Anxiety Attacks

anxiety attacks Anxiety attacks are sometimes used to describe a number of symptoms that are characterized by several anxiety disorders. However, when people typically speak of an anxiety attack that occurs spontaneously in the absence of any real danger and sometimes includes a feeling of impending doom or imminent danger, with a urge to escape, they may be speaking about a panic attack.

By not treating your panic attack you can develop panic disorder and other problems that can impact on your daily life. Outcome-based studies indicate a good success rate for treatment of panic attacks. With the right treatment you can reduce your symptoms and regain control.

What is a Panic Attack?

A Panic Attack is described by the American Psychiatric Association as 'a discrete period of intense fear or discomfort that is accompanied by at least four of thirteen physical or cognitive symptoms' (APA, 1994). These panic attacks usually have a rapid onset and generally build to a peak with 10 minutes.

There are a number of signs and symptoms of a panic attack.

The following questions can help you to assess if you have symptoms of panic attack (DSM - IV).

This assessment is not designed to make a diagnosis, or take the place of a professional diagnosis; however, it is a way for you to gain some clarity around your anxiety attacks.

As you read each of the following, click the button beside each question that relates to your cognitive or somatic experience.

Within a 10 minute period have you felt FOUR OR MORE of the following:

palpitations, pounding heart, or accelerated heart rate
trembling or shaking
sensations of shortness of breath or smothering
feeling of choking
chest pain or discomfort
nausea or abdominal distress
feeling dizzy, unsteady, lightheaded, or faint
derealization (feelings of unreality) or depersonalization (being detached from oneself)
fear of losing control or going crazy
fear of dying
paresthesias (numbness or tingling sensations)
chills or hot flushes

If you have felt 4 or more of these symptoms in a discrete period then this is a criteria for panic attack (APA, 1994).

Causes of panic attacks

It is important to seek medical help if you are at all unsure that your symptoms are due to a panic attack. The symptoms of panic attacks could be caused by a number of physical illnesses or medications and it is important to have your doctor rule these out.

Different situations can cause Panic Attacks (or anxiety attacks)

Individuals who experience panic attacks may do so within the context of other anxiety disorders, other mental disorders or due to medical conditions.

However, panic attacks can occur unexpectedly, be cued by the situation or may be situationally predisposed.

For example, an individual who has phobia of dogs may have a panic attack when confronted by a barking dog, while somebody who has social phobia may have a panic attack when about to speak in front of a group or attend a party.

While these triggers are external, they can also be internal. For example, the thought that they may die due to their heart palpitations may cue a panic attack.

On the other hand somebody who is situationally predisposed to a panic attack could typically suffer from generalized anxiety disorder. For example, after watching the evening the news that warns of economic slowdown, the individuals may become over-concerned and worried about their finances and economic well being, which escalates into a panic attack.

Similarly, a panic attack may be un-cued. For the diagnosis of panic disorder the occurrence of an unexpected panic attack is required.

Thus the context of a Panic Attack is important for the determining the differential diagnosis (DSM - IV).

Treatment for Panic Attacks

A panic attack (or anxiety attack) consists of a frightening set of symptoms. Cognitive behavior therapy is generally considered the most effective treatment for panic attacks and panic disorder.

Often panic is exacerbated by thinking patterns, which can be focused on anticipatory anxiety e.g. "I'll have a panic attack" or on an individuals interpretation of their physical symptoms "My rapid heartbeat means I'm having a heart attack" or on the individual's criticism "I'm weak".

Thus cognitive therapy helps the individual to identify and change these unhelpful thoughts to more adaptive thoughts.

From a behavioral perspective, the individual is exposed to the physical sensations of panic in an environment which is safe and then learn better ways to cope with these sensations. With each exposure to the physical sensations you become less anxious of the symptoms and have more confidence in controlling the sensations of your panic.

For individuals with agoraphobia the stimuli that you are afraid of are also used in this treatment.

Medication can also be used for the treatment of panic attacks, however, if used, should be done so as part of the overall cognitive behavioral treatment.

Self help tips for anxiety attacks

The prognosis for professional treatment of panic disorder and agoraphobia are good, with research on outcome-based studies of cognitive behavioral treatment for panic disorder and agoraphobia being 75-90% (Clark, 1996).

However, there are many things that you can do to help yourself.

Increase your education around anxiety attacks. Reading around anxiety and panic attacks the sensations that you may be experiencing can be helpful and reduce the feeling that you are going crazy.

Avoid stimulants. A panic attack occurs when the fight or flight response is activated, with no imminent danger. Stimulants such as excess caffeine or chronic stress can activate the fight or flight response.

Practice relaxation strategies. Practicing relaxation promotes the relaxation response. Activating the relaxation response is the opposite of the stress response that is activated in an anxiety attack.

Relaxation techniques such as progressive muscle relaxation, diagrammatic breathing exercises, yoga or various meditation techniques can give you a greater sense of self-control over your anxiety and promote relaxation and well being.

See these pages for more discussion of other anxiety disorders such as post traumatic stress disorder.

This site is for informational puposes only and in no way replaces treatment. Please see a local doctor, psychologist or psychiatrist to seek advice.

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