Panic attacks can be psychologically painful experiences. Often being described by people as a ‘waking nightmare’, they can profoundly affect our sense of control over ourselves and the world around us. Psychologists Martin Seif and Sally Winston describe panic attacks as “intensely and unbearably uncomfortable discrete episodes of terror, which mount rapidly and reach a crescendo in minutes”. People who experience panic attacks are sometimes diagnosed with Panic Disorder, a type of Anxiety Disorder.
Panic Attacks For No Reason
Panic disorder often begins with an initial panic attack that seems to come out of nowhere. Even though there might be an underlying cause or trigger, most people who look back on their first panic attack feel as though it happened for no reason. This first panic attack is often quite traumatic, and sets an important precedent for later attacks, establishing a fear of future panic attacks, which can then dictate how people with panic disorder live their lives. In mild cases, it can mean minor avoidance of triggers, and in extreme cases, it can manifest in people being afraid to leave their living room.
The reason that panic attacks seem to come out of nowhere is that the typical onset age for panic disorder is between adolescence and the early 30’s. People might have 20+ years of never noticing any anxiety, and they are now suddenly having panic attacks. There is a genetic component to anxiety disorders, which can be linked to their manifestation at later stages in life, as well as them appearing out of nowhere. It is exceptionally rare for panic attacks to begin after the age of 40 with no prior episodes, and in such cases there is typically a medical reason behind them.
Why Panic Attacks Happen
The main reason people have panic attacks is because of a fear of sensations. All people experience anxiety to some degree, but people who have anxiety disorders typically have a low tolerance for the thoughts, feelings and sensations that accompany anxiety. In the case of panic disorder, people are reacting to the lightheadedness, dizziness, rapid heart beat and/or fast breathing that accompanies anxiety or panic.
When individuals who have panic disorder notice these symptoms, what follows is a thought along the lines of “I’m having a panic attack!”. Whether or not this is true, the fact that they think they are having a panic attack further amplifies the anxiety, creating a feedback loop. It’s important to note that the initial ‘signs’ of a panic attack might be completely unrelated to any kind of panic attack. One might notice their heart beating after climbing a flight of stairs, or feel light headed because they skipped breakfast, or be dizzy because a flu is setting in.
The challenge facing people with panic disorder is that, by the time the symptoms have been noticed, it’s often too late. Unless they have worked with a therapist on managing their anxiety, or are able to have someone close to help them, they are likely to fall further into the cycle of panic as they continue to worry about having a panic attack. Even though panic attacks seldom last longer than ten minutes, sufferers can continue to feel “stuck” in a state of panic for hours.
What results is often a core fear of losing control or going crazy. People with panic disorder fear reaching a state wherein they lose the ability to make rational decisions, or that their body will become overloaded and they will experience a heart attack or a similar medical emergency.
Can Panic Attacks Kill You?
While panic attacks can be very serious and require the help of a qualified professional such as a psychotherapist, there is little evidence to suggest that they can kill you. Even though it might feel like you are having a heart attack, or about to pass out, often these things are not caused by panic attacks but other unrelated medical conditions.
Panic attacks can, however, negatively impact your lifestyle. One common feature of panic attacks is a related condition called agoraphobia, or fear of leaving the house. About one in three people who suffer from panic attacks develop this condition, as a result of concern that they will be unable to escape or get help in the event of a panic attack. This can result in extremes in which case people are unable to take public transport, drive through tunnels, or be in crowded places.
Will Panic Attacks Go Away?
Panic attacks don’t necessarily “go away”, because anxiety itself is a normal part of life that cannot be gotten rid of, like being hungry or tired. However, anxiety disorders are one of the most treatable mental health issues people come to therapy for. Panic disorder can be treated with the help of a therapist.
Treatment for anxiety disorders typically involves exposure to the thing that is causing the fear and anxiety. This is a step by step process that must be done deliberately, but with patience. Most people wish to avoid the anxiety they have, either by distracting themselves or trying to rationalize it. Instead, one needs to embrace the feelings and thoughts they are having, moving towards them and, in the process, recognizing that they aren’t as harmful or dangerous as they seemed.
When it comes to panic disorder, the primary fear is related to the sensations of panic, and their implications. Therefore, treatment for panic disorder typically involves becoming more and more exposed to, and accustomed to, the feelings associated with panic. One step on this journey might mean intentionally raising your heart rate in the presence of your therapist, and then with their help, processing the sensations and experiences you’re having. This in turn can help to improve your tolerance of these sensations, and help to normalize them, decoupling them from the fear of panicking. People with agoraphobia might be tasked with slowly expanding their comfort zone by moving one step beyond the boundary they have set for themselves as a means of testing their fears.
If you’re struggling with panic attacks, it's important to speak to a psychotherapist who can help you to better understand your experience and help you to overcome your fears. While there isn’t any ‘cure’ for panic attacks, with the help of a therapist you can enjoy more freedom and live a much more fulfilling life.
Shaun McMahon is a Melbourne based psychotherapist who offers therapy to people struggling with a range of mental health conditions, including anxiety and panic disorder. He conducts sessions both in person and online, and is currently accepting new clients. If you are experiencing panic attacks and are looking for help, you can arrange a FREE 15 minute consultation by clicking here.
Source: Seif, M. N., Winston, S. (2014) What Every Therapist Needs To Know About Anxiety Disorders: Key Concepts, Insights and Interventions. Routledge: London.