Panic attacks are surprisingly common. More than 1 in 4 adults (28%) in America have experienced at least one panic attack in their lifetime. About 1 in 20 adults (5%) have been diagnosed as having recurring panic attacks.
Here is how some people describe panic attacks:
“I was driving alone when I began to feel clammy. My hands started tingling, my heart began racing, and my vision blurred. I felt pain in my chest and arm. I was struck with the thought that I was going to die. My thoughts started to spin faster and faster – was it a heart attack, a stroke, an allergic reaction? It took everything I had to pull the car to the side of the road. I sat there feeling sure I would die for about an hour. After it passed, I felt completely exhausted.” – Emma*, age 19
“I was at work and the conference room got pretty crowded. All of a sudden, I felt trapped. A voice in my head told me I had to run outside the building. My muscles were tense and my legs were practically twitching. I felt hot all over. My throat tightened up, as if someone had wrapped their hands around it and was choking me to death. I started to breath very fast and felt lightheaded. I did manage to leave the room without running. When I got outside, I slumped down under a tree, feeling sure I was about to die. It was at least a half hour before I started to calm down.” – Carlos*, age 44
Symptoms of a Panic Attack
According to the American Psychological Association, a panic attack is an abrupt surge of intense fear or intense discomfort in the absence of actual danger. Panic attacks can last anywhere from a few minutes to many hours, although the average length is around 30 minutes.
A panic attack associated with some or all of the following physical sensations:
- Palpitations, pounding heart, or accelerated heart rate
- Trembling or shaking, either all over or in some parts of the body
- Sensations of shortness of breath or smothering
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, light-headed, or faint
- Chills or heat sensations
- Numbness or tingling sensations, either all over or in some parts of the body
- Derealization (feeling like the world isn’t real or other people aren’t real)
- Depersonalization (feeling detached from your body or like you are observing yourself from outside your body)
- Fear of losing control or “going crazy”
- Fear of dying or being convinced that you are dying
The symptoms can range in intensity from mild, which feels distressing but tolerable, to very severe, which feels terrifying and painful to the point that that the person would want to go to the hospital.
What Causes Panic Attacks?
Humans have complex brains that are capable of logical reasoning, emotional connection, communication, and problem solving. However, deep in the brain, there are very primitive areas that help you respond to threats in your environment. These primitive areas are similar to those found in the brains of animals, including dogs, mice, and even lizards. These “lizard brain” areas control blood pressure, breathing, heart rate, temperature, and the physical sensations that signal “fear” in the body so that you can respond to danger and survive.
Panic attacks arise from one of these primitive parts of the brain. This part is called the amygdala, and it is located near the base of the brain, just above the spinal cord. When the amygdala senses a threat in the vicinity, it will trigger a survival response that is completely out of conscious control. Your body floods with hormones and chemical messengers to prepare it react in one or more of the following ways:
- Fight: turn and face the perceived threat aggressively.
- Flight: run away from the danger.
- Freeze: hold still, play dead, be quiet and wait for danger to pass.
- Fawn: try to please the aggressor in order to avoid any conflict.
The body reacts almost instantly, without any thinking or reasoning. Your heart will beat faster and you will breathe rapidly to prepare for flight, while at the same time your emotions of anger and fear will run high to prepare for a fight or to try to please the aggressor. Energy will be sent to your muscles so they are ready to respond rapidly however is needed, and you may tremble or shake.
This survival response is very helpful when the threat is a tiger jumping out at you. However, it’s not helpful when the threat is job stress, relationship conflict, parenting difficulties, phobias, or reminders of past traumas. The reality is that our world today is filled with threats for which the survival response is not only useless, it actually makes things worse for many people. When the survival response is triggered seemingly at random, the result can be panic attacks that feel like they come completely out of the blue.
Panic attacks are frightening. Sometimes, people that have panic attacks may start to have anxiety about having more panic attacks. This can lead to withdrawal from social situations and attempts to change the daily routine to avoid anything that might trigger them. When someone’s life is negatively impacted by efforts to avoid panic attacks, it is called panic disorder. Panic disorder can interfere with school, work, social functioning, and even normal activities of daily life (shopping, errands, driving, etc.)
Treatment for Panic Attacks and Panic Disorder
Because panic attacks are triggered deep in the primitive areas of the brain, they happen without any thinking or reasoning. Therefore, stopping a panic attack and reducing the number of panic attacks you have is not something that can be done easily with thinking or logic. When you are panicking, another person telling you, “You’re fine! Calm down!” is useless at best, and can actually cause a panic attack to worsen.
The key to calming down the “lizard brain” is to talk to it in the language it can understand. This may involve breathing exercises, physical activity, body movements, temperature shifts, or visualization, among other options. Here at the Rollins Counseling Center, our clinicians have specialized training in helping people learn a variety of skills and tools to stop panic attacks and to help prevent future panic attacks. We can also work with you using evidence-based treatments to get back into a normal routine if your life has been altered in your effort to avoid panic attacks. Please reach out today! It’s time to get your life back and feel confident again!
* Names have been changed to protect privacy.
References and Further Reading
American Psychological Association (2022). Panic Attack. Dictionary of Psychology.
American Psychological Association (2022). Panic Disorder: Answers to your most important questions.
Kessler, R.C., Chiu, W.T., Jin, R., et al. (2006). The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Archives of General Psychiatry, 63(4), 415–424.
Johns Hopkins Medicine (2022). Brain Anatomy and How the Brain Works.