How often do you experience panic attacks? Have you noticed that your behaviours changed since experiencing them?
Today, I would like to provide you with the background to panic disorder and share some CBT advice on what you can do to start thinking differently about your panic attacks.
Panic attacks which can be a sign of panic disorder are characterised by period of intense fear during which the physical symptoms develop. They reach their peak within around 10 minutes, and the symptoms can include increased heart rate or palpitations, trembling or shaking, shortness of breath, sweating, feeling dizzy, experiencing hot flushes, chest pain or nausea. They are extremely frightening and it is very common to think of the worst-case scenarios when these happen.
Panic attacks can be triggered by external or internal cues. External triggers are when we are affected by something in our surroundings, any cues in our environment for example crowded places or closed spaces. Internal triggers can be physical sensations. Once we are triggered what can happen is we experience anxiety which turns into some physical sensations like becoming dizzy. What makes this panic attack state is the misinterpretation of these physical sensations as catastrophic. For example, instead of recognising that feeling dizzy is caused by anxiety, we may fear that we are going to faint and nobody will help us and so on.
People experiencing panic attacks are highly alert to any bodily sensations and usually develop behaviour changes due to the fear of this happening again for example by avoiding crowded places or behaviours to prevent panic attacks from happening. The problem with this is that you can assign the fact the catastrophic consequence did not happen due to those safety behaviours. Therefore this prevents you from learning that panic attacks are not life frightening. Let’s say you start to develop physical symptoms and you leave a crowded place because this is what you believe keeps you safe. However, you can become reliant on those safety behaviours, therefore your therapist can work with you to stop using them in a gradual way.
What is very important to remember when you struggle with panic attacks is to understand the fight or flight response and understand the physiology when we experience perceived threats. The fight or flight system is developed to protect us from the real danger; however, the side effect is also activated when the threat is perceived. Therefore, if we believe we are truly at risk through any body sensation, we contribute to the development of panic attacks.
Therefore, next time you are experiencing any physical symptoms, rather than give into the catastrophic misinterpretation, try to write down the alternative explanation for those symptoms next to your catastrophic misinterpretations. For example, you can write down if you are experiencing a symptom, for example shortness of breath. Your catastrophic misinterpretation may be: I will stop breathing and I can die, and in the alternative explanation you can put: I am experiencing shortness of breath because of the heart beating faster, as the body needs more oxygen.
One thing to add is please bear in mind this is not medical advice, so it may be helpful to check with your doctor whether there is no underlying physical health condition behind your symptoms so that you can focus on recovery from the panic attacks.