By Brian Robinson.
What is the difference between a panic attack and an anxiety episode? Well, it is possible for an anxiety sufferer to have a panic attack, and likewise, someone with Panic Attack Disorder can experience general anxiety, so it can be confusing. It may be helpful therefore, if the sufferer can distinguish between the two different experiences of anxiety as often this is not the case.
Why does anxiety exist at all? Well, anxiety exists to serve two fundamental purposes. Firstly, it is a spur to action. When fight or flight is engaged it encourages the individual to escape from the danger. Escape is the main objective.
Secondly, anxiety exists to provide the sufferer with the means to escape. Stress hormones are released and they facilitate the action. You can run faster, run further, and if you have to stand and fight, you will be able to hit harder and endure longer. However, flight is always the preferred option. Fight or flight offers encouragement: but little in the way of courage.
What then is the logic behind panic attacks? Well, it certainly is not an ideal state of affairs for the body to be flooded with stress hormones for long periods of time. It makes far more sense for the spur to action to be short and sharp provided it achieves the same outcome. Panic attacks then, are a more intense spur to action and are less of an overall drain on the body’s resources.
Panic attacks can be fairly clearly defined. They usually peak after about five or ten minutes, and then begin to subside after a further twenty minutes or so. It is unusual for an attack to last for an hour or more, but having said that, in some cases it is possible for one panic attack to roll into another with a slight trough in between. However, it is quite unusual for this to happen and we can say with some certainty that panic attacks do not go on forever. The body is simply not disposed to maintain extreme levels of panic for long periods of time.
It is very rare for a person to pass out as a result of a panic attack although many people harbour this fear. Fainting can happen due to low blood pressure and the idea is that if we fall to the ground then our brain is more likely to get the blood and oxygen it needs. However, panic usually increases blood pressure due to the stress hormones being released so fainting is unlikely.
Panic attacks can appear suddenly and unexpectedly with no obvious trigger or build-up and this sudden-onset feature can be disturbing for the sufferer. Another characteristic is that the person may be more inward-looking during the attack. You might think you are going mad or that something serious has gone wrong inside. This may be partly due to the absence of an obvious external trigger. The reasoning is: where there is no external cause: there must be an internal one? Attacks can happen months apart or they may be quite frequent. And they are often followed by periods of intense worry. This usually centres on the fear of having another attack.
People who have panic attacks can go on to develop triggers which may be linked to the first incidence. For example, if someone had their first attack in a supermarket then going to supermarkets may trigger further attacks. It is also possible for someone with Panic Attack Disorder to have attacks that fit both descriptions, i.e. sudden onset attacks and ones brought on by specific triggers.
Generally speaking, it is difficult to control panic attacks. Once initiated they have to run their course. If we could control or stop them then the disorder simply wouldn’t exist. There is some scope to improve things, but having said that, there is likewise the potential to make the experience worse. The whole idea of a panic attack is to make the person panic and escape from the danger. So, if we really do panic and start running around, calling for help etc, this tends to confirm the idea that danger is present. It is far better to stay calm, perhaps get up and make a drink, and then sit down again.
One of the big problems with anxiety and panic is the natural tendency to resist. We try and fight or block the panic even though this is futile. Resistance can be physical where we tense up further, but resistance can also be emotional and psychological. The best thing is to accept the panic and let it do what it has to do. Many people describe panic as a bully that has to be stood up to. The problem is, this attitude only increases resistance and builds tension. Acceptance is a far better strategy.
Because panic is so inward looking, it is also a good idea to try and shift our focus to the external world when trying to deal with it. Look at things in the room; look at pictures or watch TV; listen to music or the radio; reassure yourself about the panic. Slow breathing exercises are also a good way to calm our body and mind.
It is possible to recover from panic attacks and there are many therapies that have something to offer. The two main pathways are Relaxation Therapy and Cognitive Therapy. Relaxation, however, is always a progressive endeavour simply because it is impossible for the sufferer to completely relax. And it is also true that making changes to how we manage what goes on in our heads takes time. This means in practice, that we have to dig a little to find the resources that will help. But trust in the recovery process; determination; and a good work ethic will take us a long way.