Content warning: this article contains discussion on mental health.
“I swear I almost just had a panic attack!”
I can’t tell you how many times I’ve heard this phrase and cringed internally. My friends use it to describe anything from a hard test to seeing that boy from last week’s Old K party in the servery. I know for a fact that they haven’t experienced anything close to a panic or anxiety attack, but I let it slide. The phrases “panic attack” and “anxiety attack” have become so commonplace that people forget what they actually mean. Most people don’t know what a real panic or anxiety attack is, much less that they are actually two different things. It can be hard to hear the terms used so lightly for things that can have such an impact on people’s lives. It makes it hard for people to talk about their panic and anxiety attacks because others brush them off as just nervousness or mild anxiety. I thought I would use this article to set the record straight, because the more you know, the more you can help yourself or others when an attack really does occur.
Panic attack
A panic attack is defined in the DSM 5 (the manual mental health professionals use to diagnose patients) as “an abrupt surge of intense fear or intense discomfort that reaches a peak within 10 minutes… [and] can occur from a calm state or an anxious state.” In order to be a panic attack, four or more of the following symptoms must be present:
1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded, or faint
9. Chills or heat sensations
10. Paresthesias (numbness or tingling sensations)
11. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
12. Fear of losing control or going crazy
13. Fear of dying
Panic attacks tend to fall into two different categories: expected and unexpected. Expected panic attacks occur when a person has specific phobias (i.e. claustrophobia or archniphobia) or is exposed to certain panic triggers. For example, a person with claustrophobia may have a panic attack when in small, enclosed spaces, and a person recovering from a traumatic experience may have a panic attack when exposed to things that trigger traumatic memories. On the other hand, unexpected panic attacks occur for seemingly no reason. There are no specific internal or external stimuli that bring on this type of attack. It just happens. In the DSM-V, panic attacks are not diagnoses. They are actually symptoms that indicate either Panic Disorder or a variety of Anxiety, Mood, or Trauma Disorders.
Anxiety attack
An anxiety attack is very similar to a panic attack when it comes to its feeling and symptoms. The same list of symptoms above applies to common symptoms of anxiety attacks. The difference is the cause of the attack. Unlike panic attacks, there is a build-up to an anxiety attack. This is usually defined as steadily increasing worry or emotional distress. This build up can occur over minutes, hours, days, or longer. You do not have to have any sort of disorder to have an anxiety attack, but anxiety attacks are common symptoms of Anxiety and Mood Disorders.
Where people tend to go wrong is that they associate an attack with just plain nervousness or anxiety. Don’t get me wrong, nervousness and anxiety are no fun, but panic and anxiety attacks are a whole different ballgame. The way I differentiate between the two is that nerves and anxiety are feelings. Attacks, as the word suggests, are full-blown physical events. You can feel anxiety and still be able to function. A lot of us will conceal it so that others don’t know how we are feeling. On the other hand, if you are having an attack, it is nearly impossible to function in any type of social or performance situation.
Attacks of any kind can be really scary, both for the person having them and the people around them. In the moment, it can be very hard to know the right thing to do. Here is a list of things to do if you or a loved one has an attack.
Remove yourself or your loved one from the situation.
Contrary to some people’s beliefs, “sticking it out” is not an option during a panic attack. Nope, not happening. The best thing to do is to leave the situation and go somewhere quiet to ride out the wave.
Remember your medication, if you take it.
This can be hard to do in the middle of an attack, so it is best to keep your meds on you at all times, just in case. Remember, if you have a prescription, you have it for a reason. Take care of yourself.
Sit down and breathe.
An attack is a physical event happening in your body. The best and first thing to do is to get your physical symptoms under control. Attacks trigger your sympathetic nervous system, or your fight or flight response, which is where all of your symptoms come from. To counteract this, you need to trigger your parasympathetic nervous system. The easiest way to do this (and ease is key during an attack) is to focus on your breathing. I know its hard, and I know a lot of people hate to hear this during an attack, but it is very effective and worth a try. Try your best to take slow, deep breaths. There are many different breathing techniques, but my favorite is 4×4 breathing. It is basically just a fancy name for breathing in for 4 counts and out for 4 counts. Do this for a while until your symptoms become more manageable.
Take a recovery period.
Just because your heart isn’t beating out of your chest anymore and you can finally see straight does not mean you should go back to the situation. Remember, attacks are intense physical events and your body needs to recover. It can be detrimental to force yourself back into things without a recovery period, so don’t let people convince you that you have to go back. Go to your room and listen to music. Take a nap. Shower. Taking care of yourself should be your first priority.
This article isn’t meant to devalue anyone’s problems or their day-to-day experiences, but it is meant to inform on the realities of these issues. It’s important to be aware of the language we use and to be sensitive to everyone’s experiences. Ultimately, I hope this article was helpful to those of you who are going through hard times.