How Are Panic Attacks Managed Or Treated
Psychotherapy, medications or a combination are very effective at stopping panic attacks. How long youll need treatment depends on the severity of your problem and how well you respond to treatment. Options include:
- Psychotherapy:Cognitive behavioral therapy is a type of psychotherapy, or talk therapy. You discuss your thoughts and emotions with a mental health professional, such as a licensed counselor or psychologist. This specialist helps identify panic attack triggers so you can change your thinking, behaviors and reactions. As you start to respond differently to triggers, the attacks decrease and ultimately stop.
- Antidepressants: Certain antidepressant medications can make panic attacks less frequent or less severe. Providers may prescribe serotonin selective reuptake inhibitors , serotonin-norepinephrine reuptake inhibitors or tricyclic antidepressants . SSRIs include fluoxetine and paroxetine . SNRIs include duloxetine and venlafaxine . TCAs include amitriptyline and doxepin .
- Anti-anxiety medications: Benzodiazepines are the most commonly prescribed anti-anxiety medication to treat and prevent panic attacks. They help with anxiety but have risks of addiction or dependence. These medications include alprazolam and lorazepam .
What Are Anxiety Attacks
Anxiety attack is not an official diagnosis. Unlike anxiety disorders like panic disorder and PTSD, anxiety attacks are not listed in the The Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association .
Anxiety attacks is more of a colloquial term used to describe a concentrated moment of anxiety, or a more sudden attack of anxiety symptoms.
Most people do not associate anxiety attacks with life threatening circumstances or specific phobias. Anxiety attacks may involve powerful feelings of fear and stress, but they are not usually linked to depression or other mental health disorders.
Talking To A Health Care Provider About Your Mental Health
Communicating well with a health care provider can improve your care and help you both make good choices about your health. Find tips to help prepare for and get the most out of your visit at Taking Control of Your Mental Health: Tips for Talking With Your Health Care Provider. For additional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality website.
If you or someone you know is in immediate distress or is thinking about hurting themselves,call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK . You also can text the Crisis Text Line or use the Lifeline Chat on the National Suicide Prevention Lifeline website.
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Techniques To Help With Panic Attacks
The shaking caused by a panic attack tends to pass as the attack ends. However, if youre wondering how to stop shaking from anxiety, you can try techniques including the following:
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Deep breathing Slow, deep breaths can help to bring a sense of calm and reduce hyperventilation.
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Exercising Exercise releases pent-up energy and reduces muscle tension to ease physical stress, and distracts your brain from anxious feelings.
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Progressive muscle relaxation This is a technique where you tense different body muscles to release the tension in each one.
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Yoga Regulate your breathing and calm your body through a variety of flowing poses. Regularly practicing yoga can help decrease your symptoms of anxiety.
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Meditation This is a practice of focused concentration that brings your mind back to the present moment and allows you to acknowledge your current feelings, whether positive or negative. Meditation can work to reduce feelings of anxiety by also incorporating deep breathing.
Other anxiety or panic disorder treatments can provide a long-term solution, including:
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Exposure therapy/EMDR This interactive type of psychotherapy helps to reprocess traumatic memories and is recommended for PTSD and trauma.
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Medications If you experience panic attacks or anxiety frequently, you may want to talk with your doctor about medication. Your doctor may prescribe benzodiazepines, antidepressants such as SSRIs , or beta-blockers like propranolol.
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Can You Prevent Nocturnal Panic Attacks
These steps may lower your risk of having panic attacks:
- Eat a healthy diet, cut back on caffeine and exercise regularly.
- Find healthy ways to manage stress, like meditation, tai chi or calling a friend.
Talk to your healthcare provider before taking herbal supplements or over-the-counter medications. Certain ones can heighten anxiety.
Things You Can Try Yourself
The next time you feel a panic attack coming on, try the following:
- do not fight the attack and stay where you are, if possible
- breathe slowly and deeply
- remind yourself that the attack will pass
- focus on positive, peaceful and relaxing images
- remember it is not life-threatening
To reduce the chances of a further attack, it may also help to:
- read a self-help book about how to control anxiety using CBT
- try other therapies such as massage and aromatherapy
- try activities like yoga and Pilates to help you relax
- learn breathing techniques to help ease symptoms
- do regular physical exercise to reduce stress and tension
- avoid sugary food and drinks, caffeine, alcohol and smoking as these can make attacks worse
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Panic Disorder With Agoraphobia
Agoraphobia was traditionally thought to involve a fear of public places and open spaces. However, it is now believed that agoraphobia develops as a complication of panic attacks and panic disorder. Although it can develop at any point, agoraphobia usually appears within a year of your first recurrent panic attacks.
If you’re agoraphobic, you’re afraid of having a panic attack in a situation where escape would be difficult or embarrassing. You may also be afraid of having a panic attack where you wouldn’t be able to get help. Because of these fears, you start avoiding more and more situations.
