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What Causes Panic Attacks And How To Treat Them

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Panic Attack: Causes And Treatments

A sudden surge of overwhelming anxiety and fear - panic attack - may trigger when thinking about or facing the feared object or situation. However, regular attacks with no obvious reasons as such (panic disorder) could be traced to traumatic life events and catastrophic thinking. Practicing yoga, meditation, or opting for cognitive behavioral therapy may help.

A panic attack can leave you overwhelmed with anxiety or fear. An attack can come on suddenly and you might find yourself trembling and sweating with terror. You may also get chest pains and find it difficult to breathe. It is estimated that around 6 million adults in America suffer from panic disorder in a year, where they experience panic attacks regularly, usually for no obvious reason. This condition typically develops during early adulthood and women have a greater chance of getting it than men.1

Children and teenagers can experience panic attacks too. Panic attacks in children can lead to crying, screaming, and hyperventilation.2 However, this condition is more common in teenagers. In fact, according to estimates, 2.3% of 13- to 18-year-olds have experienced panic disorder.3

Let’s take a look at the factors that could lead to panic disorder and how you can deal with this condition.

What Causes Panic Attacks?

Some people get panic attacks when they’re faced with an object or situation that they fear unrealistically (a phobia). People can develop phobias about a wide range of things like spiders or going to the dentist. Other people get panic attacks regularly for no apparent reason. This is specifically known as panic disorder. We don’t yet know the exact causes of panic disorder but a combination of psychological and physical factors have been implicated.

1. Traumatic Life Events

Traumatic events like the loss of a family member can sometimes set off anxiety or panic. These feelings may be experienced immediately after the event or unexpectedly surface years later.

2. Imbalance In Neurotransmitters

Neurotransmitters are chemical messengers which transmit information through the body and brain. According to experts, an imbalance in these chemicals can up your risk of developing panic disorder.

3. Genetics

You may have an increased risk of developing panic disorder if a close family member has it. Therefore, your genetic material may have a role in the occurrence of this condition.

4. Sensitivity To Carbon Dioxide

It has been observed that breathing in higher levels of carbon dioxide can trigger panic attacks. According to some experts, panic disorder is associated with a stronger sensitivity to carbon dioxide.

5. Engaging In Catastrophic Thinking

According to one theory, engaging in catastrophic thinking, that is, imagining the worst possible outcome can play a part in a panic attack. It is thought that interpreting minor physical sensations catastrophically can trigger a response from your nervous system and lead to a panic attack.4

Can You Have A Panic Attack In Your Sleep?

Panic attacks may also occur while you’re sleeping, startling you awake. This phenomenon is known as a nocturnal panic attack. It happens if your brain is extra alert because of anxiety and perceives small bodily changes to be signs of danger. Panic attacks during the night can be especially frightening and you may feel confused and helpless when it happens.5

According to research, people who experience panic attacks in their sleep have more respiratory symptoms of panic like difficulty in breathing.6 Experts are also of the opinion that conditions like sleep-related gastroesophageal reflux disease (which causes heartburn, leading to a reflexive increase in respiration where you take short gasps of breath); obstructive sleep apnea (where you have trouble breathing during sleep); and sleep-related laryngospasms (where your vocal chords block your airway, making it difficult for you to breathe) are linked to nocturnal panic attacks.7

How Do You Treat Panic Disorder?

what causes panic attacks and how to treat them

Your doctor may advise medication, psychotherapy, or a combination of both for the treatment of panic disorder. Where children or adolescents are concerned, your doctor may veer toward psychotherapy as certain medications used to treat this condition may not be suitable for them.

Let’s take a look at some therapeutic approaches which can be helpful if you have this condition.

1. Go For Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is considered to be the most effective therapy for panic attacks. This therapy focuses on thought patterns or behaviors that trigger or sustain panic attacks and aims to change them. It helps you look at your fears more realistically.

One favored technique used during CBT for panic disorder is exposure therapy. During this, your therapist exposes you to physical sensations of panic in a safe space. Through the experience of facing a fearful situation, you realize that the situation is not harmful and that you can control your emotions and cope in a healthy way. For instance, your therapist may ask you to hyperventilate, hold your breath, or shake your head from side to side, triggering bodily sensations that are similar to those experienced during a panic attack. And with each exposure, your fear of these sensations decreases and you gain more control over your sense of panic. Exposure therapy is also helpful for people with phobias.8

2. Try Eye Movement Desensitization And Reprocessing Therapy

According to research, eye movement desensitization and reprocessing (EDMR) therapy can reduce the frequency of panic attacks. It also decreases the fear of physical sensations that usually occur during an attack in people with panic disorder.9

In this psychotherapy approach, the therapist asks you to keep the memory of an anxiety-triggering stimulus in your mind while tracking the movement of his/her finger from one side to the other with your eyes. This lateral eye movement has been found to result in changed emotions or thoughts. Other forms of alternating bilateral stimulation like audio stimulation or physical taps can also be used.

