I think I’m having panic attacks. What should I do?

A panic attack is when someone has an episode during which he or she suffers — suddenly, temporarily, and as an isolated event — intense fear or discomfort, without the reason always being clear to them or to those around them; this can happen at any time, without warning. Panic attacks usually don’t last long (they tend to reach peak intensity within 10 minutes), but they are so intense that, for the affected person, they seem to last forever.

Often, people suffering an attack feel like they are in imminent danger of death, and they experience an urgent need to escape from their current location or situation. If they cannot physically escape from the context where they are experiencing this extreme fear, their panic symptoms become even more acute, and on such occasions, the episode can actually last more than an hour.

Symptoms

Panic attacks are characterized by very intense physical symptoms typical of situations of acute stress, even though often no proportional cause is apparent.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (APA — DSM V), in coordination with the National Institute of Mental Health (NIMH), lists various symptoms for diagnosing this kind of crisis:

• Palpitations, pounding heart, tachycardia
• Sweating
• Muscle trembling, shaking
• Shortness of breath, sensations of smothering
• Choking sensations
• Chest pain or discomfort
• Nausea, abdominal distress
• Dizziness, lightheadedness, instability, feeling faint
• Derealization (a sensation of being disconnected from reality), depersonalization (feeling disconnected from one’s own body or thoughts)
• Fear of losing control or going crazy
• Fear of dying
• Numbness, tingling sensations
• Chills, hot flashes.

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How to deal with the symptoms

Controlling panic requires time and patience in order to redefine your attitude towards the extreme fear you are experiencing, so you can understand and face the event that provoked the attack, instead of avoiding it.

One of the strategies that works best for panic attacks consists of applying 10 rules:

• Remember that what you are experiencing is an exaggeration of normal reactions to stress.
• A panic attack is neither dangerous nor harmful as such; it is merely unpleasant. Nothing worse can happen.
• Don’t indulge in additional alarmist thoughts about what is happening or what could happen.
• Pay attention to what your body is actually experiencing at that moment, not to your fears about what could happen later on.
• Wait, and let the fear pass. Don’t fight it; accept it.
• When you stop thinking alarming thoughts, your fear will dissipate on its own.
• Remember that the main thing is to learn to face fear, not avoid it. Take advantage of the opportunity to make progress.
• Think about the progress you’ve made, despite difficulties, until that moment. Think about the satisfaction it will give you to have overcome this episode.
• When you start to feel better, look around and make plans for what you will do when the attack passes.
• When you feel ready to continue your usual activity, take it slowly and calmly. You don’t need to rush or make a great effort.

Lastly, as always when dealing with mental health issues, it’s highly recommended to seek the assistance of a mental health professional, and rely on the support of your trusted family and friends. It’s never a good idea to try to face such challenges alone.

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