I’ll always remember my first full blown panic attack. It was 2009 and I was in an undergraduate creative writing class. We were workshopping some nonfiction essays when abruptly a guy about 3 seats back from me started having a seizure. The kid sitting next to him had gotten the teachers attention and told her that there was something wrong with the guy. I turned around to see what was happening and there he was – red faced, wracked with tremors, veins bulging in his neck and forehead, gripping the front of his desk. I had never seen anyone have a seizure in my life. Something about seeing him like this felt really intrusive so I turned around and stared at the essay in front of me.
Ultimately he was ok and apparently had a history of seizures and had been sick with a fever. A friend walked him over to our medical center and that was that. I would say that the whole thing probably took about 15 minutes.
It hit me when he left the room. It started in my head. I felt lightheaded, dizzy. I was having a hard time seeing the words on the paper in front of me. I started sweating and my heart was pounding. I felt like I was going to pass out so I got up and booked it to the bathroom. By the time I got to the bathroom I could barely see or hear anything. I couldn’t breath. I sat in a stall scared shitless that I was going to pass out while simultaneously trying to find a way to call public safety to come save me because the only logical explanation for this was that clearly I was dying and what are the chances that my poor teacher had to deal with a kid having a seizure and a girl dying in the bathroom in the same day.
For some reason, I called my boyfriend first. He was obviously concerned and spent time talking to me. He was asking me a lot of questions that were requiring me to think, which started to help me calm down. Gradually I came back to myself, having really no idea what had happened. I rinsed my face off and dragged my sweat soaked self back to class.
That was the first of many panic attacks that year. Ones that followed me to the most unsuspecting and ironic places – yoga being my favorite.
And thus began my clinical interest in anxiety and panic symptoms.
What is a panic attack? The ADAA defines a panic attack as “the abrupt onset of intense fear or discomfort that reaches a peak within minutes and includes at least four of the following symptoms: Palpitations, pounding heart, or accelerated heart rate. Sweating. Trembling or shaking. Sensations of shortness of breath or smothering.”
In a nutshell a panic attack is when you have all these physical symptoms that feel like you are dying (and you are probably telling yourself that you are dying or having a heart attack in your head) but really you are not.
Panic attacks are complex and in my opinion, just having one makes you more susceptible to others. Why you may ask? Well now you are going to be hyperaware of body symptoms and getting panicky about having a panic attack which of course, brings on a panic attack.
The physiology of panic attacks is complicated but essentially it involves your amygdala, which is in charge of fear, and your parasympathetic nervous system, or rather your lack thereof. During a panic attack your amygdala is telling you that you are in danger and that you need to be afraid. Your parasympathetic nervous system is in charge of calming your responses however during a panic attack, for whatever reason, your parasympathetic nervous system is like “sorry bro, you’re on your own”. For those of you looking for some more fun science type info on this, I will post some article links at the end!
So what do you do if you think you are having a panic attack?
Personally, I find that for my clients, and myself in the past, a combination of addressing both the cognitions ( or thoughts) and the body responses simultaneously works pretty well.
For addressing body symptoms I love cold on pulse points and/or the back of your neck. Its grounding and helps to cool and calm. Once you’ve gotten yourself all iced down, this is where you do your self talk. Tell yourself that you are safe, over and over again. Create flexibility in thinking, come up with other reasons why you may be feeling this way other than that you are dying.
I recently had a client tell me about a recommendation for her son when he has panic attacks – sorting playing cards. I love this. Its a great way to distract and reengage that “thinking” part of your brain instead of the primal part that is pumping all that adrenalin into you and making you panic.
If you are having a hard time bringing yourself back on your own, call somebody. This can help to ground you and get you calmed down.
For Panic attack specifically, I really do feel that a combination of medication and therapy is a great approach. Medication for panic attacks helps to quiet that amygdala and get your parasympathetic nervous system doing what its supposed to.
For a lot of my clients who suffer from panic attacks, and take medication for it, I encourage them to keep their medication within reach as often as possible. Just to have it on hand, never mind taking the thing, can help to reduce anxiety in the moment as well.
Panic attacks are miserable but the good news is that they are definitely treatable.
If you are suffering from panic attacks I encourage you to seek therapy! You do not have to live like this.