This may seem obvious but it isn’t. Panic feels so dreadful and sometimes comes ‘out of the blue’. It is this unexpectedness that makes it seem dangerous and as if it is something far more serious. A panic attack can seem so unusual that you might not know that you are experiencing a panic attack.
Gaining an awareness of the symptoms of panic can help in learning to overcome panic attacks. The following are some common symptoms, some people will experience all of these symptoms and some only a few:
Has anything happened in your life recently that has led to your alarm system being triggered; for example, loss of employment, relationship problems, loss of a loved one or financial difficulties? Please see my page on Stress for more information.
Panic attacks can accompany concerns about a person’s health. Sometimes someone close to you has died suddenly. This can cause people to become worried about their own health. This might lead a person to develop a heightened awareness of changes in their bodies and to an over vigilance about health. This then leads to a raised level of anxiety and anxiety symptoms which may be misinterpreted as signs of a serious illness, which may then lead to panic.
Sometimes we don’t know why panic attacks begin and some people might experience one in the night. This could be because you have dreamt about something that your body has interpreted as frightening and this has triggered your alarm system.
The physical symptoms of panic described above arise because of an extreme form of fear. Please see my page on Anxiety for an explanation of the fight-or-flight response. As it mentions, fear is very useful as it prepares your body for action. It just feels very unpleasant. The problem with panic attacks is that they can occur ‘out of the blue’ with no obvious cause and that makes them seem very dangerous and disturbing. The other problem is that the symptoms of panic can seem like signs of something being seriously wrong with us. It is not always easy to accept that it is our body’s alarm system that was designed a long time ago when we had real dangers to contend with. Panic and anxiety are designed to protect us, even if it doesn’t feel like it.
Physical symptoms of panic create anxious thoughts that form a vicious cycle that keeps panic attacks coming back again and again. When experiencing a panic attack it is common to focus on the body and to notice small changes and interpret these as threatening. For example, thinking that chest pains and heart palpitations are signs of a heart attack.
Another part of the vicious cycle is that you may start to fear having a panic attack and may start to worry about going into certain situations because of a fear that it might happen. This, unfortunately, makes it more likely to happen.
You might have started to avoid situations where you have experienced a panic attack because you fear another one will result in being in the same situation again. You might try and escape the situation as soon as you can when panicking. For example, rushing around the supermarket to get out as soon possible. People also adopt strategies to keep themselves safe, for example, straining to take in air if you think you are suffocating or sitting down if you think you might faint. These all seem rational responses to the feared situations although they keep the problem going. You never find out that if you didn’t adopt these strategies then it would have been alright anyway. Often, people need to adopt more and more safety behaviours to control their levels of panic.
My experience is that people with symptoms of panic and panic attacks respond very well and quite quickly to treatment with CBT.
As your therapist I would work with you so that we could get a shared understanding of your own vicious cycle of panic. Just understanding why this is happening can be a huge relief. I would take you through some exercises that are designed to help reduce the feelings caused by panic. In therapy I would help you to learn some techniques to control your breathing and to actively relax.
During my sessions we would talk about thinking, feeling, physical changes and behaviour. We would look at anxious thinking and at how you might be focusing on your body. We would explore how shifting your focus of attention and experimenting with this might distract you from focusing on your body. We would also look at establishing the evidence that the physical symptoms you are experiencing are a sign of panic or a sign of a more serious physical health concern.
It is likely that we would work together to change your behaviour and for you to be exposed to the situations that you fear, in a graded way. This would always be done by starting with the situations that cause the lower levels of anxiety. This would always be with your full agreement and with my full support.