks can be very frightening.
Physical symptoms such as a pounding heart, breathlessness, nausea and dizziness can make you feel like you are truly in danger - going crazy, having a heart attack, collapsing or even dying.
So what exactly happens during a panic attack?
Before we answer that question let’s talk about what happens when we are in a truly threatening situation. Imagine that you’re walking through a dark alley and suddenly a menacing shadow jumps out in front of you. You realize that you’re being mugged. How would you feel in this situation? Your body would likely immediately go into fight-or-flight – a basic survival response that we have evolved to manifest when confronted with real danger. These symptoms are caused by the release of stress hormones such as adrenaline and cortisol which prepares the body to deal with perceived danger. They can include:
- Dilated pupils
- Pale or flushed skin
- Rapid heart rate and breathing
- Blood pressure increases
- Numbness and tingling
- Muscle tension
- Trembling
Are Panic Attacks Dangerous?
The important thing to realize about fight-or-flight is that the symptoms themselves are not dangerous. You can think of them as the body’s natural “alarm system”. In fact, in a truly dangerous situation, these physical changes are adaptive. For example, the body tenses up to prepare for physical activity, heart and breathing rate go up to increase oxygen delivery to muscles, and tingling can occur in response to adrenaline and blood being redirected from extremities to the larger muscles in the body.
You might have noticed that these are the exact symptoms that one experiences during a panic attack. And that is no coincidence. Because fight-or-flight is exactly what we experience during a panic attack.
What Triggers Panic Attacks?
Sometimes a panic attack can be triggered by a particularly stressful situation, even when there is no risk to your physical safety. At other times, panic attacks can seem to “come out of the blue”. In any case the body’s natural “alarm system” gets triggered in the absence of real danger. So why exactly does the fight-or-flight response misfire in panic disorder?
People with panic disorder are alarmed by the physical sensations of the emergency response system because of a catastrophic misinterpretation of these sensations.
Let’s break it down:
First, your experience physical sensations in your body (e.g. increased heart rate) that may be caused by mild anxiety or could just be a part of the “noise” that we all experience in our bodies in the course of a typical day. This leads to a catastrophic misinterpretation of these symptoms (e.g. “Oh no, I’m going crazy!” or “I am having a heart attack” or “I’m going to faint”). It is this misinterpretation of symptoms that leads to the full-blown activation of the fight-or-flight response i.e. a panic attack.
Sometimes you may be aware of the negative thoughts, and at other times anxiety and panic may occur without conscious thoughts of danger.
In addition, because panic attacks can be so terrifying, we start being on the “look out” for signs of a potential panic attack, which paradoxically increases our chances of having one. This contributes to the “vicious cycle” of panic.
How Does Treatment for Panic Attacks Work?
Among other things, treatment for panic disorder focuses on retraining your brain to perceive the symptoms as harmless. This is done through a combination of cognitive restructuring (i.e. changing the way you think) and exposure therapy. We’ll talk more about exposure therapy in a future post.
In summary:
Panic attacks can be very frightening and can cause physical symptoms such as a pounding heart, breathlessness, nausea and dizziness.
The fight-or-flight response is the body's natural alarm system that is triggered in dangerous situations.
The symptoms of fight-or-flight, such as dilated pupils, rapid heart rate, and muscle tension, are the same symptoms that occur during a panic attack.
Panic disorder is triggered by the misinterpretation of physical sensations as dangerous, even when there is no actual danger present.
Scanning your body for physical symptoms increases the chances of having another panic attack.
Treatment for panic disorder focuses on retraining the brain to perceive symptoms as harmless through cognitive restructuring and exposure therapy.
The bottom line is that panic disorder is a condition that we understand well and can treat effectively. Please don’t hesitate to reach out for help if you are struggling.
Hopefully this post provides a helpful introduction to panic disorder and its treatment.
Please feel free to contact me for a free consultation.
Learn more about anxiety and panic treatment in Ontario.
References:
Clark, D. A., & Beck, A. T. (2010). Cognitive Therapy of Anxiety Disorders: Science and practice. Guilford Press.
VA Health Care: Panic Attacks. https://www.mirecc.va.gov/cih visn2/documents/patient_education_handouts/panic_attacks_version_3.pdf
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