IMAGE: Genevieve Pizzale
Pounding heart, shortness of breath, impending doom—how to recognize a panic attack.
A racing heart, nausea, excessive sweat—though the symptoms of a panic attack seem straightforward enough, when it’s happening to you it can be hard to recognize what’s going on. It wasn’t until I was in my mid-twenties that I realized the “episode” I was having had a name, and that I’d had a few of them before. Because at the time you can hardly think past how your body is reacting (to nothing you can discern) and it’s causing a single-track thought process that ultimately leads to doom and death. Fun.
So when I started writing about panic attacks I wondered how many of my friends and colleagues had also experienced one. Turns out, a lot of them have. And they all described their experiences (which were often similar) in many different ways. “Fear and suffocation,” “like I had too much Red Bull,” “like I can’t breathe,” “like the end of the world.”
Which is when I realized that despite my familiarity with the symptoms, I had no idea what a panic attack was or what was happening when my heart started beating so fast I thought my chest couldn't contain it. I reached out to Dr. Heather Fulton, a registered psychologist with the Burnaby Centre for Mental Health and Addiction to learn more.
Panic attacks are incredibly prevalent
“This year a third of Canadians will have a panic attack,” says Dr. Fulton, “and the majority of people have had a panic attack at some point in their lives.” Some of the mental health nuances occur when you consider that panic attacks can be related to other anxiety disorders like panic disorder and generalized anxiety disorder. While you can have a panic attack without an anxiety diagnosis, if you’re finding that the attacks are interfering with your life—for example, you don’t want to go out or do certain things for fear of having an attack—it may be time to seek out help.
Panic attacks often present differently in different people
“Someone might feel like something terrible is going to happen, their heart is pounding, they’re worried they might be having a heart attack, they might worry that they’re losing their mind or they might feel light-headed, dizzy, nauseous, shaky, sweaty,” says Dr. Fulton. “You don’t need all of these symptoms in order to be having a panic attack.” But often, you will experience some of these reactions.
Panic attacks are a response to fear or threat
Though it may be hard to believe, panic attacks are actually an incredible bodily response that can be helpful—but not in the way you want them to be. “Panic attacks are a sign that danger is happening,” says Dr. Fulton. They are meant to keep you safe in the face of danger by triggering the fight, flight or freeze response. “When you’re hyperventilating, that’s increasing the oxygen to your blood supply which can go to major muscle groups,” says Dr. Fulton. “Feeling nauseous—that’s blood flowing away from your stomach, again to major muscle groups.” A panic attack is meant to prepare your body for fighting or fleeing. “These are really helpful things—but only really if you’re faced with an external threat.” It’s not so helpful if you don’t know what the threat is, or if there is no tangible threat at all.
Sometimes panic attacks are an indication of panic disorder
If you have frequent panic attacks that seem to come out of nowhere, and if they lead to increased anxiety about having more panic attacks, that may mean you should speak to a professional about a more concrete mental health diagnosis. Panic attacks can be linked to anxiety disorders, most commonly panic disorder, but also other mental health diagnoses like Post-Traumatic Stress Disorder (PTSD) or Generalized Anxiety Disorder (GAD). The bottom line is, if the threat or possibility of a panic attack is causing you to alter your behaviour, it’s worth speaking to a therapist. Panic disorder is largely treated with Cognitive Behavioural Therapy.
Sometimes panic attacks are a misinterpretation of bodily sensation
Though it can be easy to read into a panic attack to see if it’s an indication of something more—and if it’s happening frequently enough or if it’s disrupting your day-to-day it can be—sometimes it’s as simple as mistaking what’s happening with your body. For example, you may be out of breath for a completely non-panic-related reason, but hyperventilating can trigger a heightened bodily response which becomes a threat signal—meaning that your body starts to go into that fight, flight, freeze mode which presents as a panic attack.
A panic attack is not (in and of itself) dangerous
Though it may seem hard to believe, a panic attack is not dangerous and it will go away. “They are incredibly unpleasant,” says Dr. Fulton, “but having a panic attack is not actually dangerous.” It’s also an episode that is usually fairly brief—only about ten minutes long at its peak on average. Which means that treatment is often about recognizing the warning signs of a panic attack and finding ways to get through one quicker.
How to get out of a panic attack faster
When you’re in the midst of a panic attack it’s difficult to keep both your mind and your body from escalating. But there are a few things you can think and do that can help get you through your panic attack and back to a state of calm.
Take slow, regular breaths
When we hyperventilate it often exacerbates other panic attack responses including increased lightheadedness and dizziness which in turn contributes to more anxiety. Try to take calm, deep and regular breaths through your nose.
Remember that despite intense feelings, a panic attack will not cause you to faint, lose control or die. A panic attack is a hassle, but it is not something that will cause danger to you. Instead of catastrophizing focus on these facts to help you through.
Challenge your fear
If you’re unable to get your fears out of your head, try to challenge them. If you’re afraid of fainting, try to think about whether that has ever happened before (very unlikely, considering your blood pressure rises during a panic attack and a drop in blood pressure is what causes someone to faint), and whether this moment will matter in a year from now. Think about how you would solve any of your panic-attack related fears. For example, if you’re afraid of embarrassing yourself, you can be reminded that excusing yourself from a social situation to go to the washroom or a quiet place is something you can do without alerting anyone.