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Conquering Panic Attacks

Imagine this: You are a busy, working mom, running late for your first meeting while trying to get your young daughter dressed for school in the one dress she is currently willing to wear. Suddenly, out of the blue, you notice your heart start to beat faster. Not like it felt during the great spin class you took yesterday, but more quickly and almost painfully. Next, you begin to feel dizzy and need to sit down. Your daughter is calling your name from the next room, but her voice sounds muffled. You realize you are suddenly incredibly warm and starting to sweat through your t-shirt. Finally, the pain in your chest begins. This is just too much. Something must be really wrong.

Next steps? You call your husband, tell him you think you’re having a heart attack. He rushes home and brings you and your daughter to the nearest emergency room. You are sure you are dying, but you try to be strong for your family. The waiting is torture. When you are finally examined by the busy emergency room doctor, you are told, “This is anxiety, not a heart attack. Here’s an Ativan. You can go home.”

As a psychiatrist in private practice, I work one-on-one with patients struggling with many different mental health concerns, and over the years they have shared hundreds of their unique stories. However, one narrative I hear is surprisingly consistent: their description of their very first panic attack.

Panic attacks can be terrifying, especially when they occur “out of the blue” and cause such intense physical symptoms and fearful thoughts. However, when I meet with a new patient who is struggling with panic attacks, I always start with the same statement: “Panic attacks are not dangerous. Your body is doing EXACTLY what it is supposed to do when it is facing a threat.” My next phrase? “I can help you.”

I go on to tell them that a panic attack is a surge of your body’s natural adrenaline, (called epinephrine), released by the sympathetic nervous system. Essentially, this is your body’s “Fight or Flight” mechanism. For example, picture yourself driving through the twisting lanes of a country road, and suddenly a deer runs in front of your car. After slamming on the breaks, the physical sensations you may be having: racing heart, faster breathing, lightheadedness, may be the same as during a panic attack, but the EXPLANATION you have (instantly, in this case) is that there is a very good reason for these symptoms. You almost crashed into a deer at 40 mph!

This next point is important enough to repeat: A panic attack is your body’s natural and appropriate response to threat. It just gets triggered at the wrong time. Maybe you were dehydrated after a night out with the girls and little too much chardonnay. Maybe you had been seeing patients on the unit for several hours and forgot to eat. Maybe you were anxious because your kids were going back to school in an uncertain time. Whatever the initial reason, you start feeling shaky or lightheaded, and think “Something must be really wrong.” And that’s all it takes to trigger a panic attack. Once that adrenaline is released, it has to run its course.

After my initial session with a patient struggling with panic attacks, I think “I wish more people knew what a panic attack is, and, even more importantly, what it isn’t: dangerous.” Many individuals with panic attacks notice improvement after our first session, armed with the information I’ve described above. If more people had this understanding to begin with, this would mean fewer lost moments with family, fewer hours distracted and fearing another panic attack, fewer trips to the emergency room. Instead, by the time they come to my office, they may have been struggling with panic attacks for months or even YEARS, slowly removing activities from their lives that they fear might trigger a panic attack (exercise, social gatherings, sex!), and living under the shadow of anxiety.

It’s a vicious cycle, but one that can be broken with a straightforward explanation of why this happens, and the confidence that it is highly treatable. I have seen so many people overcome these experiences and truly move forward with their lives. You are not going crazy, panic attacks are not dangerous, and they don’t have to control you. Help is out there.

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