Panic Attacks


If you’re unfortunate enough to be someone who suffers from panics attacks, I’m pretty certain you don’t need me to describe what having one feels like!

However, I’ll bet you feel the people around you don’t have a clue about panic attacks, or that they just don’t “get” how scary and overwhelming having one is. I therefore thought it might be useful to spend a little time explaining just what they are, why they happen, and how you can overcome them.

What Are Panic Attacks and What Do They Feel Like?

Panic attacks are recurrent episodes of intense fear or apprehension which happen suddenly, and are relatively brief in duration. They generally begin without any valid trigger or cause, reach their peak within 10 minutes and are usually over within 30 minutes, although some individuals may continue to feel their effect at some level for a number of hours.

The nature and severity of panic attack vary widely between sufferers. Whilst some individuals experience nothing more than a moderately unpleasant episode, for many others, experiencing a panic attack is one of the most intensely frightening, upsetting and uncomfortable experiences of their life, frequently accompanied by the belief that they are having a heart attack, or are about to die.  Symptoms of a typical panic attack include the following:

  • heart palpitations
  • chest pain
  • difficulty in breathing
  • hyperventilation
  • tunnel vision
  • feeling hot, or cold
  • faintness
  • sweating,
  • nausea
  • dizziness
  • trembling
  • light-headedness,
  • tingling or numbing sensations
  • feeling unreal, or out of this world (“derealization”)

What’s Happening During A Panic Attack?

A panic attack is one of those conditions which is physiological (physical) in nature, but psychological in origin. It is a response of the sympathetic branch of the body’s autonomic nervous system. This is the part of the brain which is responsible for looking after you when there is a clear and present danger.

Unfortunately, if you’re someone who experiences panic attacks, your sympathetic nervous system is not functioning as it should. To draw an analogy with everyday events,  when a panic attack happens, it is as if the sympathetic nervous system is an over-sensitive smoke detector  alarm which misinterprets benign or minor situations as life-threatening. Like a mis-functioning smoke detector, it fires off at the slightest trigger, loading your body with adrenalin in preparation for a fight-flight response to a danger which does not exist in reality.

What Causes Panic Attacks?

You may be able to identify clear local triggers for your panic attack, for example, being faced with the prospect of having to fly, or coming across a spider. Alternatively, you may experience your panic attacks spontaneously and without any apparent cause. Regardless of how it happens for you, there will usually be an originating trigger, situation or run of events which led to the first panic attack and caused the deregulation of the nervous system.

Common originators of panic attacks include trauma, loss, environmental or social stress and life transition stages, such as a move of home, school or job, adolescence or parenthood. Other triggers may include the use of medication and recreational drugs, including alcohol and caffeine, as well as biological causes and physical illness.

What’s The Treatment for Panic Attacks?

It is generally agreed that the most effective treatment for panic attacks is cognitive behavioural therapy. This may be accompanied by a small dose of SSRI medication. A therapist will work with you to uncover your originating trigger(s) and to understand the negative assumptions, fears and beliefs which you’ve built up around that event or set of circumstances. Armed with this information, you and your therapist can begin to deconstruct the damaging beliefs and to build an alternative set of rationales relative to difficult circumstances.

Over the course of the treatment, which will generally last 12-20 sessions, you’ll also be encouraged to undertake a series of tasks related to the triggers for your panic attacks, and to build in strategies for managing yourself during these tasks, so that you have the experience of being able to be in a previously stressful situation without catastrophic events, including the experiencing of a panic attack having to happen.

Therapists at The Therapy Hour are trained to use CBT for the treatment of panic disorder and can help you recover from the debilitating effect of trying to managing your life around the fear of recurrent panic attacks. There are also some very good self-help CBT-based programs available online, including The Linden Method and Panic Away, both of which we use as part of our management program when working with sufferers.