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Panic Attacks and Things That Go Bump in the Night

by Dr. Dorothy McCoy (2002)

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Panic attacks are extremely frightening. Panic sufferers often believe they are having a heart attack and they dash to their physician or end up in an emergency room. Which is exactly what they should do. An accurate diagnosis is the first step in relieving panic attacks. A diagnosis is vital, because panic attacks mimic a number of potentially serious physical disorders. The next step is treatment. No one should have to endure repeated episodes of distressing panic. Furthermore, early treatment may prevent the condition from becoming chronic.

Not all panic attacks are created equal. The symptoms are unique to the individual sufferer. However, according to the Diagnostic and Statistical Manual of the American Psychiatric Association, typical symptoms are:Racing or pounding heart:

Sweating, flushing or feeling chilled
Chest pains or tightness
Difficulty getting your breath, or a sense of smothering or choking
Dizziness, light-headedness, tingling or numbness
Trembling or shaking
Nausea or abdominal discomfort
Fear of losing control

Sometimes panic attacks appear to come out of the blue without rhyme or reason. This is not true with a phobia, such as agoraphobia, which has a distinctive pattern. Agoraphobics may have an attack in situations from which escape is difficult or embarrassing (i.e., on a bridge, a crowded theater). Someone who is fearful of flying may have a panic attack while entering an airplane, or perhaps, while contemplating a flight. The person could then become frightened by the "idea" of having another panic attack. The panic attack itself becomes the feared event. He or she begins to avoid situations that are associated with the attacks. This can become a distressing pattern from which it is difficult to break free.

Cognitive theorists believe that our thoughts create our anxiety. Consider these examples for a moment. A professional athlete consistently felt his chest constrict and his heart pound whenever he passed through a tunnel. A woman walking her dog in a park a couple of blocks from her home suddenly felt faint. If one were to ask the athlete what he thought immediately before the symptoms began, he might say, "Tunnels can collapse. If this one collapses I will be buried alive. I won't be able to breathe." As he envisaged potential engineering blunders, a visualization of a collapsing tunnel brusquely flashed through his mind. He gasped for breath.

Let's return to the woman in the park. She might answer, if asked about her thoughts before she felt faint, "I am too far from home to cry out if someone jumped from the bushes and grabbed me. No one would hear me. I could be killed." Simultaneously, she visualized a huge Neanderthal of a man lunging for her. It is very likely that their thoughts and visualizations contributed the material to which they reacted. According to Aaron T. Beck (1976), we can learn to "observe that a thought links the eternal stimulus with the emotional response." In other words, "tunnel" does not signal danger, until the thought "It will collapse" links to it--stimulating the emotional response--anxiety.

As stated previously, panic attack symptoms are frightening, especially when one does not understand why one's body is reacting in such a bizarre manner. A panic attack is an example of one's body doing what it was designed to do, yet, at an inappropriate time. The attacks are part of the body's cautionary or alarm system. It is saying, "Be alert, there is danger-react!" The autonomic nervous system cannot differentiate between a genuine physical danger (an 18 wheeler running amuck) and environmental stress "created" by life in the worldwide web century. Heredity, other biological factors, stressful life circumstances, and thought patterns that create needless stress combine to encourage the onset of panic attacks. The specific panic mechanism is unknown, however, be assured researchers are eagerly seeking the answers.
Is there any good news? Yes, panic attacks can be, and frequently are, successfully treated. Cognitive-behavioral therapy and medication are commonly the recommended treatments. Anti-anxiety medication works rapidly to relieve distressing symptoms. Cognitive-behavioral therapy contributes tools with which to cope more adaptively, thereby, reducing the likelihood that panic attacks will reoccur.

What can you do if you are currently experiencing panic attacks? Here are a few suggestions:

Don't be frightened-panic attacks cannot harm you.
Write everything you can remember about your attack immediately after it passes (You will gather important information about when, where and under what circumstances your attacks occur.).
Watch those scary thoughts (The tunnel will not collapse. That is a safer bet than the lottery.).
Repeat to yourself, "I will not look crazy, faint, die or lose control."
Try deep breathing. Breathe in through your nose, hold it a few seconds, and then breathe out through your mouth. We tend to breathe in shallow, rapid little breaths when we are anxious, which can exacerbate the problem.
Get professional help.

Panic attacks are not an infrequent stress reaction. Panic sufferers have an abundance of company. According to the National Institute of Mental Health, approximately 3 million Americans will have panic disorder at some time during their lives.

Research studies indicate that a healthy body is a great advantage in successfully coping with stress. One does not have to be Arnold Schwarzenegger to be healthy. Simply strive to be your healthiest. Nutritional intake, exercise, quality sleep, supportive relationships, spirituality and adaptive coping patterns contribute to your overall wellness. If you are not sure how to be healthier, perhaps, you would like to learn more. There is a wealth of wellness information on the Internet and in your neighborhood bookstores.

If you are experiencing panic symptoms and have not consulted your primary care physician for a diagnosis-- please call him or her today. You will be glad you did.

Dr. Dorothy McCoy (2002)
Psychotherapist and author of self-help books, workbooks, CDs and e-courses on anxiety and other health issues. Website: or

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