Panic Attack Treatment
Panic Attack Treatment Chicago
It can happen anywhere and at any time. One minute you’re pacing your way through a regular day, and the next minute you feel your heart start to race and hurt, your palms become sweaty, you struggle to gasp for air and the world appears to be spinning. Of course these symptoms seem alarming and you start to wonder if you’re having a heart attack or asthma episode.
Most people will experience at least one panic attack in their lifetime. They are often mistaken for heart attacks because chest pain and heart palpitations are the most common panic attack symptoms.
Other panic attack symptoms can include nausea, feelings of choking, numbness, chills, hot flashes, fear of losing control, fear of dying, feeling detached from your body, dry heaving and shaking.
Panic attacks differ from anxiety in the sense that anxiety usually involves worries about the future while panic involves present-based fear and has a sudden onset.
There are 2 types of panic attacks:
Cued Panic Attacks: can be traced to a specific trigger that sets them off. Perhaps every time you fly, drive under a bridge or have your blood drawn, you experience a panic episode.
Uncued Panic Attacks: usually more distressing because they seem to “come on for no particular reason” or “out of nowhere”. When your heart suddenly starts racing when you’re sitting calmly at your desk, your mind doesn’t know what to make of that, so it starts to make up catastrophic stories about why your heart is suddenly racing.
While panic attacks can feel extremely scary, they are actually not harmful at all. One usually experiences a surge of physical symptoms that peak in intensity after about 10 minutes and gradually decrease over the next 20 minutes or so.
What happens in your body during a panic attack?
During a panic attack, your brain perceives that there is a threat or that you are in danger when in reality there is no actual threat (sometimes people have panic attacks in response to actual threats but usually panic attacks occur seemingly “out of nowhere” or in response to long periods of chronic stress).
During a panic attack, the amygdala (a brain structure) perceives that you are in danger and initiates a reaction in the body that leads to the release of adrenalin and cortisol. Unfortunately the amygdala is not always able to tell the difference between the type of danger that requires the body to spring into action (fight or flight response) such as if you’re being chased by a tiger, and the type of danger/threat that is more chronic and does not need you to be running from a tiger (such as the type of stress during a panic attack). Either way, when the amygdala senses any kind of threat, it puts your body into “fight or flight mode”. During a panic attack, this occurs on an extreme level. The symptoms that arise from that adrenalin release can include but are not limited to: racing heart, rapid breathing, difficulty breathing, feeling like you’re choking, nausea, feeling very hot or cold, shaking, sweating, numbness, dizziness, feeling faint, feeling like you’re separating from your body or feeling as if things around you are unreal, and feeling that you are dying. While these symptoms are extremely scary, they are not harmful, just very uncomfortable.
What usually happens to folks who experience these symptoms is that their immediate response is MORE PANIC… “oh no, why is my heart racing?” “am I having a heart attack?” etc. Your amygdala then thinks that there really is MORE danger and so it releases MORE adrenalin which amps up your symptoms even further and the cycle continues (and the panic attack continues). The reason adrenalin causes your heart to race is because when there is a true threat and you have to move quickly, your heart would need to pump blood to your muscles at a rapid pace so that you can move away from the danger as quickly as possible which is why your heart rate goes up. The rapid breathing would also help you move quickly as the lungs need to pump oxygen to the muscles more quickly when you are running from danger. The brain does not know that the threats of “today” do not require us to run away quickly and so the body still responds to stress in a very primitive manner.
Treatment involves proving to your brain that there is no actual danger present so that your amygdala can stop releasing adrenalin & cortisol, and then in turn, your symptoms can subside.
Watch this short video clip below for a helpful explanation of the panic cycle:
“The Struggle Switch” by Dr. Russ Harris on Youtube
And remember “what you resist, persists”
After watching the video, think about “how” you STRUGGLE against the panic attacks. What reactions or thoughts do you have that amplify your panic attacks?
A few different thought examples that may end up worsening panic attacks are:
“this panic attack is never going to end”
“I am always going to have panic attacks”
“I must be having a heart attack”
“this is unbearable”
“I can’t breathe”
“I must stop this panic attack any way I can”
“I can’t survive this”
“this means I’m weak”
Actions that make panic attacks worse:
Anything that involves you trying too hard to make the panic attack go away. When you do that, you are signaling to your brain that there is danger, and your brain then keeps making the panic hormones (adrenalin and cortisol) as it believes you are in danger and that you need to run (fight or flight). In turn, the physical panic symptoms caused by adrenalin continue.
