Counseling Center

University of Mississippi

Panic Attacks

Are you having panic attacks?

If you can relate to the story above, you might suffer from panic attacks. Taking this handy questionnaire can help determine whether you’re having panic attacks and how severe they are. You might want to print it out, since you can’t fill it out on-line.

1. Do you have sudden surges of intense fear, terror or dread that strike for no apparent reason?

2. During these episodes, do you feel one or more of the following physical symptoms?

  • Heart racing, pounding or skipping beats?
  • Tightness, pressure, or discomfort in your chest?
  • A lump in your throat or choking sensation?
  • Shortness of breath or erratic breathing?
  • Light-headedness or dizziness?
  • Tingly, prickly sensations or numbness in parts of your body?
  • Shakiness or trembling?
  • Increased sweating?
  • Nausea or butterflies?
  • Hot flashes or chills?

3. During these episodes, do you think any of the following things?

  • that you’re sick, dying or going crazy?
  • that you might throw up, suffocate, or have a heart attack?
  • that things seem unreal or that you are detached from your body?
  • that you must escape or flee the situation?
  • that you might lose control and embarrass yourself in front of others?

4. Even when you’re not having a panic attack, are you nervous because of worrying about future panic attacks?

5. Do you avoid certain places or situations for fear they’ll trigger a panic attack?

If you answered “Yes” to Question 1 and checked off one or more symptoms under Questions 2 and 3, you may be having panic attacks. If you also answered Yes to Questions 4 or 5, panic attacks are beginning to interfere with your daily life even when you’re not panicking. If any of these questions hit home, this brochure is for you.

You’re Not Alone…

If you’ve been having panic attacks, you’re not alone. Panic attacks are actually very common. At least 3 million people in the United States report having panic attacks. There are probably many more people who are affected but never seek help or never label their problems as panic attacks.

What Is a Panic Attack Anyway?

A panic attack is an intense physical and mental chain reaction. It can begin with a simple bodily sensation or a thought about something threatening. Within seconds, a chain reaction is underway, involving fearful thoughts, escalating physical reactions, and feelings of terror and desperation. In most cases, a panic attack will start with a variety of symptoms and peak within 10 to 15 minutes before gradually tapering off. The aftereffects, however, can last a long time. Sometimes, it can take a day or so just to get back to your usual mental and physical state after a panic attack. Over time, panic attacks can begin to alter the way you think, behave and feel in your everyday life, even when you’re not having an actual panic attack.

One way to think of a panic attack is as a “false alarm.” We all have a built-in system that’s supposed to alert us to danger so that we’re ready to either defend ourselves (fight) or escape (flight). It’s the old “fight/flight response.” We need this alarm system so that we don’t get eaten by bears, flattened by busses, or whatever. But when you have a panic attack, your alarm system goes off without any real danger. It’s like a “false alarm” that goes off, signaling danger that isn’t really there or is much less serious than your reaction suggests. It’s kinda like those car alarms that go off in the middle of the night because a cat jumps on the car, or the wind blows, or someone sneezes two blocks away . . . kind of annoying!

Anyway, while the specific causes of panic attacks are not known, experts think a lot of different factors probably contribute to panic attacks. For example, some people may just be more physically susceptible to panic due to their biological makeup. Their alarm responses may be more sensitive than others’ or they may be more “tuned-in” to their bodies in ways that increase their chances of having “false alarms.” For other people, experiences of trauma or abuse may increase their chances of reacting to future events with a “hair triggered” alarm response. In other cases, a person’s tendency to bottle up emotions, like anger, sadness, or grief, may lead to an increase in stored-up tensions that later come out as panic. Still other people experience panic attacks because of the effects of certain drugs on their minds and bodies.

GOOD NEWS, BAD NEWS

First, the Bad News:

It sorta goes without saying that panic attacks are pretty unpleasant and really scary. What’s worse is that, once panic attacks have happened, your mental and emotional reactions to them may actually increase the odds of their happening again. It happens like this-during a panic attack, you think scary thoughts, like “This’ll never stop,” or “I’m gonna die, go crazy, or publicly embarrass myself.” Once you’ve had a panic attack, you might naturally start to worry about having another one. You expect that next time, it WON’T end, or you WILL die or go crazy or embarrass yourself.