For example, you may begin to avoid:
- Crowded places such as shopping malls or sports arenas.
- Cars, airplanes, subways, and other forms of travel.
- Social gatherings, restaurants, or other situations where it would be embarrassing to have a panic attack.
- Physical exercise in case it triggers panic.
- Certain food or drinks that could provoke panic, such as alcohol, caffeine, sugar, or specific medications.
- Going anywhere without the company of someone who makes you feel safe. In more severe cases, you might only feel safe at home.
What You Can Do
To get through a panic attack, try to take control of your breathing first. Find a place where you can sit or be comfortable. Concentrate on making your breath slow and even. Try to inhale through your nose for 4 seconds, hold it for 2 seconds, then exhale through your mouth for 6 seconds. Tell yourself that youâre not in danger and that the attack will pass.
If youâre not sure if youâre having a panic attack, itâs a good idea to go to the hospital to rule out any other health problems.
Panic disorder is one of the most treatable types of anxiety disorders. Medication and a type of talk therapy called cognitive behavioral therapy can help. See your doctor if you have panic attacks often.
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When Might I Have Panic Attacks
Panic attacks happen at different times for everyone. Some people have one panic attack then don’t ever experience another, or you might find that you have them regularly, or several in a short space of time. You might notice that particular places, situations or activities seem to trigger panic attacks. For example, they might happen before a stressful appointment.
Most panic attacks last between 5 to 20 minutes. They can come on very quickly. Your symptoms will usually be at their worst within 10 minutes. You might also experience symptoms of a panic attack over a longer period of time. This could be because you’re having a second panic attack, or you’re experiencing other .
“My panic attacks seem to come out of the blue now. But in fact, they seem to be triggered mainly at night when I want to go to sleep but cannot stop my mind racing, experiencing worry and panic about anything that may be on my mind.”
What You Need To Know About Panic Disorders
Unlike anxiety, which often has clear triggers, panic attacks occur suddenly and unexpectedly and typically only last for a few minutes.
Those who experience panic attacks have reported lightheadedness, chest pain, hot flashes, chills, and stomach discomfort. Some say they feel like they were being choked or suffocated. Others say an attack made them feel detached from reality.
Occasional panic attacks can happen to anyone, although for some individuals, they occur more frequently and cause significant distress and impairment.
Evidence-based treatments for panic disorder are similar to those for anxiety and involve exposure-based treatment. Mindfulness and meditation can also be useful to curb stress and promote increased psychological flexibility.
Sometimes medications are used to augment behavioral treatments for panic disorder and include beta-blockers, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors.
If you have had continued panic attacks, you may need to seek professional help. Your doctor will ask about your symptoms, other mental health and medical conditions, and whether you are experiencing abnormal stress or anxiety. Blood tests and a heart examination may also be required.
Both panic and anxiety are treatable and manageableeven when they may feel as if they are out of your control.
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Causes Of Panic Attacks And Panic Disorder
Although the exact causes of panic attacks and panic disorder are unclear, the tendency to have panic attacks runs in families. There also appears to be a connection with major life transitions such as graduating from college and entering the workplace, getting married, or having a baby. Severe stress, such as the death of a loved one, divorce, or job loss can also trigger panic attacks.
Panic attacks can also be caused by medical conditions and other physical causes. If you’re suffering from symptoms of panic, it’s important to see a doctor to rule out the following possibilities:
Panic Attack Vs Anxiety Attack
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Anxiety attack is primarily what we feel when we are concerned about a future event and expect a negative outcome. It is frequently associated with physical symptoms like muscle tension and a general sense of unease. And it usually happens gradually. A panic attack differs from an anxiety attack in some aspects. It is associated with a sudden onset of intense fear resulting from an impending threat or the fight-or-flight response that we are genetically programmed to have to deal with immediate danger.
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Alcohol Can Lead To Withdrawal Symptoms
Severe hangovers and withdrawal symptoms if you drink regularly can put both your mind and your body through stress. Withdrawal symptoms during a severe hangover can include:
The fact that all these physiological changes can cause symptoms so similar to those of a panic attack can trick your brain into having a real one.
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Don’t Fight A Panic Attack
Fighting a panic attack can often make it worse. Trying to resist the attack and finding you’re unable to can increase your sense of anxiety and panic.
Instead, during a panic attack, reassure yourself by accepting that although it may seem embarrassing, and your symptoms may be difficult to deal with, the attack isn’t life-threatening. Focus on the fact that the attack will evetually end and try your best to let it pass.
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What Do Panic Attacks Feel Like
During a panic attack, physical symptoms can build up very quickly. These can include:
- a pounding or racing heartbeat
- feeling faint, dizzy or light-headed
- feeling very hot or very cold
- sweating, trembling or shaking
- pain in your chest or abdomen
- struggling to breathe or feeling like you’re choking
- feeling like your legs are shaky or are turning to jelly
- feeling disconnected from your mind, body or surroundings, which are types of .
