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Panic attacks usually come without warning and without an apparent cause. The unpredictability of panic attacks often adds to the stress of dealing with them. The sufferer dreads a repeat of the unpleasant experience, and he or she may develop a fear of having another attack, in addition to the initial disorder.
The basis of panic attacks is fearful thoughts, often barely conscious to the sufferer, such as “No one will ever love me,” or “If I lose my job my life will be over.” These type of thoughts can be difficult for people to identify as fearful thoughts, since they seem perfectly logical to them. However, most people strongly want to avoid fearful feelings. Ironically, avoidance of the fearful thoughts exacerbates the panic attacks, creating even more fear in the individual.
Symptoms of Panic Disorder
When we are threatened with physical danger, the body’s natural defense system, called “Fight or Flight Response” gets activated, causing adrenaline to be released into the bloodstream. However, the same fear response is triggered during a panic attack, even though no physical danger is present.
A panic attack seems to come “out of the blue,” but it is actually a physical reaction to extreme anxiety (conscious or unconscious), and is triggered, in the moment, by fearful thoughts that the sufferer is avoiding feeling. The acute body sensations that accompany a panic attack are usually misinterpreted by the person as dangerous, catastrophic or life-threatening.
A panic attack is a cycle of intense anxiety that starts with a sudden perception of danger or a threat, even though there is no physical evidence of it. This frightening thought is immediately followed by a surge of adrenalin, which causes physical sensations, such as accelerated heart rate, rapid or difficult breathing, dizziness, shaking, hot or cold flashes, nausea and a choking or smothering sensation, that escalate the frightening experience, especially when they come without warning.
There are secondary, emotional symptoms of fear and dread, where the sufferer believes their distorted interpretation of the panic experience, or recognize the irrationality of their fears (that no danger is actually present), but feel helpless to do anything about them.
People having panic attacks regularly show up in Emergency Rooms, thinking they are dying or having a heart attack, since there is usually no obvious reason for their physical symptoms.
There is a mental, or psychological, aspect of panic attacks, where sufferers describe having a “sense of unreality,” feeling out of control, or having thoughts such as, “I’m going to die” or “I will go insane.” Some who experienced an attack while driving their car, believed they will faint while driving in traffic. These erroneous thoughts are fueled by a lack of awareness of the nature of panic attacks and not understanding of what is happening to them; and they contribute to a sense of dread of repeating the panic experience in the future.
The mistaken belief that the sufferer is out of control, may do something irrational or dangerous, or harm themself or others adds to intensity of the anxiety and unpleasantness of the experience. However, none of these things will actually happen – outside of the sufferer’s imagination. For example, in the case of fear of fainting, only a sudden drop in blood pressure will cause a person to faint; anxiety causes one’s blood pressure to rise, which makes it nearly impossible for them to faint.
Some possible causes of panic attacks are: physical illness, major stress, hormonal imbalances and underlying emotional or psychological factors, such as, serious relationship problems, worry about finances, legal problems, trauma, PTSD – Post Traumatic Stress Disorder, and physical or emotional abuse.
Research shows that panic attacks are often connected to major life transitions, such as marriage, divorce, a first child, school graduation, a new job, etc. But, the cause of a panic attack can be biological, behavioral or psychological.
Physical causes may include hormonal imbalance, a brain or inner-ear dysfunctions prescription-medication side effects or a physical illness. Panic attacks can also be triggered by major stress and underlying emotional or psychological factors, such as serious relationship problems, worry about finances, legal problems, past trauma (PTSD – Post Traumatic Stress Disorder), physical or emotional abuse, or a combination of these factors.
Managing and Treating Panic Disorder
How EMDR Works
Copyright 2011 by Carol Boulware, Ph.D.
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