PANIC ATTACK: WHEN FEAR OVERWHELMS

A panic attack occurs when an individual suddenly falls into sudden feelings of anxiety and completely uncontrollable fear, lasting for several minutes.

What Is A Panic Attack?

A panic attack is a psychological state that occurs suddenly, causing intense stress in a short time. The individual suddenly falls into sudden feelings of anxiety and completely uncontrollable fear, lasting for several minutes. Panic attacks often include physical symptoms that can feel like a heart attack, such as trembling, tingling, or rapid heart rate, and they can happen at any time.

Although panic attacks themselves are not dangerous or harmful to your health, frequent panic attacks can reduce your quality of life and cause other problems.

Statistics from Spain and the United States show that the estimated proportion of people experiencing a panic attack within 12 months ranges from 9.5% to 11.2% among adults. Of these, about 8.5% of American Indians reported having experienced a panic attack in their lifetime. Women are more frequently affected by panic attacks than men, although this gender difference is more pronounced for panic disorder. Panic attacks can occur in children but are relatively rare until the age of puberty when the prevalence rates increase. The incidence decreases in older people, possibly reflecting diminishing severity to subclinical levels.

WARNING: It is necessary to distinguish between "panic attack" and "panic disorder". Panic attacks are a psychological state, not a clinical disorder; meanwhile, panic disorder is a mental health problem that requires intervention and treatment.

Symptoms And Diagnosis

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5 TR), Panic attacks are characterized by an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes. During that time, the individual faces four (or more) of the following symptoms:

1. Palpitations, pounding heart, or accelerated heart rate. 

2. Sweating. 

3. Trembling or shaking. 

4. Sensations of shortness of breath or smothering. 

5. Feelings of choking. 

6. Chest pain or discomfort. 

7. Nausea or abdominal distress. 

8. Feeling dizzy, unsteady, light-headed, or faint. 

9. Chills or heat sensations. 

10. Paresthesias (numbness or tingling sensations). 

11. Derealization (feelings of unreality) or depersonalization (being detached from oneself). 

12. Fear of losing control or “going crazy.” 

13. Fear of dying.

A panic attack can arise from either a calm or anxious state, and the time to peak intensity must be assessed independently of any preceding anxiety. In other words, the start of the panic attack is when there is an abrupt increase in discomfort rather than the point at which anxiety first developed. Likewise, a panic attack can return to an anxious state or a calm state and possibly peak again. The difference between a panic attack and feelings of anxiety is that the panic attack occurs at its peak intensity, which occurs within minutes; is sporadic, and is often more serious.

One thing to note is that panic attacks are not a mental disorder. Panic attacks may occur in the context of any other psychiatric disorder (such as anxiety disorder, depressive disorder, post-traumatic stress disorder, or substance use disorder), and certain medical conditions (such as cardiac, respiratory, vestibular, and digestive problems).

WARNING: The symptoms listed are for reference only. If you suspect that you have a panic attack, see a psychologist for an accurate diagnosis.

What Leads To Panic Attacks?

The exact reason why some people experience panic attacks is unknown. However, the role of the brain and nervous system in the perception and processing of fear and anxiety is very important. Researchers suggest that dysfunction of the part of the brain responsible for processing fear and other emotions and chemical imbalances in the brain may be responsible for panic attacks.

In addition, the risk of panic attacks increases if a person has:

  • A family history: If one of the first-degree relatives (siblings, children, parents) has an anxiety disorder or panic disorder, the individual will have a 40% increased risk of developing panic disorder.

  • Mental health conditions: People with anxiety disorders, depression, or other mental disorders are more likely to experience panic attacks.

  • Adverse childhood experiences (ACE): Negative experiences, and traumatic events, that occur between the ages of 1 and 17 may contribute to the development of panic attacks and panic disorder in general.

Triggers may vary depending on the causes behind the panic attack: for example, if the panic stems from ACE, then anything, no matter how seemingly benign it may be, that can remind the person of their childhood trauma may potentially trigger the panic. However, people with phobias may experience phobia-related triggers that lead to panic attacks. For example, someone with a fear of needles (trypanophobia) may experience a panic attack if they have to get their blood drawn for a medical test. For some people, the very fear of panic attacks can actually trigger another panic attack.

