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Panic Attacks

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Dennis Bergkamp, famous soccer player from Holland, cannot take a flight as he faces intense episodes of frightening and overwhelming fear every time he has tried to take one. So acute is is fear that he is paranoid about the very situation that triggers such emotions. In fact he did not play in the World Cup in South Korea as it would have required him to take a flight.

Another is the case of a busy executive, recently promoted to a better position in his company who gets a tightness in his chest and intense suffocation if he does not find a washroom nearby. In fact he has been admitted to the hospital two times on grounds of an impending heart attack, yet nothing was found wrong with him. His inter-personal exercises are taking a beating due his panic sticken reactions to the absence of a bathroom nearby.

Both the above cases are examples of those experiencing Panic Attacks. There are millions of people in the world who find themselves in a similar situation wherein a certain kind of event is accompanied by so much of stress that it leaves the individual with tightness in the chest, suffocation, and a desperation to move away from the situation. In certain cases the person may also experience a ‘black out’ or undergo spells of dizziness.

Such attacks are not too infrequent as a startling fact would have us believe. In fact 5 per cent of the world's young adults are prone to such episodes of intense fear. This makes it a more young adult kind of phenomenon and is more likely to affect more women than men. So what is it that brings on such attacks in young people? Is it inexperience in handling life’s changes and transitions, or is it a genetic disposition.

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[edit] Triggers

The exact triggers are still unclear and it is believed to be an amalgamation of the body and the mind. This means that genetic dispositions along with stressors could well give rise to episodes of panic attacks. Biological malfunctions are yet to be identified and it has been seen that certain groups are more susceptible than others. For example women as a collective whole or young adults as a group, usually on the threshold of responsible life are more prone to this kind of anxiety attacks. The reason that makes these groups more vulnerable is as yet not identified.

Most theorists would like to theorise that it is stressful events that trigger episodes of intense anxiety, fear, desperation and a feeling that death could be far more peaceful than the situation at hand. Stress unleashes a chain of events wherein the General Adaptation Syndrome, so coined by Hans Selye (1956, 1976), is triggered. This syndrome usually consists of 3 stages: the alarm reaction, the stage of resistance and the stage of exhaustion.

The alarm reaction as the name suggests sets off the emergency response of the body. The sympathetic nervous system is set off which in turn releases a chain of set responses such as sweating, increased blood pressure, increased heart beat and pulse rate, and increase in the blood sugar and hormone activity level. The hormones epinephrine and norepinephrine are secreted which help coping mechanisms to fall in place so that energy can be made available both to the brain and various parts of the body to deal with the stressful situation.

If the stressor continues to be present, then the body develops a tendency to become resistant. In the final stages, the body is unable to cope with the old and the new stress factors that may be present, and the person’s health may be seriously compromised. This is also a time when a host of diseases may appear on the scene or the person may even become a prey to psychosomatic disorders.

In panic attacks, it is the first stage that is more pronounced. In fact, it may be so dominant in its stranglehold and appearance that the very thought of such reactions may continue to prey on the individual's mind. He therefore makes a connection between the stressor and the alarm reaction so set off by his own body mechanism. Consecutive episodes of this order cement this connection in his mind. So an initial attack that may have happened out of the blue, given time and the recurrence of these episodes, makes the person not only extremely fearful of the stress-inducing incident but also of the symptoms associated with it too. Often the latter is enough to trigger another episode of panic attacks. This explanation is favoured by those with a behavioural point of view where such panic attacks are a result of associating unfortunate events with panic reactions.

There is yet another interpretation and a possible explanation of such attacks and this stems from a psycho dynamic point of view. Here the entire panic attack is seen as stemming from unconscious impulses and desires.

Finally the entire recurrence of panic attacks is acquired through a process of learning-instrumental conditioning and classical conditioning. It may even be due to observational learning, especially in the case of phobias. Whatever the origin, it is soon forgotten and all that remains is an irrational fear and an exaggerated response to a seemingly harmless event or thing.

