Panic Attacks


Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

When Terror Takes the Reigns

Panic attacks are brief moments when the fearful part of a person's thoughts take momentary control of their physical and intellectual capacities.

Panic is the instinctive last resort instinct to change something - anything - in the face of an otherwise certain death. As the human race evolved through the millennia, the panic attack is a survival skill which we have evolved to assist with survival in the wild.

However, an instinctive reaction to danger which was useful to avoiding a sabre-toothed tiger in the prehistoric Savannah is often less helpful in dealing with the typical domestic problems of 21st Century life.

Emotional Avalanche

Emotional Avalanche is the cognitive process where the more primitive, emotional part of the brain temporarily takes control over the more deliberate, thoughtful, logical part of the brain. When a person is experiencing a momentary loss of reason in favor of unbridled courage, love or fear, it is often because they are experiencing an emotional avalanche. During this time, oxygen supply to the frontal cortex is restricted, and diverted in an adrenaline-charged surge to the amygdala - the emotional, impulsive region of the brain.

What It Looks Like

  • A man becomes unresponsive and refuses to communicate in the face of bad news.
  • A young woman starts shaking and shivering uncontrollably when remembering a difficult situation.
  • A young man begins thrashing violently when asked a difficult question.

DSM-IV-TR Diagnostic criteria for Panic Attack

The American Psychiatric Association has identified a number of manifestations of panic attacks as follows:

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, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, light-headed, or faint
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or going crazy
  • Fear of dying
  • Paresthesias (numbness or tingling sensations)
  • Chills or hot flashes

What if Feels Like

To the bystander, a panic attack only makes sense if they feel can simultaneously feel the same level of threat that the panic attacker feels. However, since most modern day threats are not immediately visible to the eye of the bystander, most view the physical and emotional response of someone who is having a panic attack as exaggerated, irrational, counter-productive and even dangerous.

How to Cope

When someone is experiencing an emotional avalanche, they temporarily shut off their thinking brain. It is a time to get yourself, vulnerable bystanders and the family china out of the way. Most panic attacks last only a few minutes and subside in less than an hour. Many people who experience a panic attack will feel exhausted and may become placid - needing to nap or sleep it off in the immediate aftermath.

What NOT To Do:

  • Don't argue, question or interrupt another person's panic attack.
  • Don't stay in a dangerous environment.

What TO Do:

  • Get yourself, your kids and your valuables to a safe place
  • Go find a safe place where you can think
  • Talk to a friend who can speak objectively to your situation

Related Personality Disorders

Paranoid, Borderline, Histrionic, Dependent, Obsessive-Compulsive