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What is a panic attack?

A panic attack feels like the “eruption of a volcano”: it is wholly unexpected, surprisingly intense and absolutely terrifying. While experience flows peacefully, you detect inside you the sudden emergence of a disquieting hint of fear. You try to discover why is it that you feel afraid but you find nothing to calm you down. Soon you discover that your internal experience changes speedily and the next thoughts you have is that you will not be able to take another breath and that you will faint.

The first panic experience is particularly alarming because you internally interpret it as a developing heart attack. This interpretation amplifies the initial apprehension and you now start to breathe faster and deeper to ensure that you will get all the air you need to survive. You also feel that your heart is about to “fly out of your chest” at this rate of beating. In other words, you are having a panic attack.

This is the way most people describe their first experience of panic. Many report that they feel a sudden increase in their body temperature, as if they burn inside, while others say that they feel cold, as if they had gone out of their warm house in an icy winter day. Others experience shaking in their body or numbness in their hands and legs, as if they have thousands of ants under their skin. Lastly, most sufferers have intense chest pain, “butterflies in their stomachs” and they fear they will lose consciousness soon. Most prefer to keep to themselves what they go through and avoid letting others know of their experience. This is because they believe that, if people knew, they would form the perception that the sufferer is weak or mentally imbalanced. Soon after the initial panic attacks they realize that they are compelled to engage in avoidant behaviors in order to protect their social image. In most cases, people feel the need to immediately withdraw from the place where the panic attack occurred and seek reassurance in their familiar environments, most often in their homes.

The transition from sporadic panic attacks to Panic Disorder

If you have ever experienced a panic attack yourself and you read these words you will immediately recognize the nature of the experience I describe to you. But the people who have never had a panic attack themselves will never be able to empathize with you in this. Please, stop feeling disheartened, if others do not appreciate what a panic attack feels like. They will not be able to “see things trough your eyes”. In most cases, they will tell you that it is all a product of your mind and they will try to convince you that you must be able control your panic by your powers of self-reassurance.

Clinical psychology characterizes a panic attacks as the ultimate anxiety experience. I want to set your mind at rest by telling you that your life is not in any medical danger during a panic attack. In reality, the body functions during a panic attack very similarly to the way it functions during a period of intense exercise. And yet, the quality of your psychological and social life is indeed seriously compromised. Most people who suffer from panic attacks think secretly to themselves: “what will happen to me, if this occurred in the presence of my friends or professional colleagues”?

They soon start to progressively restrict their social activities. It becomes a nightmare to queue in a line and they feel imprisoned and hopeless in a traffic jam. Even if they find the courage to attend a social event, the thought of a possible panic attack during the event follows their every step like a faithful pet animal. They simply cannot take the thought out of their minds, irrespectively of how hard they have tried. If they find themselves in an indoor public space, like a cinema theatre or a shopping mall, they need to know in advance where the emergency exit is located, so that they may experience some sense of security, by having developed a silent plan of escape, if something were to go wrong. Others carry a bottle of water with them at all times, because they find that a ship of water calms them down, if a panic attack occurred. This is exactly the way in which panic disorder is introduced into the organism. Agoraphobia, the avoidance of public places, follows. Agoraphobia is an extremely cruel psychological reality. In extreme cases, sufferers cannot take two steps away from their own houses.

The goal should be to eliminate panic disorder, not cope with panic attacks.

Now, many sufferers do something about it. Some take medication. Medication is helpful no doubt but when it is over with relapse is very common. This is because medication is like covering the stem of the volcano with a cap. However, the volcano is not more than a tube that connects the crust of the earth with its deeper layers. It is from the deep that the lava of the panic attack originates.

A panic attack is an anxiety explosion. In order to stop the psychological eruptions one must go to the psychological lava in the deeper layers. The only process that promises this opportunity is a quality psychotherapeutic intervention. You may learn more about it in this web site.

Dr. Pericles A. Goudopoulos

Hellenic Association for Anxiety Disorders International Association for Panic Disorder