What Panic Attacks Are… and Aren’t

If you have ever had a panic attack, you know how scary they can be. When you are in the middle of one, you can think you are having a heart attack, stroke or other life-threatening crisis.

Panic attacks are surprisingly common. Up to 40 per cent of us will experience one at some point in our lives, says Beyond Blue. The anxiety related to the pandemic and its impacts may result in many people experiencing panic attacks for the first time.

Despite how terrifying they can be, panic attacks are not inherently dangerous, although the fear of having another can limit your daily life.

“At its core, a panic attack is an overreaction to the body’s normal physiological response to the perception of danger,” says Dr Cindy Aaronson, clinical psychiatrist at Mount Sinai Health System in New York.

What triggers a panic attack?

A panic attack typically happens when you are under physical or emotional stress. The effects of stress can accumulate so slowly that you may be unaware of the extent of your stress until a panic attack happens.

A panic attack starts with the amygdala, the brain region involved in processing fear, explains Dr Aaronson. When the amygdala perceives danger, it stimulates the sympathetic nervous system, she says, which triggers the release of the hormone adrenaline.

Adrenaline prompts an increase in the heart and breathing rate to get blood and oxygen to the muscles of the arms and legs. But during a panic attack, this response is exaggerated beyond what would be useful in a dangerous situation.

The intense rush of fear or anxiety you feel during a panic attack is usually accompanied by at least four of the following symptoms, says reachout.com.

  • racing heart or palpitations
  • sweating
  • shortness of breath or feelings of choking
  • dizziness, trembling or shaking
  • numbness or a tingling sensation
  • hot and cold flashes
  • fear of dying or of losing control
  • queasy stomach or nausea
  • feeling detached from yourself and your surroundings.

How to react to a panic attack

Panic attacks come on rapidly, but usually subside within 10 to 15 minutes. Dr Aaronson believes the most important technique to help you ride them out is recognising that you’re having a panic attack and not a more serious medical crisis.

“Just knowing what it is helps people,” she says. To be sure, double check that you’re not experiencing any heart-attack specific symptoms such as pressure in the chest or pain that builds or radiates into the arms or jaw.

If you see someone having a panic attack (or are experiencing one yourself), try not to ‘feed the fear’ by responding with anxiety or fear, advises Justin Kenardy, Professor of Clinical Psychology at the University of Queensland. He suggests the following:

  • Calmly remind the person that even though the experience is unpleasant, it’s not dangerous and will pass.
  • Help to re-focus their mind away from the thoughts that are causing stress.
  • Help them to slow and pace their breathing. For example, calmly ask them to breathe in for four seconds, hold their breath for two seconds, and then breathe out slowly over six seconds. Repeat for a minute or so, or as needed.