The skills listed below are a small sample of available skills to help you until you connect with a therapist.
First, remember that panic attacks don’t last very long, even though it can feel like they do! They usually reach a peak of intensity after 10-20 minutes and then slowly subside. If you do absolutely nothing, the panic attack will rise like a wave, peak, and go away on its own. The body simply cannot sustain a panic arousal response for very long. The most effective approach is to have a relaxed attitude toward the panic symptoms and wait for it to pass. However, below are some helpful strategies to use while you’re waiting for the symptoms to subside.
Note: All of the skills below engage your prefrontal cortex to signal the panic center of your brain (amygdala/hypothalamus/pituitary) to turn off. Remember, the goal is to remind your brain that “there is no danger” and it does not need to prep your body for fight/flight.
- Acknowledge the arrival of anxiety/panic – you can even greet it with “hello panic attack, my old friend, you can just hang out, I’m not going to fight you.”
- Cover your face with a very cold ice pack or dip/splash your face or head into ice cold water. This should work quite quickly to slow or stop the panic symptoms as cold lowers the heart rate.
- Name 5 things around you that you can see, 4 things you can touch (and touch them), 3 things that you can hear, 2 things you can smell and 1 thing you can taste. This is called grounding.
- Remember, all panic attacks take the form of a wave. They rise to a peak and eventually fall on their own. Part of coping is learning to surf that wave of panic knowing it will ultimately subside provided you don’t attempt to “resist” it. When you first notice the panic attack, imagine that you are on a surfboard on a beautiful blue wave and picture where you are on that wave based on the intensity of your symptoms. Keep visualizing riding up that blue wave on your surfboard, and when the symptoms are most intense tell yourself that you’re at the top of the wave, looking out across the ocean onto the beach and at the other surfers, and then recognize that at any moment, you are going to surf down the wave and your symptoms are going to subside.
- DEEP BREATHING! Slowly breathe in through your nose- HOLD for 4 seconds, and then breathe out through your mouth- HOLD for 7 seconds. While breathing, ensure that your belly and chest are visibly rising and falling. This is important to decrease hyperventilation and the likelihood that you worsen panic symptoms.
- Locate all the points in your body where you feel panic. Check to see if you are resisting these feelings in any way and make a conscious effort to let go of that resistance. Instead, accept and allow those feeling to be present. Remember that the feelings/symptoms are not actually harmful- they are just natural bodily sensations (a cluster of energy and a surge of adrenaline and cortisol) so you really can tolerate it! Take a deep breath and visualize the air flowing through all of those various panic points in your body.
- Ask yourself and answer the following questions: If this feeling had a shape, what shape would it be? If it had a color, what color would I assign it? Is the feeling heavy or light? Is it tight or loose? Is it moving or still? Does the feeling have more than one layer? Does it have any pulsating points?
- Talk directly to your panic in a way that welcomes it and allows it to be with you and move around freely.
- Finally, turn your attention to another task while your panic/anxiety hangs out in the background – just observing it, not doing anything to “try and get rid of it”. Like a wave, it will eventually peak and pass on all on its own.
Here are some signs that you may be suffering from Panic Attacks:
- You find it difficult to catch your breath
- It feels like you might be choking
- You have chest pain or a racing heart that might feel like a heart attack
- You feel dizzy, like you might faint or even die
- You have an out of body experience
- The world around you might seem unreal
- You may also feel nauseas and break out in a sweat
Sometimes panic attacks can be triggered by a specific event, but oftentimes they appear to come out of nowhere. You may begin to worry about the next time a panic attack will strike and this can cause avoidance of certain places and activities that you worry you can’t escape from. This avoidance may increase over time and therefore rob you of the places and activities that used to bring you joy.
Using evidence-based coping skills, our anxiety therapists can help you reduce symptoms of anxiety, including panic attacks. Please see below for examples of basic coping skills you can try at home. More advanced coping skills can be learned and mastered in therapy.
The good news is that here at Cityscape Counseling, our therapists are panic attack specialists in Chicago, who love teaching those struggling with panic attacks useful skills to both cope with and lower the intensity of panic attacks. Some people even learn to notice when a panic attack is starting and can stop it before it becomes full blown. Panic attacks and panic attack disorders are highly treatable with techniques drawn from ACT, DBT, ERP & CBT.