This type of worry can actually heighten your physiological arousal level and make it easier to have future panic attacks. It’s like walking around with a totally full cup of coffee all the time-you’re a lot more likely to have spill-over when you’re brimming full with anxiety. (Incidentally, you’re also more likely to have panic attacks when you’re brimming full of coffee, but we’ll get back to that later . . . .) Anyway, one of the worst things about panic attacks is the fear and anxiety about having more panic attacks. This “fear of fear” can become so intense that you begin to avoid certain people, places, and activities for fear of having another panic attack. Eventually, some people even have trouble leaving their homes because of the fear of panic attacks!

It’s easy to see how panic attacks can be so upsetting and life-altering that many people become depressed or turn to alcohol or drugs as a result. Ironically, drugs and alcohol often only serve to increase problems with panic and depression.

Whoa, enough bad news! How ’bout the Good News?

You Can Get Help!! People who seek treatment for panic attacks have VERY good chances of having success. In fact research shows that 70 to 90% of people who seek treatment and follow through with it will experience relief.

The treatment of panic attacks usually involves learning new skills. Once you learn these skills, you can practice them on your own. Since the skills are relatively easy to master, you can be sure that you’ll know what to do when a panic attack starts and how to reduce the likelihood of future attacks.

5 Steps to help you with Panic Attacks

Here are 5 steps that have proven to be helpful to a whole bunch of people who experience panic attacks.

Step 1: R-e-l-a-x…

One step that helps lots of people get a handle on their panic attacks is to learn and practice relaxation strategies. Here are three different types of relaxation strategies you can try:

First, try changing your breathing patterns. Stress often causes us to breathe shallowly. Unfortunately, breathing shallowly can actually prolong stress by depleting your oxygen supply and increasing muscle tension. This can lead to headaches, nervousness and a lowered threshold to panic attacks. To overcome this, practice monitoring your breathing and noticing when it becomes shallow or rapid. When this happens, take a minute to slow down, get comfortable, and breathe deeply. Begin this process by slowly but forcefully blowing all of the air out of your lungs, deep-down into your belly. This allows you to slowly and effortlessly “refill” your lungs with fresh air. Try breathing in through your nose and focusing on filling the bottom of your lungs first before filling the top. As you breathe in, your abdomen should rise slowly; and, as you breathe out, it should fall slowly. Gradually breathe more deeply and more slowly until you reach a comfortable plateau. Sighhh . . . .

A second technique is to scan your entire body, tensing and relaxing all your muscles. Begin by sitting in a chair with your feet flat on the ground. Focus on your feet and notice any muscle tension in your feet or toes. Tense your feet muscles by curling your toes like you’re trying to dig into the carpet. Tense the muscles for a five-count, then allow them to go limp and release all the tension. It helps to exhale deeply and think the word “relax” at the moment you release the tension. After relaxing your feet, move up to your calves, tense and release. To your thighs, tense and release, and so on. Try to move through all of the following muscle groups: your feet, calves, thighs, “glutes,” abdomen, lower back, chest, upper back, neck and shoulders, and finally, facial muscles. To tense up your facial muscles, squint hard and press your lips together (think Clint Eastwood), then just let your face go slack and expressionless. When you’ve completely covered your entire body, your muscles should feel warm and relaxed. Ahhhhh….

Finally, try taking a “mental vacation.” No, not a trip to the Betty Ford clinic-just an imaginary visualization of a peaceful place. Mental imagery can be a great way of creating peaceful feelings. Start by imagining a peaceful, serene setting. Perhaps this will be someplace you’ve gone before where you felt totally calm and relaxed. Or maybe it can be a fantasy place with all the ingredients to help you relax and unwind. Once you’ve imagined this fantasy place, take a “sensory inventory” by asking yourself: “What do I see that’s peaceful or beautiful?” “What do I hear that’s soothing?” “What do I smell that reminds me of pleasant, peaceful feelings?” “What do I feel on my skin (is it warm, cool, breezy, still?)” and “What do I taste?” For example, someone who loves the beach might think about seeing a beautiful sunset over the water, hearing the waves gently lapping at the shore or the seagulls peacefully calling, smelling the scent of suntan oil, feeling the warmth of the sun and the gentle breeze, and tasting the salty air….Ahhhhh….

Imagining each of these sensations in detail actually helps to create the same peaceful feelings in your body that you’d experience if you were actually at the beach. Plus, no sand in your undies!

