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Are You Having a Panic Attack? What Can You Do?

by Mike on August 19, 2008 · 19 comments

Your heart is pounding, you are trembling, and you feel that you’re going to die!

Are you having a panic attack? How do you know?

And what can you do to reduce the symptoms like choking or nausea?

There’s a lot of confusion over what the symptoms a panic attack actually are. Much of this confusion can be attributed to the media’s misrepresentations of panic attacks and the lack of real knowledge by the general public. This leads to clinomorphisms in which a person will exaggerate their symptoms and call it a panic attack, when all it is is a moment of great surprise or unpleasantness.

The “real” symptoms of a panic attack are detailed in this post, along with a list of suggestions for ways to deal with it while it’s happening. They are excerpted from my full article on panic attacks found under the resources in the right sidebar.

The real, “official,” definition of a panic attack

The DSM-IV is used worldwide

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association is the “official” manual for diagnosing mental illnesses. It is used all over the world. This is the same resource your psychiatrist uses. It details the following criteria for a panic attack as:

A discrete period of intense fear or discomfort, in which 4 (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

1. Palpitations, pounding heart, or accelerated heart rate

2. Sweating

3. Trembling or shaking

4. Sensations of shortness of breath or smothering

5. Feeling of choking

6. Chest pain or discomfort

7. Nausea or abdominal distress

8. Feeling dizzy, unsteady, lightheaded, or faint

9. Derealization (feelings of unreality) or depersonalization (being detached from oneself)

10. Fear of losing control or going crazy

11. Fear of dying

12. Paresthesias (numbness or tingling sensations)

13. Chills or hot flushes

Panic attacks reach a peak within 10 minutes and typically last 15 minutes. However, they may recur rapidly. Once the symptoms are reduced, a severely anxious state may not go away for several hours.

Or maybe you’re having a Limited-Symptom Attack

A Limited-Symptom Attack has 3 or fewer symptoms

A Limited-Symptom Attack is a panic attack that meets all criteria for a “full-blown” panic attack, but has fewer than 4 of the listed symptoms. These are very common in people with Panic Disorder, though they can happen to a person without any diagnosed Anxiety Disorder. People with other Anxiety Disorders may be prone to Limited-Symptom Attacks, particularly those with Social Phobia.

What can I do if I’m having a panic attack?

Relax. Reassure. Breathe.

There are many sources for advice out there that can help you deal with a panic attack as you are having it. Some are genuinely strange. But the better ones mostly boil down to three words: Relax, Reassure, Breathe. 

Here is a short summary of many sources of suggestions for taking care of yourself when you’re having a panic attack. They have worked for me; I hope they work for you:

  • Gently reassure yourself that you are not dying or going crazy. Take deep breaths and repeat this to yourself mantra-like. 
  • Learn and recall the symptoms of panic attacks and one-by-one identify each one you are having, all the while reassuring yourself that the attack will only last a short while.
  • If you are concerned about not being able to breathe or you are choking, tell yourself that if you can talk, you can breathe. Relax your muscles and slow down your breathing. Take deep breaths, hold them and let them out slowly as if blowing out a candle.
  • For trembling and shaking, or numbness and tingling sensations, try shaking the arms and/or legs to help relax the muscles. Tell yourself that the tingling and numbness are caused by the body’s “fight or flight” reaction, which redirects blood to the lungs, brain and large muscles.
  • If you are nauseated or feeling dizzy and faint, try to find a quiet place to sit down and put your head between your knees. Lacking that, seek something that you can steady yourself on, breathe deeply and relax your muscles.
  • Relax your muscles, particularly in the shoulders and neck. Become conscious of any tension that you may be feeling in your muscles. Then progressively tense and relax all the large muscle groups. For example, tighten the muscles in your left leg with a deep breath in, hold it, then release the muscles. Proceed with the right leg, then move up the body, one muscle group at a time.
  • If you are hyperventilating or over-breathing, hold your breath for as long as you comfortably can to prevent the dissipation of carbon dioxide. If you hold your breath for a period of between 10 and 15 seconds and repeat this a few times, it will be sufficient to calm hyperventilation quickly. Alternatively, breathe in and out of a paper bag, which causes you to inhale the carbon dioxide you exhaled. This may not be possible under some situations.
  • Slow down your breathing. This may be done by blowing out each breath through pursed lips as if blowing out a candle. Also, place your hands on your stomach to feel the rapidity of your breathing. 

Don’t just suffer! Get help!

There’s no need to suffer

It cannot be emphasized enough that if you are having panic attacks, you need to seek the help of a mental health care professional as soon as possible. Panic attack treatment has one of the highest success rates of all mental health treatments. However, if left untreated, panic attacks can rapidly escalate into Panic Disorder and Agoraphobia, and a quickly deteriorating quality of life.

What do you think?

I have not had a “full-blown” panic attack in quite some time. More often I have 2 or 3 symptoms that I am able to control by using the suggestions listed above. But it’s taken years to get to this place. Do not do as I did — go it alone — with your panic attacks; get help now!  (Note that this article is excerpted from the full article on panic attacks found under Resources in the right column of this blog. )

  • Have you had panic attacks in the past or are you having them now?
  • Were you able to control them, and if so, how?
  • What advice could you give to others who are having panic attacks?

As always, your comments are welcome!

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Resources used in this post:

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Arlington, VA: American Psychiatric Association. 1994.

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