Treatment And Prevention

Psychotherapy

Psychotherapy plays an important role in treating panic attacks and providing a sense of stability to the individual. There are many specific psychotherapy methods used to help individuals understand and control their symptoms. Commonly used types of psychotherapy include:

  • Cognitive Behavioral Therapy (CBT): The individual discusses his or her thoughts and feelings with a psychologist. A psychologist will help identify panic attack triggers so that the individual can change his or her thoughts, behaviors, and reactions. As the individual begins to respond differently to triggers, panic attacks may decrease and eventually stop.

  • Exposure Therapy: The individual is gradually and repeatedly exposed to panic attack triggers - either imagined or in reality. Over time, the individual learns to become comfortable with the situation instead of anxiety and panic. They will be taught relaxation techniques, such as breathing exercises, to control their anxiety and manage physical symptoms.

Medications

Using medication is one of the important methods in treating panic attacks, especially in severe cases or when other treatments do not have the desired effect. There are some commonly used medications to reduce symptoms and prevent the occurrence of panic attacks including:

  • Antidepressants: Some antidepressant medications can make panic attacks less frequent or less severe.

  • Anti-anxiety medications: Anti-anxiety medications can help treat and prevent panic attacks. They help reduce anxiety but are potentially addictive, so it’s important to take them with caution.

Warning: Medication use should not be carried out independently but should be prescribed and supervised by a psychiatrist. Medication use must be accompanied by healthy lifestyle changes and psychotherapeutic measures (if necessary) to ensure maximum effectiveness and safety.

4 Steps To Help Someone Experiencing A Panic Attack

Step 1. Identify And Name It

Recognizing and naming a panic attack can help your loved one gain more information and know what is happening, thereby helping to reduce feelings of anxiety and fear of the unknown. Let them know that the panic attack will pass. According to the Anxiety and Depression Association of America (ADAA), panic attacks can last from 5 to 30 minutes, with symptoms usually fading after about 10 minutes.

If this is the first time your loved one has experienced a panic attack, you should seek medical attention to rule out other possible causes of similar symptoms. Everyone experiences anxiety differently, it's important to remember that what works for one person may not work for another. So don't be afraid to try different strategies.

Step 2. Keep Calm

One of the best methods for helping someone who is experiencing a panic attack is to stay calm, even if you feel a little uneasy about what is happening. Maintain calm by taking deep breaths and reminding yourself that this is only temporary. If the situation becomes overwhelming for you, reach out to someone else for help.

Step 3. Give Them Space

Your loved one may need to be alone while they are experiencing a panic attack. When the state of panic is too high, their brain goes into a state of "high alert", so common environmental factors such as touch, music, bright lights, or other types of sounds may become too stimulating for them. After reminding them that they can handle their symptoms, you can give them some space until their panic attack passes.

Step 4. Encouragement

When a loved one is experiencing a panic attack, you want to show empathy, but you don't want to convey that the panic is dangerous, harmful, or needs to be reduced or eliminated.

Instead of trying to provide comfort or bother your loved one, a wiser approach is to remind them that they can deal with the situation on their own. This will give them the strength to deal with the problem. Remind them that, although panic attacks can last, they usually peak after about 10 minutes. The body cannot maintain a state of vigilance longer than that.

If you feel you are having symptoms of a panic attack, go to a medical facility for a timely examination and diagnosis, or contact the Vietnam - France Psychology Institute via Hotline: 0979.158.463 for specific advice. Early intervention is key to improving health and quality of life.

References:

[1] Panic Disorder: When Fear Overwhelms. https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms

[2] Panic Attacks & Panic Disorder. https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder

[3] 4 Steps to Help Someone Having a Panic Attack. https://psychcentral.com/anxiety/how-to-help-someone-having-a-panic-attack

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VIETNAM - FRANCE PSYCHOLOGY INSTITUTE

HEADQUARTER & PSYCHOTHERAPY CENTER: WINCO Building, 54 Tran Quoc Vuong Street, Dich Vong Hau Ward, Cau Giay District, Hanoi, Vietnam

PSYCHOTHERAPY CENTER IN HCMC: Landmark 81 & Landmark Plus, Vinhomes Central Park, 720A Dien Bien Phu Street, Ward 22, Binh Thanh District, HCMC, Vietnam

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