By themselves, deep breathing, muscle relaxation, and mental imagery can be very powerful. When you put them all together, you’ve got a combination that can melt away your physical tension and anxious thoughts and replace them with peace and relaxation.

Step 2: Change Habits

Sometimes it helps to make some changes in your daily routine, like adding exercise and reducing or eliminating stimulants like caffeine, nicotine and sugar. Exercise helps to burn off excess tension that might otherwise come out as anxiety or panic. Eliminating stimulants, like caffeine, helps prevent your cup from “running over” with anxiety.

If you tend to bottle up your feelings and worry a lot by yourself, it may be helpful to pay more attention to your emotions and become more willing to express them to others.

Step 3: Discover The Power of Positive Thinking

Another way of tackling panic attacks is to look at the way you talk to yourself, especially during times of stress and pressure. Panic attacks often begin or escalate when you tell yourself scary things, like “I feel light-headed . . . I’m about to faint!” or “I’m trapped in this traffic jam and something terrible is gonna happen!” or “If I go outside, I’ll freak out.” These are called “negative predictions” and they have a strong influence on the way your body feels. If you’re mentally predicting a disaster, your body’s alarm response goes off and the “fight-flight response” kicks in.

To combat this, try to focus on calming, positive thoughts, like “I’m learning to deal with panicky feelings and I know that people overcome panic all the time” or “This will pass quickly, and I can help myself by concentrating on my breathing and imagining a relaxing place” or “These feelings are uncomfortable, but they won’t last forever.”

Sometimes it’s helpful to remind yourself of these FACTS about panic attacks:
  • A panic attack cannot cause heart failure or a heart attack.
  • A panic attack cannot cause you to stop breathing.
  • A panic attack cannot cause you to faint.
  • A panic attack cannot cause you to “go crazy.”
  • A panic attack cannot cause you to lose control of yourself.

If it’s too hard for you to think calming thoughts or to concentrate on relaxation strategies when you’re having a panic attack, find ways to distract yourself from the negative thoughts and feelings. Some people do this by talking to other people when they feel the panic coming on. Others prefer to exercise or work on a detailed project (such as gardening, deep cleaning your bathroom, sheep shearing, or reenacting historic naval battles with scale models constructed entirely from paper clips and Junior Mints). Changing scenery can sometimes be helpful, too, but it’s important not to get into a pattern of avoiding necessary daily tasks. If you notice that you’re regularly avoiding things like driving, going shopping, going to class, or taking buses, it’s probably time to get some professional help.

Step 4: Getting Help

You might find that dealing with panic attacks will be easier if you have a person who can act as a coach as you learn how to cope with the attacks. Meeting with someone who has experience working with panic attacks and anxiety can help you find the right mixture of strategies that will work for you. This might be a therapist, psychiatrist or family doctor. Here at UT, you can come to the Counseling & Mental Health Center and talk to a counselor about different ways of overcoming panic attacks. In individual counseling, group counseling, or a combination of the two, you’ll probably be able to learn the skills and develop the self-understanding you need to overcome your panic. If you’d prefer to remain anonymous or to talk to a counselor from the comfort of your own room, call the UT Telephone Counseling Service at 471-CALL.

In addition to counseling, sometimes it can be helpful to talk to a psychiatrist or other physician about taking medication to help you cope with panic attacks. This has been a helpful tool for many people, though lots of people also recover from panic problems without medicine. Taking medicine for panic problems is usually temporary. It can provide relief of some symptoms while you focus on learning strategies for managing anxiety in the future.

Step 5: Keep the Faith!

Above all, have faith that you CAN learn how to handle panic attacks. If you practice the techniques you’ve learned about here, or seek out more information through counseling or the self-help resources below, the chances are EXCELLENT that you’ll be able to overcome the panic problems in your life!
Anxiety & Panic Workbooks

Resources

For Panic Attacks

Bourne, Edmund, Ph.D (1995). The anxiety and phobia workbook (2nd edition). New Harbinger Publications, Inc.

Elke Zuercher-White, Ph.D (1995). An end to panic: Break through techniques for overcoming panic disorder. New Harbinger Publication, Inc.

Wilson, R. Reid, Ph.D. (1987). Don’t panic: Taking control of anxiety attacks. Harper Perennial Publishers.

For Test Anxiety

Johnson, Susan (1997). Taking the anxiety out of taking tests: A step-by-step guide. New Harbinger Publications, Inc.