This monster is called ‘Panic Attack’ and is a nasty one to deal with.
First, let’s see what the specialists can tell us about it:
Panic attacks are periods of intense fear or apprehension that are of sudden onset and of variable duration from minutes to hours. Panic attacks usually begin abruptly, may reach a peak within 10 to 20 minutes, but may continue for hours in some cases. The effects of a panic attack vary. Some, notably first-time sufferers, may call for emergency services. Many who experience a panic attack, mostly for the first time, fear they are having a heart attack or a nervous breakdown. Common psychological themes associated with panic attacks include the fears of impending death or loss of sanity.
Like I said: Nasty!
This Monster is often triggered by something. This could be a activity, sounds, surroundings or even a smell.
Signs and symptoms
The DSM-IV describes a panic attack as the experience of intense fear or discomfort where four or more of the following things are felt:
•pounding heart or increased heart rate
•trembling or shaking
•feeling as though you are being smothered or having difficulties breathing
•chest pain or discomfort
•nausea or adbominal pains and/or discomfort
•feeling dizzy, lightheaded, or faint
•feeling as though things around you are unreal or feeling detached from yourself
•feeling as though you are going to lose control or go crazy
•fear of dying
•numbness or tingling feelings
There has never been a recorded instance of a person dying of a panic attack. They can only be fatal if accompanied by pre-existing medical conditions, such as asthma, or if extreme behaviors subsequently result (like jumping out of a window).
PTSD and panic disorder commonly co-occur. This may not be surprising given that people who have experienced a traumatic event or have PTSD are at a heightened risk to develop a number of other psychiatic disorders, such as depression, substance use disorders, or other anxiety disorders.
Significant personal loss, including an emotional attachment to a romantic partner, life transitions, significant life change.
Avoidance of panic-provoking situations or environments, anxious/negative self-talk (“what-if” thinking), mistaken beliefs (“these symptoms are harmful and/or dangerous”), withheld feelings.
Chronic and/or serious illness
What to do if you are being attacked by this monster:
Panic disorder can be effectively treated with a variety of interventions including psychological therapies and medication with the evidence that cognitive behavioral therapy has the longest duration of effect.
So get yourself some help, there is no need to battle this monster all by yourself!
Tell people in your immediate surroundings that you suffer from panic attacks. Tell them what they can do to help you if you ever get attacked by this monster.
Having panic attacks is NOT something to be ashamed off and it may be easier to deal with or to keep under control when you know that you are not alone in this.
When being attacked by this monster because of a trigger from your PTSD:
- Try to calm yourself down by walking away from the trigger
- Use breathing exercises
- Repeat to yourself that this isn’t now, it’s in the past. You are safe now. Get back to the present.
- Reach out for support.
In the great majority of cases hyperventilation is involved, exacerbating the effects of the panic attack. Deliberate deep breathing exercises help to rebalance the oxygen and CO2 levels in the blood.
One such breathing exercise is a 5-2-5 count. Using the stomach and not the chest. You inhale (feel your stomach come out, as opposed to your chest expanding) for 5 seconds. As you reach the maximal point at inhalation, hold your breath for 2 seconds. Then slowly exhale, over 5 seconds. Repeat this cycle twice, and then breathe ‘normally’ for 5 cycles (1 cycle = 1 inhale + 1 exhale). The point is to focus on the breathing, and relax the heart rate.
Meditation may also be helpful in the treatment of panic disorders, or using a mantra you teach yourself.
What to do if someone you know is being attacked by this monster:
- Understand what they’re going through. People with panic disorder have sudden and repeated attacks of fear that last for several minutes. A panic attack can occur without warning and for no obvious reason. The mind is preparing for a false fight or flight mode, forcing the body to take over to help the victim face or run from the perceived danger, real or not.
- Watch for the symptoms. If you can pinpoint that they’re going through a panic attack, this alleviates half the problem.
- If this is the first time the individual has experienced this, seek emergency medical attention. This is mostly important if the individual has diabetes, asthma or other medical problems. The signs and symptoms of a panic attack can be similar to those of a heart attack. Do keep this in mind when assessing the situation.
- Find out the cause of the attack. Talk to the individual and determine if he or she is having a panic attack and not another kind of medical emergency (such as a heart or asthma attack) which would require immediate medical attention.
- If there is a trigger that causes the panic attack, remove the cause or take the individual to a quiet area. The person will probably have an overwhelming desire to leave where they are. Sometimes a person with panic disorder will already have techniques or medication which they know will help them get through the attack, so ask them if there is anything you can do.
- Speak to them in a reassuring but firm manner. Be prepared for the possibility of the individual trying to escape. Remain calm yourself. Ask the individual to remain still, but never grab, hold, or even gently restrain them. Suggest an activity that can help them focus. This can be something as simple as lifting their arms up and down.
- Do not dismiss or write off their fears. Saying things like “there’s nothing to worry about,” or “it’s all in your mind,” will exacerbate the problem. The fear is very real to them at that moment, and the best you can do is help them cope. Just say “it’s OK” and move onto breathing. Emotional threats are real as life and death threats to the body. Just listen and let them talk.
- Encourage them to try to control breathing. Try counting breaths. One way of helping them to do this is to ask the individual to breathe in and out on your count. Begin by counting aloud, encouraging the individual to breath in for 2 and then out for 2, gradually increase the count to 4 and then 6 if possible until their breathing has slowed down and is regulated. Get them to breathe in through the nose and out through the mouth, making the exhale in a blowing fashion like blowing up a balloon. Do this with them.
- Keep them cool. Many panic attacks can be accompanied by sensations of warmth, especially around the neck and face. A cold object, ideally a wet washcloth, can often help minimize this symptom and aide in reducing the severity of the attack.
- Don’t leave them alone. Stay with them until they have recovered from the attack. Never leave someone who is struggling to breathe. A person with a panic attack may seem like they’re being unfriendly or rude, but understand what they are going through and wait until they’re back to normal.
Even if you don’t feel all that helpful, know that you’re a sense of distraction for them. If they were left alone, all they would have is themselves and their thoughts. You just being there is helpful to keep them grounded in the real world.
Wait it out. Though it may seem like forever (even to you — especially to them), the episode will pass.
Tackling Severe Panic Attacks
Seek medical help. If the symptoms do not subside within a few hours, consider seeking urgent medical advice. Though it’s not a life or death situation, make the call, even if only for advice. The ER doctor most likely will give the patient Valium or Xanax and possibly a Beta-Blocker like Atenolol to calm the heart and the adrenaline in the body.
If this is the first time he or she has had a panic attack, they may want to seek medical attention because they are frightened of what is happening to them. If they’ve had panic attacks in the past, however, they may know that getting emergency care will worsen their state.
Ask them. This decision will ultimately depend on the individual’s experience and your interactions with him or her.
And the most imporant thing of all: Don’t Judge, Just Care!
Lots of love