Panic Attacks 101: What They Are and Ways to Get Help

Have you ever wondered if the symptoms you are feeling could be a panic attack?

Do you know how to discern between a panic attack and other possible causes for your symptoms?

Do you know how you can handle one if it occurs to you or a loved one?

If you are feeling puzzled in answering any of these questions, you are not alone.

Many people are unaware of what the symptoms of a panic attack are, how to look for signs that one may be on the verge of occurring, and how to handle one if it occurs. In fact, in my history of working with clients who have experienced panic attacks, many have shared that they were first diagnosed with panic attacks in the emergency room, when they thought they were experiencing a heart attack!

According to the DSM-V (The Diagnostic Statistical Manual of Mental Disorders, by the American Psychological Association), panic attacks are typically identified by having at least four of the following thirteen symptoms at once:

1) Palpitations, heart pounding or rapid increase in heart rate

2) Trembling or shaking

3) Shortness of breath/smothering sensations

4) Chest pain or discomfort; a feeling of choking

5) Sweating

6) Feelings of dizziness, unsteadiness, lightheadedness, or faintness

7) Nausea or abdominal distress

8) Depersonalization/derealization feelings (a feeling of being detached from self and/or a feeling of reality being ‘different’)

9) Fear of dying

10) Fear of going “crazy” or losing control

11) Chills or hot flashes

12) Numbness or tingling sensations.

13) A feeling of choking

Let’s face it, panic attacks can be scary. In fact, the term attack even sounds a bit fear provoking; let us call them panic occurrences. Perhaps we can be gracious toward ourselves and think of these occurrences as our bodies responding to an outside stimulus the best it knows how, by warning us that we’re experiencing a high level of emotional distress. Now, wouldn’t it be nice to know the signs leading up to this distress before it exacerbated to a panic occurrence?

There are two types of panic occurrences:

1) The Sudden Onset Type: These can feel like there were no signs prior; the easily identified type, which occurs when we face a particular stimulus (trigger) that we are aware could cause us high levels of unease.

2) The Anticipated Type: These can be predictable and are often connected to situations. If we know we have had a difficult experience with public speaking in the past, and are now about to stand in front of that podium again, feeling panic setting in.

Arguably, there are many signs that can occur prior to each of these types of panic occurrences that can serve as warning signs for us.

These are included but not limited to:

- noticing an increase in heart rate, respiratory rate or blood pressure (sudden redness or even paleness in the face)

- tension building within the body that just will not subside (neck, hands, jaw, shoulders, etc.)

-increase in ruminating thoughts (those ones we just can’t seem to turn off)

- increase in “what if” thoughts, or doom and gloom thinking patterns (when we are waiting for, “the other shoe to drop,”)

-extreme difficulties in sleeping

-noticing a large amount of stress that is ongoing (ie., anything that has brought change during the COVID-19 pandemic, our election, or the ongoing civil unrest in our country)

- and much more.

Does this sound like it could be you?

If so, let’s work on getting those feelings under control.

We can begin to take back control over our panic occurrences by:

1) Identifying if we have had this occur before, and if so, what were the possible stimuli “triggers,” and warning signs you experienced prior to your experience?

2) Begin to normalize your experience by knowing that these feelings are temporary, and the best way to get through emotions, is to go through them. Bottling emotions up, pushing them aside, distracting yourself without ever experiencing the emotions or denying that we are even experiencing emotions can all lead up to a panic attack, as we are not allowing the nature of emotions to occur. Before emotions become so dysregulated that they lead into a panic occurrence, consider the following:

3) Sit with your emotions. I don’t mean isolate yourself and run through ruminating thoughts 24/7 under your covers, I mean really sit with emotions. Identify what emotion you are feeling, what may have caused this emotion to arise (internal thoughts, external stimuli), where you feel this emotion within the body, and most importantly, what you need to work through this emotion.

4) Spend time engaging in self-care as a preventative measure. This may include physical care (walking, yoga, biking),

spiritual care (meditation, prayer, singing/dancing), emotional & personal care (journaling, setting boundaries, saying no when needed, engaging in a hobby, creating short and long-term goals, laughing), and other areas of environmental, professional, social and psychological self-care.

5) Talk it out. Whether you have a good social support network, online support group, or therapist; share what is happening for you in your thought process and emotions, to the best of your ability.

If a panic occurrence has already begun, here are a few things you can do:

6) Stop. Literally, just stop what you are doing and sit if you can. Give your body and mind the space it needs to work through these feelings. Do not avoid the emotions; avoidance increases anxiety!

Educate yourself. Remind yourself that the anxiety you may be feeling is just like a wave, and it will subside after working through the emotion.

7) Breathe. Try out square belly breathing: Place one hand on your belly, and one on your chest. Imagine a square, but instead of lines for sides, each side has four dots in a line. Each of these dots represents one second. Let us now start at the top left corner of the square, and imagine breathing in through the nose (feeling the belly expand while the chest stays as low in movement as possible) while counting the dots on the top portion of the square (one, two, three, four). Then, hold the breath going down the right side of the square (one, two, three, four seconds). Next, breathe out through the mouth, feeling the belly contract toward the spine, (one, two, three, four seconds along the bottom of the square). Finally, pause the breath for four seconds running up the left-hand side of the square. Repeat this as many times as you need to.

8) Mindfulness & Meditation or Grounding. Notice that we can view things not as good or bad, but just as they are. Try out a quick meditation or progressive muscle relaxation video - many can be found on our technology these days in the form of videos or apps. However, you can also engage in your own mindfulness. For the next few minutes, notice your surroundings; notice your feet grounded to the floor, notice everything in the room around you that is blue (or any color you choose), or even notice all of your senses, naming five things you are see in detail, four things you can touch, three things you can hear, two things you can smell and one thing you can taste. The more descriptive you get with yourself, the better! Try saying it out loud as well, this will force your body to begin to breathe differently.

9) Engage the body. Try to identify where in the body you are feeling the emotions you are experiencing. Is there tension in the hands? Stretch them, move them. Is there tension in the neck/shoulders? Roll them back, gently extending and stretching the neck. Get moving when you are ready; emotions can often stay stored within the body. Let us let them out with expressive movement. What dance could you do in this moment that represents how you feel?

10) Reach out to a friend, family member or therapist for support.

Often, gaining a different perspective on our “what if,” or “doom and gloom” thought patterns can be SO helpful!

Once you have experienced and successfully worked through the emotions of a panic attack, you may feel exhausted. It is okay to give yourself space to regain strength. It is also okay to say no to some of the tasks on your “to-do” list for the day, and just focus on taking care of you. Be sure to keep hydrated and tend to your basic needs, post-panic attack, but also on a daily basis. Dehydration can often lead to increase distress within the body as well.

Panic does not have to take on the role of the “attacker,” in your life. You CAN gain control over your emotions and become the person you would like to be when experiencing emotions; perhaps, EMPOWERED!

At Wilcox Wellness, we are here to listen and assist you in meeting your therapeutic goals to achieve emotional wellness.

Reach out to us today if you are experiencing emotional distress, increased stress and/or panic and would like to connect with one of our therapists: 860.266.6098 or help@wilcoxwellness.com.