Greater Peoria Metro Area, IL

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The Anatomy of a Panic Attack


By Brad Post, LCSW, CADC, Chapin & Russell Associates

As we attempt to manage the seemingly endless barrage of demands placed on us from our job, family, school, and leisure pursuits, we can become overwhelmed when it comes to managing stress. For many of us, stress is just part of our everyday lives as we try to be everything to everyone. But, for others these high levels of stress can result in a panic attack that occurs either as an isolated incident or begins to reoccur as part of pattern.

Unfortunately, in the face of the COVID-19 pandemic, it appears that more and more people are suffering from these sometimes debilitating attacks that can result in an unplanned visit to the emergency room. Statistics predict that one in sixty people will suffer an anxiety attack at least once during their lifetime. Such an attack is typically a response to an excessive amount of adrenaline that sets off the natural fight or flight response. Researchers are still trying to understand why some people are more likely to experience intense feelings of anxiety than others.

A panic attack is a physiological reaction to psychological stress. However, the physical symptoms felt during an anxiety attack are real to those who are experiencing them. During an episode, sufferers report feeling an intense level of fear that is so powerful that it is often incapacitating. My hope is that by educating you about the biological components of a panic attack that much of the fear will be removed.

Let’s look a little more closely at this physiology that is often misunderstood during panic. There are a number of physical changes that occur when we flip on that emergency switch. (Technically this stimulates hormones that engage the sympathetic branch of the autonomic nervous system that regulates the fight or flight response.)

These changes are normal, healthy, lifesaving changes in the body’s physiology and are intended to help us respond to an actual threat. For example, the eyes dilate to improve vision, the heart rate increases to circulate blood more quickly to vital organs, respiration increases to provide increased oxygen to the rapidly circulating blood, and the muscles tense in the arms and legs in order to move quickly and precisely. Even our blood sugar level increases to fuel the body’s response.

When there is an actual emergency we hardly notice these changes. Instead, we focus on the crisis. However, since this kind of panic is not a response to a real threat, two problems may develop. First, we become stuck focusing on our fearful thoughts and our physical sensations instead of taking action to problem solve. Not using our body’s energy constructively, our tension and anxiety continue to build. The second problem occurs when our breathing rate and pattern change. Instead of breathing slowly and gently from the lower part of our lungs, we begin to breathe rapidly and shallowly from our upper lungs.

This shift not only raises the oxygen levels in our bloodstream but it causes us to exhale too much carbon dioxide. In a real physical emergency we produce excess carbon dioxide, so this breathing rate is needed. However, when we are not physically exerting ourselves, it causes us to hyperventilate by discharging too much carbon dioxide. Hyperventilation is responsible for most of the uncomfortable sensations we experience during a panic.

Subsequently, most of the interventions for managing a panic attack will focus on how we breathe to significantly reduce our uncomfortable symptoms. Breathing is also influenced in part by the thoughts and the images we focus on, so changing our thinking and imagery is part of counseling for panic.

Possible symptoms that can occur from hyperventilation include: irregular heart rate, lightheadedness, tightness in our throat, blurred vision, numbness or tingling of mouth, hands or feet, shaking, fatigue and inability to concentrate. Other symptoms might be shortness of breath, dizziness, nausea, sweating, heart palpitations, and chest pain. In fact, many people in the middle of a panic attack confuse the symptoms with those of a heart attack. Most frightening, however, can be the feeling of suffocating.

Anxiety attacks often surface with little or no warning and can last anywhere from several minutes to several hours. At the end of such an attack, a sufferer may often experience extreme exhaustion and feel extremely fatigued for hours.

While stressful events or difficult challenges can increase overall anxiety and provoke a periodic attack, those who suffer from ongoing panic attacks may often be diagnosed with an anxiety or panic disorder. The good news is that anxiety and panic attacks can be effectively treated through education and counseling utilizing a variety of interventions including guided imagery, relaxation training and biofeedback training.

For more information on how to deal with anxiety or panic please feel free to contact Chapin & Russell Associates at (309) 681-5850.