Panic attacks: What are they?
Panic attacks are episodes of intense, almost paralysing fear where, as a result of the “fight or flight” response, the body is flooded with the stress hormone adrenaline. Panic attacks can be triggered suddenly and unconsciously. Before the sufferer has been able to identify the symptoms as a panic attack, the sufferer can feel as if they are having a heart attack or even think that they are dying.
During the early development of panic attacks, the sufferer can perceive their external situation to be quite “normal” making the panic attacks appear unpredictable and unavoidable. Having had one panic attack, the sufferer then becomes sensitised to the symptoms. Without have any coping strategies, the mildest trigger can set off a panic attack.
Panic attacks: how long can they last?
They can last anything from a few seconds to several minutes, sometimes developing in waves if the sufferer believes they are unable to alter the course of the panic attack e.g. remove themselves from a “closed” situation or relieve some of the symptoms when turbulence is causing panic when flying.
Sometimes the panic relates to internal or medical fears e.g. fear of having a heart attack. In this situation, panic attack sufferer is unable to distinguish between the symptoms as either anxiety or an actual heart attack. This may be have been triggered by someone they know who has suffered a panic attack. A similar situation can be created by an asthma sufferer whose asthma symptoms are anxiety-induced.
Panic attacks: What causes them?
- Physical or medical causes:
Some panic attacks can have physical or medical causes. A doctor should always be consulted to dismiss the following conditions: certain heart conditions, overactive thyroid, low blood sugar, medication withdrawal and stimulant overuse.
- Major lifestyle changes:
Stress caused by some of the big lifestyle changes include getting married, changing jobs, moving house, divorce, having a baby and suffering a bereavement. Due to the amount of change in these events, these lifestyle changes place an increased demand on your physical and emotional coping abilities. These symptoms are made worse when several of these events occur in close succession.
- A family trait:
Panic attacks can run in families, although the specific nature of the link is unknown. This could be a genetic or a learned response. Young children are vulnerable to learning coping behaviour displayed by their parents. The parents may suffer from extreme anxiety (catastrophic thinking) or have specific phobias. The child can learn this way of dealing with anxiety.
- Phobias and anxious/stressful situations:
Panic attacks are closely associated with phobias. The common coping response with a phobia is avoidance to protect you from the feeling of panic. Not all situations can be avoided however. A panic attack can be generated as a shock response when the phobic person is brought into contact with the cause of the phobia without warning. An example is when someone who has an arachnophobia panics when they see a spider in a friend’s bathroom.
Anxious and stressful situations can create also panic attacks. When someone is aware of the situation that can create a panic attack, avoidance can again be used as a common coping strategy. There are situations where the sufferer feels obliged to confront their panic e.g. someone who fears public speaking has to give a presentation at work. In the absence of any helpful resources, a panic attack can be experienced whilst giving the presentation.
The panic attack may also happen through anticipation. This is when the presentation is planned say next week and the sufferer accumulates an increasing amount of anxiety as the presentation nears. Your anxiety then “takes” you to your panic attack, near to or during the presentation.
Left unmanaged, these situations can accumulate more fear of panic attacks (fear of fear). An example is when the spider phobic feels increasingly embarrassed about having a panic attack around people. A social phobia develops until they enter a state of helplessness. The sufferer then believes that by staying at home, they can prevent a panic attack. The situation accumulates into agoraphobia.
Panic attacks: What are the common symptoms?
The symptoms of a panic attack are similar to general anxiety but are usually higher up the intensity scale. They can include one or more of the following:
- Intense sweating (armpits, hands, forehead or complete cold sweat)
- Shaking, trembling or feeling petrified
- Chest pain or tightness, heart pounding, beating faster, palpitations
- Thoughts of dying or impending doom
- Sudden intense anxiety or fear of danger
- Shortness of breath or shallow, rapid breathing
- Nausea, faintness or dizziness, hot flashes
- Fear of losing control
- Dry mouth, problems swallowing, throat feeling constricted
- Mind going ‘blank’, dreamlike sensations or perceptual distortions
- Ringing ears
- Muscle tension
- Weakness, fatigue, feeling of powerlessness
- Tummy upset or nervous diarrhoea
- Heightened alertness to danger, constantly feeling on edge
Without knowledge of these panic attack symptoms, the sufferer can become highly anxious about them, inducing further panic attacks.
