Panic Attacks

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I saw a funny poster on Pinterest that reads “Even my anxieties have anxieties.” Actually this is a pretty good way to describe panic attacks. They are often the physical, visible manifestation of deeper existential issues. One of the best ways to eliminate panic attacks from your life is to bring existential anxiety into conscious awareness and confront it head on.

Obviously people want relief from painful symptoms immediately. We will talk about how to help manage panic attacks in the present while keeping our eyes fixed on the future. The best way to find long-term relief is to learn everything you can about anxiety and start applying your knowledge to concrete situations in your life. First let’s look at the clinical criteria for panic attacks and then discuss some brain teasers that can help in the present.

DSM IV-TR Criteria for a Panic Attack: A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

-Palpitations, and/or accelerated heart rate
-Trembling or shaking
-Sensations of shortness of breath or being smothered
-Feeling of choking
-Chest pain or discomfort
-Nausea or abdominal distress
-Feeling dizzy, unsteady, lightheaded, or faint
-De-realization (feelings of unreality) or depersonalization (being detached from oneself)
-Fear of losing control or going insane
-Paresthesias (numbness or tingling sensations)

All of these symptoms are terrifying and make you feel like you might be dying. This is why one of the most simple and effective ways to combat panic attacks is to realize that you are in no danger of dying. The body is built to withstand drastic physiological changes when they are of short duration. Just consider the state of an athlete after running a marathon or completing a triathlon. .

A vicious cycle is created when your anxiety about dying funnels into symptoms that make you feel like you are dying. In the middle of a panic attack you have to be able to come into the moment and recognize that while your symptoms are terrifying they do not indicate that you are in life-threatening danger.

Anticipatory anxiety also reinforces panic attacks. This means that people spend most of their time worried that they will get one, and this heightened state of anxiety produces the very event they are trying to avoid. To break this cycle we use a strategy called paradoxical intention. This means that you actively try to get more of whatever it is you are avoiding. Most are miffed to find that when they put their minds to it, getting results is impossible. They are unable to have a panic attack when trying to induce one, and they are unable to purposefully make one worse while it is going on.