Help & Recovery from Panic Attacks

Many people who first experience a panic attack don’t know what is happening to them.  Moreover, people who experience a panic attack or panic attacks find it reassuring to understand what is happening to them biologically and psychologically.  This knowledge (knowing what is happening) can be a real and initial form of help with panic attacks.

As per the Mayo Clinic's website:

A panic attack is a sudden episode of intense fear that develops for no apparent reason and that triggers severe physical reactions. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.

You may have only one or two panic attacks in your lifetime. But if you have had several panic attacks and have spent long periods in constant fear of another attack, you may have a chronic condition called panic disorder.

Panic attacks were once dismissed as nerves or stress, but they're now recognized as a real medical condition. Although panic attacks can significantly affect your quality of life, treatment is very effective.¹

As per the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Panic Disorder involves the following:

Recurrent unexpected panic attacks and at least one of the attacks have been followed by 1 month (or more) of one (or more) of the following:

The attacks are not due to the direct physiological effects of a substance (such as drug of abuse or a medication), or a general medical condition.

The attacks are not better accounted for by another mental disorder, such as social phobia (such as occurring on exposure to feared social situations), specific phobia, obsessive-compulsive disorder, post-traumatic stress disorder or separation anxiety disorder

If the above criteria are met, the diagnosis is further clarified by the presence or absence of agoraphobia (such as Panic Disorder with Agoraphobia or Panic Disorder without Agoraphobia). ²

My Initial Experience

I know how scary it can be, first hand.  I initially felt like I was going crazy - the thought that I might be suffering from a panic attack - a highly treatable illness - never crossed my mind.        

Unfortunately I was not sure where to turn to for help with my panic attacks (of course at the time though I did not know that I was suffering from panic attacks).
                                                  
When I described my symptoms to my family doctor, after having my first panic attack, he didn’t provide what I considered helpful treatment or advice.  He only recommended that I see a psychologist.  He did not suggest to me that I might be suffering a panic attack.
 
While the doctor’s referral to a psychologist led to me receiving help, it was really hard going through this period not knowing anything about what was happening to me.  Knowing something about the process would have put me somewhat at ease.      

Now in fairness, most medical doctors, at least general practitioners, are not trained in panic attacks, mental health issues, at least in any real depth, and are not prepared to provide any type of counseling, as their training is in only a biological model. 
 
Furthermore most healthcare systems require physicians to work within many time constraints.  Obviously this does not help the panic attack sufferer.  So dealing with panic attacks in many senses is outside a general practitioner’s expertise, hence the recommendation made by my doctor was a good one, real help followed because the psychologist really had the right training and experience.
 
Fortunately, though, awareness of panic attacks is increasing, and now, when patients experience a panic attack, more family doctors will tell them so and can then direct them to the help they need.
 
Once a physical exam is completed by a medical doctor and this exam rules out any physical causes/issues, then a diagnosis of a panic attack can be made.  Medical doctors, psychologists and psychiatrists can make a diagnosis of panic attacks or panic disorder.  If you suspect you might be suffering from any of these conditions then see a medical professional as noted above.
 
Now although a medical doctor can make a diagnosis of a panic disorder and prescribe medication, more is necessary.  A referral to a mental health professional with experience in panic attacks is very important.  This is where the real help continues, in my opinion.
 
I will now discuss the process of a panic attack.
  
During a panic attack what is known as the “fight or flight response” is activated,³ even though the individual is not any real danger.
 
The “fight or flight response” activates the body’s mental and physical survival responses which are to fight or flee from a perceived attacker, harm or threat.
 
When this response is initiated chemicals such as adrenaline, noradrenaline and cortisol are released into the bloodstream which causes a series of physiological effects.  Heart rate increases, pupils dilate, and respiration increases.  Blood flow to the brain is reduced, which means that rational thinking is compromised.
 
This in turn causes one's thoughts to race and puts one on a heightened alert.  One is hypersensitive to things that normally wouldn’t bother him or her.
 
The whole process is cyclical because one's racing thoughts and worries increase his/her physiological symptoms, and in turn one's physiological symptoms increase his/her racing thoughts and worries.
 
While many people suffering from panic attacks feel that they are either having a heart attack or going crazy, initially, it can be helpful to know that this is not the case.
 
Of course if you’ve experienced a panic attack you are probably concerned about experiencing another.  This is where agoraphobia can come in.

I like to define agoraphobia as fear of fear. 

The Mayo Clinic's website indicates that Agoraphobia is a type of anxiety disorder in which you avoid situations that you're afraid might cause you to panic. You might avoid being alone, leaving your home or any situation where you could feel trapped, embarrassed or helpless if you do panic.

People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. The fears can be so overwhelming that you may be essentially trapped in your own home.

Agoraphobia treatment can be tough because it usually means confronting your fears. But with medications and psychotherapy, you can escape the trap of agoraphobia and live a more enjoyable life.⁴

Please be reassured that if you’ve been diagnosed with panic disorder you are not losing your mind or having a heart attack.
 
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