Panic attacks: Can they happen spontaneously?
During the early stages of panic attacks, the sufferer may not understand them or be able to attribute any situational cause and so is left “waiting” for the next one to happen. Some panic attacks can appear to happen spontaneously but have an undiagnosed medical cause. When diagnosed and appropriately treated, the panic attacks subside. Panic attacks can happen in the middle of the night causing the sufferer to wake from their sleep. There may not be a recognised cause at the moment of happening, but nocturnal awakening can be stress-related.
Panic attacks: what is panic disorder?
Whereas panic attacks can occur during bouts of stress, panic disorder is a condition where the person suffers recurrent panic attacks. They live in fear of their panic attacks which exacerbates their condition (fear of fear). Panic disorder is a type of anxiety disorder which is characterised by persistent worry.
Panic attacks: How can hypnotherapy treat them?
- Hypnotherapy can teach relaxation techniques
Breathing techniques can be taught to alleviate some of the anxiety symptoms. When used correctly, you can slow down the pace of your breathing thereby reducing the potential to hyperventilate. During a hypnotherapy induction, you are in a deeply relaxed state that helps you to be more receptive to suggestions used. The learning ability is enhanced in hypnosis, which means you take away a more profound experience of the relaxation achieved with the breathing techniques used.
- Hypnotherapy can release negative beliefs (triggers) that cause the panic attacks
With panic attacks, the sufferer may not be aware that there is a deep internal conflict between unconsciously (and consciously) acquired beliefs. You can be torn between two or more opposing belief patterns, or the opposing consequences of taking a certain course of action e.g. trying to please too many people at once. When they conflict, it creates the surge of adrenalin and the sudden awareness of the panic symptoms (the “fight or flight”). You may inadvertently try harder to resolve or control the situation, sometimes exacerbating the panic attack. Hypnotherapy can identify which negative beliefs are in conflict and causing the adrenaline responses.
An example of a conflicting situation is when an employee is desperate for promotion to help pay off a loan. They have an opportunity for promotion but the method includes an interview and a presentation. The employee suffers with presentation anxiety and finds it hard to speak when anxious. They suffer anticipatory anxiety leading up the day of the presentation and then realise they have made a gross error in their preparation during the interview. This realisation sets off a panic attack. There are conflicts between the need for promotion and the need to perform well during a presentation.
Everybody is likely to react differently in that situation. The individual who does not have an internal “vent” or way or coping is likely to find their adrenaline pushing some of the above symptoms to the upper limits. Hypnotherapy can be used to control the build up of these symptoms.
- Hypnotherapy can help identify the nature of unconscious panic responses
Deep-rooted unconscious issues can sensitise you to a particular situation as a child. They can remain dormant and then resurface when the situation is encountered again as an adult. For example childhood bullying which re-surfaces as panic attacks when the adult is confronting an aggressive boss at work. Hypnotherapy can help re-frame the emotion from your childhood helping you to cope as an adult.
- Hypnotherapy can help de-sensitise the sufferer from panic-causing situations
As the sufferer has more control over their panic attacks, they can begin to challenge the situations that they have avoided. Progressively dealing with that situation can alter the panic responses and break the anxiety-response habit. Hypnotherapy helps you to rehearse your coping in each stage of your progress as if the event as actually happened.
Panic attacks summary
Panic attacks are extremely distressing episodes of intense anxiety. In the absence of any conflicting medical conditions however, panic attacks don’t cause death. Once you can identify them for what they are, hypnotherapy can help you cope with them and change the meaning of them. As you have more control over your panic attacks and change your beliefs towards them, they usually subside.