[edit] Symptoms of a Panic Attack

A panic attack is set apart from other attacks of a similar kind by sheer dint of its appearance that comes on without any prior warning. What is even more peculiar to this attack is that it can be triggered by the most innocuous seeming incident or event. For example, if drinking coffee has brought on these attacks earlier on, chances are that coffee will be a stressor for the individual and the very sight of coffee may bring on the panic attack. And it is needless to say how harmless coffee really is and yet the feelings are probably far more intense than those experienced by others in actual stressful situations.

The most common symptoms that accompany a panic attack are: a racing heartbeat and higher pulse rate, breathlessness, suffocation, trembling accompanied by sweating, fear of death, paralyzing terror, tingling in the toes and fingers, hot flushes or sudden chills, feelings of nausea, giddiness and light headedness and a feeling that one is going completely insane and wishing one could die.

Panic attacks can occur without any warning, without a direct trigger and even in one’s sleep. There is no way to stop it once it begins and this is what makes it dangerous. The level of fear is also disproportionate to the actual situation. In certain cases it may be totally unrelated. In addition the alarm reaction does not go into a stage of resistance making these attacks a short-lived one. However recurring episodes may occur.

[edit] Do not Hide – Seek Help

Panic attacks are terrifying episodes as long as they last. They are beyond a person's control too and, since they can come on anytime, it is imperative that a person who does recognize the symptoms seeks professional help. Given the fact that most therapists are unsure as to what the actual predisposing factors are, the therapeutic process is an amalgamation of psychological, sociological and physiological interventions.

Once a person recognizes that he has the symptoms he should talk to family and friends and consult a psychiatrist or psychotherapist, because only a well-qualified person can help cure or ameliorate panic attacks. Delaying treatment will only make the attacks come back with more vigor and may also be a precursor to phobias or depression. The medical complications may not be too helpful in the long run and may ruin the person’s state of mind enough for him to become suicidal at times.

[edit] Cures Available

Panic attacks can occur anytime and may afflict anyone who has the ability to grasp the enormity of any stressful situation. Hence children are out of the purview of this disorder. Therapies and so-called cures are available and as earlier stated it basically includes physiological, genetic, sociological and psychological make-up in its ambit. This therefore makes it a holistic diagnosis and treatment procedure.

As a first line of treatment most of the doctors would administer a course of antibiotics. However this is just to soothe the nerves and help the person allay his fears and get some rest. This is not given in isolation and there are sessions in which the psychiatrist would try and understand the underlying reasons for the onset of the panic episodes. A therapist with a psychodynamic point of view is more likely to probe the unconscious through a process of hypnosis or free association.

The kind of therapies that are most likely to be followed are of two kinds; one that is based on ‘cognitive therapies’ and the other based on ‘behavioural therapies’.

Behavioural therapies are by far the most appropriate and effective as they try to change observable behaviour through various behaviour-modification techniques. Instrumental conditioning techniques are used wherein the pay-offs are identified. Negative and positive reinforcers are identified and gradually those that are reinforcing the panic attack are removed. This would be done by employing methods such as systematic de-sensitization where the person is slowly taught to produce feelings of relaxation and comfort from the same set of stressors that had so long produced the panic attacks.

Cognitive therapies can also be employed to cure panic attacks. The RET or the Rational Emotive Therapy can be used to break down irrational beliefs and therefore behaviour. Such therapies usually attempt to restructure cognitions. One of the very successful techniques used is Self Instructional Training. This would include self talk, meditation and teaching a person how to relax in face of a stressful situation. Hypnotherapy and Biofeedback Therapy can also be employed to produce the desired results.

A panic attack is very overwhelming while it lasts but proper therapeutic help given at the right time can cure the person of the attacks and help him lead a normal and happy life. This is not a disease, neither is it a disorder that cannot be cured. All that is required is the sympathetic shoulder of a friend or family member, a keen eye to understand these symptoms and timely intervention to help the person gather himself and stop the recurrence of these attacks in future.


Discussion

10 tips for coping with panic attacks

One: If you feel a panic attack coming on and find you are breathing rapidly, breathe slowly in and out of a brown paper bag or cupped hands. Although you may feel you can't catch your breath, you are probably over breathing and taking in too much oxygen - making you feel giddy. A paper bag will help your oxygen levels return to normal. ...... Read more inside