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Panic Attacks and Panic Disorder

Photo of a girl having a panic attack in the middle of a busy crowd
Panic Attacks and Panic Disorder

What is a panic attack?

A panic attack is a short-lived and abrupt onset of intense discomfort that reaches its peak within minutes, lasting about 15 minutes total, accompanied by 4 or more of the following symptoms:

  • Heart palpitations
  • Sweating
  • Trembling
  • Accelerated heart rate
  • Numbness and/or tingling of limbs or entire body
  • Shortness of breath
  • Feeling of choking
  • Chest pain or tightness
  • Feeling a loss of control or reality (as if you’re in a living nightmare)

Is a panic attack the same as an anxiety attack?

No – a panic attack and anxiety attack are not the same. Though it’s common for people who suffer from anxiety to experience panic attacks, the difference between a panic attack and an anxiety attack are the physical symptoms and the causes: during a panic attack, your body will experience extremely heightened physical symptoms, whereas in an anxiety attack, the symptoms are predominantly mental fears and thoughts, coupled with less severe physical symptoms – if at all (such as sweating, shortness of breath, and trembling)

In addition, panic attacks are generally (but not always) prompted by specific events and stressors – such as when entering an overwhelming social situation or thinking about an excess workload or class load that simply feels impossible. The panic attack is triggered as a result of the body’s fight-or-flight response; the body is thinking it’s under physical duress and responds accordingly.

What should I do when I am experiencing a panic attack?

The best thing to do during a panic attack is to lean into the symptoms. Remind yourself that symptoms of anxiety are uncomfortable, but not dangerous.

It’s human nature to run away from discomfort – it’s an evolutionary trait! But you must remind yourself that the panic attack you’re experiencing is not a result of danger – root your feet on the ground and breathe deeply. Do not breathe into a paper bag the way you commonly see in movie or TV – that actually only makes things worse, because it’s signaling your body it is in danger because you’re taking additional measures – it’s like you’re saying “hey brain, this situation is so bad that I’m doing this to help you, so keep panicking!”

One of the best ways to cope during a panic attack is to be aware of what’s happening to the body on a physical and biological level when a panic attack occurs:

Your thalamus intercepts incoming sense and sends them to your cortex, which gives sights and sounds meaning. Your prefrontal cortex is a vital component of your cortex that gets involved later, when making judgements about your situation and determining, once your fears and anxiety are made conscious, how to proceed.

The hypothalamus is what sends information to the amygdala, the emotional core of your brain, whose primary role is to trigger the fear response, as its main role is assigning emotional significant to the information it processes, and the bed nucleus of the stria terminalis (BNST) sits right alongside it, perpetuating whatever signal the amygdala sends the rest of the brain.

Note: senses of smells and touch bypass the thalamus completely and going straight to the amygdala, which is why those 2 senses evoke the strongest emotions.

If and when the amygdala senses fear, it sends the signal to the locus coeruleus, triggering the physiological response of stress and panic. Your body’s sympathetic nervous system kicks into high gear as a result of your pituitary and adrenal glands pumping out high levels of cortisol (the stress hormone). This is what causes the physical discomfort: sweating, raised blood pressure, heart palpitations, et cetera. In addition, adrenaline floods to muscles, shifting the brain’s focus from digestion to potential danger (which is why you often have to use the restroom before important events)

Only AFTER the fear response is activated does the consciousness kick in! The cortex and prefrontal cortex then decide if the sensory information requires this heightened fear response! If the fear is a genuine threat in space and time, the cortex signals the amygdala to keep the fear response going. That’s why the most important thing to do when experiencing a panic attack is to consciously tell yourself “this is not a physical threat or danger” – this will cut the cord between your brain and amygdala that thinks it needs to keep the stress signal going!

Please note: panic disorder occurs when a person gets repeated panic attacks – and the person is consistently concerned with “when will it happen next?” – it can be extremely debilitating, but a doctor can help you reduce and even eliminate the occurrences. They are completely treatable, so we urge you to visit your doctor to start living your life with less panic if you experience panic attacks regularly.

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