During a panic attack you might feel very afraid that you’re:
Anxiety Attacks Vs Panic Attacks
Anxiety attacks share many of the same symptoms as a panic attack, including rapid heartbeat, sweating, and racing thoughts. Anxiety attacks are usually slightly less severe than a panic attack, and may not involve a specific trigger or phobia. Anxiety attacks usually also dont involve fear of the specific place where the attack took place, as panic attacks often do.
To be diagnosed with panic disorder, physical ailments like thyroid and respiratory issues need to be ruled out. You usually have to have had multiple panic attacks, and the panic attacks have to had impacted your quality of life and ability to function well.
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How Is Panic Disorder Diagnosed
Medical or mental health providers can diagnose panic disorder. Your provider may diagnose panic disorder when you have repeated panic attacks and you:
- Persistently worry about having more panic attacks or their consequences.
- Obsess about losing control during a panic attack.
- Change your behaviors to avoid situations that may trigger a panic attack.
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Techniques For Calming Down
Here are some of the techniques clinicians teach anxious children, adapted from CBT and mindfulness training:
Deep breathing: Drawing in air by expanding the belly, sometimes called belly breathing, helps kids relax by slowing breathing, and reducing the heart rate, blood pressure and stress hormones. It can also help relax tense stomach muscles.Mindfulness exercises: Techniques such as focusing on whats around them, what they see and hear, can help pull children away from the anxiety and ground them in the moment.Coping statements: Children are taught to talk back to their worries, Ms. Greenspan explains. They can say, Im feeling scared and I can handle it. Or something along the lines of, Im bigger than my anxiety.Coping ahead: Children are taught that when you have to do something that makes you nervous, it helps to anticipate that you might have some discomfort, and plan what you can do to counteract it, knowing that if you can push through it, it will get easier.Acceptance: This involves acknowledging the discomfort without fighting it. Instead of trying to push the feeling away and get rid of it, Dr. Domingues explains, we ask you to hold onto it and tolerate it and get through it.
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What Is A Panic Attack
A panic attack is a brief episode of intense anxiety, which causes the physical sensations of fear. These can include a racing heartbeat, shortness of breath, dizziness, trembling and muscle tension. Panic attacks occur frequently and unexpectedly and are often not related to any external threat. A panic attack can last from a few minutes to half an hour. However, the physical and emotional effects of the attack may last for a few hours. Panic attacks are common. Up to 35 per cent of the population experience a panic attack at some time in their lives. A panic attack can also be called an anxiety attack. Without treatment, frequent and prolonged panic attacks can be severely disabling. The person may choose to avoid a wide range of situations for fear of experiencing an attack.
Believing You Have No Control Over Your Feelings
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One of the objectives of Cognitive Behavioral Therapy is giving you more power over your thoughts. And because your thoughts are directly linked to your body and your feelings, when you heal your mind your physical symptoms will decrease.
It may seem like panic happens to you, but in reality it doesnt. Once you understand this, you will have more control.
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How To Get A Diagnosis
If you experience symptoms of a panic attack for the first time, you may want to seek emergency medical care. Many people who have a panic attack for the first time believe theyre having a heart attack. It can be hard to differentiate the symptoms without the help of a medical professional.
While at the emergency care facility, a healthcare professional will perform several tests to see if your symptoms are caused by a heart attack.
These include:
- an electrocardiogram to check heart function
If they determine you do not need emergency care, youll likely be referred back to your primary care physician if you have one.
Your primary care physician will likely:
- review any earlier lab results
- ask about your symptoms
- perform a mental health examination
Your primary care doctor or a mental health specialist can diagnose panic attacks and panic disorder.
When Does Shaking From Anxiety Become A Real Problem
Shaking is a natural physiological response to stress. Through evolution, it developed to help people recognize dangerous situations so that they could escape or defend themselves.
This is why when you face stressful situations in modern life, you get nervous due to this built-in evolutionary response. As youre facing a situation thats dangerous, scary, or exciting for you, its natural for you to feel anxious.
The issue isnt the anxiety or the shaking itself. The issue is when you cant control the anxiety you are feeling, even when youre not even facing a stressful situation, in which case you may have an anxiety disorder.² People with an anxiety disorder may find they shake even without being in a dangerous situation. Types of anxiety² that can cause shaking include:
Generalized anxiety disorder
If you have a generalized anxiety disorder , you are likely to experience excessive worry or anxiety that you are unable or find difficult to control most days for a minimum of six months. The anxiety could be about:
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Work and finances
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Social interactions
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Other life situations
Symptoms include restlessness, irritability, muscle tension, fatigue, difficulty concentrating, or sleep problems. You may also experience shaking in conjunction with anxious thoughts even if there isnt a clear trigger.
Panic disorder
Post-traumatic stress disorder
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