As you walk on a green path, your eyes catch sight of a coiled object, and your body springs into action. Your heart races as you instinctively react to the sight of that object. It is only after the reflexive leap that you realise it was just a random wire lying on the ground. Your autonomic nervous system, your body’s safety system, took over, temporarily making you react to protect you from possible danger. This reaction is quite akin to what happens during a panic attack, only magnified a few times over, especially when one’s mind misinterprets harmless cues as threats.
Identifying a panic attack
At first, Pavani Srinivasan (name changed), 24, Hyderabad, was confused by the occasional chest tightness and dizziness. She says that it was only later that she recognised them as symptoms of panic attacks. Srinivasan has now come to learn that panic attacks occur in an overwhelmed nervous system, which means that your mind is taking in too much in very little time.
Dr Kamlesh Patel, a psychiatrist from Rajkot says that a panic attack is basically the fear of something unknown. “A panic attack can feel like abrupt waves of fear or discomfort,” says Ankita Chavda, 29, a counselling psychologist from Dehradun.
These episodes may include symptoms such as breathlessness, a racing heart, a disoriented mind, and a feeling of disconnection from one’s body and surroundings, she adds.
While individual experiences may differ, Dr Patel says, “Most panic attacks tend to intensify and reach their peak within 10 to 15 minutes, gradually subsiding over the course of one to two hours.” Ankita adds that these episodes can leave individuals feeling helpless and questioning their sanity.
Know your triggers
“Triggers can be either genuinely life-threatening, signifying a real danger, or they can be mistakenly perceived as catastrophic by one’s body. This misinterpretation prompts the stress response system to become flooded with stimulation, geared to combat perceived threats,” says Ankita. Triggers based on past negative experiences may cause miscommunication between two different parts of the brain: the prefrontal cortex, which dictates logic and reason and the amygdala which regulates our emotions. By design, in the event of danger, the amygdala takes over while the prefrontal cortex takes a backseat causing one to panic.
Who is vulnerable?
Dr Patel says that biology, including family or genetics, and psychological and behavioural health challenges are among the many risk factors. Ankita sheds light on the diathesis-stress model, clarifying that individuals with underlying vulnerabilities, such as a family history of panic attacks or significant life stressors, are more predisposed to experiencing panic attacks and related conditions when exposed to triggers. An imbalance in neurotransmitters in the presence of traumatic experiences and adverse childhood events (ACEs) further aggravates these vulnerabilities.
Matters of the heart
Dr Patel urges anyone experiencing a panic attack for the first time to be investigated for underlying cardiac pathology. He suggests that routine tests are enough, and “one need not do an in-depth investigation which might also be heavy on the pocket.”
Getting through a panic attack
Ankita and Dr Patel share some tips for someone experiencing a panic attack:
- Deep breathing: Incorporate regular breathing exercises into your routine, especially after experiencing your first panic attack.
- Grounding techniques: Practice the 5-4-3-2-1 grounding exercise, where you identify five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. This exercise helps you reconnect with your surroundings.
- Sticky notes of reframed thoughts: Place notes with reframed thoughts around your home as reminders. For instance, you might write, “It may feel like everything is falling apart right now, but not all my thoughts are true.”
- Reach out to a trusted friend: Loved ones can instill a sense of safety and grounding.
On keeping calm
“Keeping one’s cool in the event of someone experiencing a panic attack is important and it is counterproductive to tell them to calm down,” says Ankita. To help one, Dr Patel suggests noticing difficulty in breathing or trembling, while avoiding the urge to ask questions or give suggestions. “Allow the person to feel fearful while you provide them with your own sense of calm,” he adds.
Preventing future panic attacks
While Ankita and Dr Patel emphasise distracting oneself during the attacks, they suggest sitting with one’s fears to work out the root causes of triggers and, as Srinivasan puts it, “Create space for unpleasant emotions and having healthy ways to let it out and express it.”
While explaining how therapy for panic attacks works, Ankita says that a mental health professional helps identify and challenge negative thought patterns in a controlled and supportive environment. “One learns the skills to manage and control the physical symptoms of anxiety and panic,” she adds.
Dr Patel says recurrent panic attacks can be helped through long-term therapeutic practices, like breathwork in yoga, relaxation techniques, medication, and a balanced lifestyle, to reduce the symptoms.
Although panic attacks have a theme of engulfing one with an overarching fear, the underlying causes are often treatable and allow individuals to lead a healthy and fulfilling life. While being cognizant of the significant effect of panic attacks on one’s personal and professional life, Ankita suggests investing in one’s well-being through therapy. A little help can go a long way.