Worry, stress, and fear are all feelings that most people have experienced; life is full of times that cause us to feel a sense of unease, frustration, or difficulty thinking things through without feeling some sort of anxiety. While this is a natural part of life, some people experience such significant amounts of worry or fear that they develop mental health conditions that can induce “panic attacks”. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a panic attack involves four or more of the following symptoms:
- Palpitations, pounding heart, or tachycardia (accelerated heart rate)
- Shaking or trembling muscles
- Shortness of breath, feeling smothered
- Feeling the sensation of choking
- Chest pain or discomfort
- Nausea or abdominal pain
- Dizziness, feeling unsteady, lightheaded, or faint
- Feeling as if things are not real, or feeling detached from oneself
- Fear of losing control or going crazy
- Fear of dying
- Numbness or tingling sensations (paresthesias)
- Chills or hot flushes
These symptoms can either be expected (due to a specific trigger), or unsuspected (no known trigger), and the symptoms can appear intense enough that people will go to a hospital or call emergency medical support because they are afraid they are dying or having a heart attack. They are terrifying for those experiencing them and those around them, as it may seem like there is little that anyone can to do help other than wait for the panic attack to pass.
Mental health professionals are often consulted by those who experience panic attacks because many fear the possibility of having one in the future and want to learn ways to stop them. Therapists help people identify what the triggers may be for these panic attacks and can help them develop an awareness of how to recognize the signs and to stop them. Some techniques used to decrease the likelihood of panic attacks involve stress-reducing strategies such as mindfulness/meditation techniques, deep breathing, and other “grounding” techniques that help a person focus on the present. Panic attacks often arise as a result of a person ruminating, or incessantly thinking, about something that is out of their control.
The first step in stopping a panic attack is maintaining a present-focus and not wondering or worrying too much about things that have already happened or may happen in the future. Lots of different cognitive strategies are taught to people suffering from panic attacks to help them do this; some examples include looking around the room and identifying colors or shapes, counting backwards or forwards to a certain number, progressive muscle relaxation (tensing and relaxing muscles), and many more. Those who experience regular panic attacks are encouraged to use relaxation techniques, meditation, and things like yoga to help them stay present to decrease the possibility of a panic attack occurring and also consult a mental health professional who can teach these skills in more thorough detail.
Even with these strategies and knowledge, many people still experience panic attacks, and can ultimately develop panic disorder, which is defined by the DSM-5 as someone who experiences at least 1 panic attack, then one or more months of fear and worry that another attack will happen. When someone meets this criteria, it is possible that in addition to cognitive behavioral therapy to help develop coping skills to manage these panic attacks, as mentioned above, they may need to consult a psychiatrist who specializes in anxiety and panic to prescribe them medication to further assist them in managing these symptoms in collaboration with therapeutic techniques.
Dr. Shannon McHugh is a Licensed Clinical and Forensic Psychologist in Los Angeles, California. She specializes in assessment and treatment of children, adolescents, and adults who have developmental and social delays, behavioral difficulties, and those who have experienced traumatic events