We don’t know exactly how this works. But experts have suggested that factors like relaxation, distraction, synchronization of the two hemispheres of your brain and simulation eye movements seen during rapid eye movement sleep (REM sleep) could be at play.10

3. Go For Art Therapy

Art therapy combines psychological techniques with creative processes such as drawing, painting, and sculpture to improve mental health. Since imagery plays a role in anxiety disorders art therapy used along with CBT can be a helpful treatment. For instance, one study found that a patient who had panic disorder with agoraphobia (fear of getting trapped in a place with no escape or access to help) and avoided driving friends on a road trip due to the fear of experiencing a panic attack was able to judge the likelihood of her fears when she created a drawing of the road trip. The process of drawing served as imaginal desensitization, which involves visualizing what you’re fearful of while in a relaxed state. It also made her more excited about positive aspects of the road trip.11

4. Practice Yoga

Yoga is an ancient holistic system of mind–body practices from India. It involves techniques like controlled breathing (pranayama), physical postures (asana), deep relaxation (yoganidra), and meditation (dhyana). According to one study, people with panic disorder showed a significant decrease in anxiety levels, panic-related body sensations, and panic-related beliefs when they practiced yoga. It’s noteworthy that these benefits were even greater when yoga was combined with CBT.12

5. Join A Support Group

Joining a support group can be helpful if you get panic attacks. Meeting other people who are going through the same thing reassures you that you’re not alone. The experiences of other people can also provide useful information on how to manage your condition.13

6. Practice Self-Help Techniques

Here are some things that you can do yourself to deal with panic attacks:

Learn About Panic Disorder

Finding out more about panic and anxiety can in itself help you deal with it better. You’ll understand that you’re not going crazy and that the scary thoughts and sensations that you experience during an attack are only momentary and will pass.

Learn To Control Your Breathing

Hyperventilating can bring on sensations like lightheadedness and also worsen feelings of panic. Try to breathe deeply and slowly. This is an important coping skill that can help calm you.

Confront Your Fear

When you get a panic attack, try to identify the fear at the root of it and challenge it. You can do this by reassuring yourself that your fear is not real and that it will pass in a while.

Visualize And Focus

Many negative thoughts can come to your mind during a panic attack. Instead of allowing them to take over your mind, visualize a situation or place that makes you feel relaxed and focus on that. You can also focus on something non-threatening like items placed on a shelf or the moving hands of a clock to distract yourself during an attack.

Let It Pass

Don’t try to fight a panic attack. Finding yourself unable to resist it can only increase your anxiety. Instead, reassure yourself that the attack isn’t dangerous and that it will end in a little while.

Adopt Relaxation Techniques

Activities like deep breathing practices, yoga, and meditation can make your body’s relaxation response (the opposite of the stress response that you have when you panic) stronger. This can be helpful in dealing with the constant anxiety that you might experience about when the next panic attack may occur. You might also find aromatherapy or massage to be useful in helping you relax.

Exercise Regularly

Exercising regularly can lower stress and stimulate the release of the chemical serotonin which improves mood. Adults are advised to get in at least two and a half hours of moderate-intensity aerobic exercise (for instance, brisk walking or cycling) every week. You can also do muscle strengthening exercises for a couple of days a week. But do check in with your doctor before you start an exercise program if you haven’t exercised in a while.

Have A Healthy Diet

Unstable sugar levels, alcohol, caffeine, and smoking can contribute to panic attacks in people who are vulnerable. So, eat a healthy balanced diet and avoid stimulants like cigarettes, alcohol, and coffee as well as sugary drinks and food.14 15

References   [ + ]

1. Panic Disorder & Agoraphobia. Anxiety and Depression Association of America.
2. Panic disorder – Complications. National Health Service.
3. Panic Disorder Among Children. National Institutes of Health.
4. Causes of panic disorder. National Health Service.
5. Anxiety and panic attacks. Mind.
6. Sarísoy, Gökhan, Ömer Böke, Ali C. Arík, and Ahmet R. Şahin. “Panic disorder with nocturnal panic attacks: symptoms and comorbidities.” European Psychiatry 23, no. 3 (2008): 195-200.
7. Panic Attacks and Sleep Disorders. Sleep Review.
8. Panic Attacks and Panic Disorder. Helpguide.
9. Goldstein, Alan J., and Ulrike Feske. “Eye movement desensitization and reprocessing for panic disorder: A case series.” Journal of Anxiety Disorders 8, no. 4 (1994): 351-362.
10. EMDR: Taking a Closer Look. Scientific American.
11. Morris, Frances J. “Should art be integrated into cognitive behavioral therapy for anxiety disorders?.” The Arts in Psychotherapy 41, no. 4 (2014): 343-352.
12. Vorkapic, Camila Ferreira, and Bernard Rangé. “Reducing the symptomatology of panic disorder: The effects of a yoga program alone and in combination with cognitive-behavioral therapy.” Frontiers in psychiatry 5 (2014): 177.
13. Panic disorder – Treatment. National Health Service.
14. Panic disorder – Self-help. National Health Service.
15. Panic Attacks and Panic Disorder. Helpguide.