“Help! I’m in danger!” – What is a panic attack?
“I felt like I was going to die. I woke up suddenly at midnight with the feeling that I couldn’t breathe; I was trembling all over and there was tightness in my chest. I thought I was having a heart attack that I had to get to a hospital as quickly as possible. After being examined, they determined that I had had a panic attack. I haven’t been the same since. Fear has taken hold of me. Fear of being ill, fear of dying, and fear that the frightening situation might happen again.”
A panic attack is a truly traumatic experience than can have long-term effects on the life of an individual. The onset is sudden and followed by a feeling of intense fear, terror and/or discomfort, accompanied by physical and psychological symptoms, and also by catastrophic, irrational beliefs of imminent danger and lack of control.
A panic attack can occur unexpectedly, unpredictably, “out of nowhere”, for example during sleep or due to a specific situation (an occurrence, a context or a specific object may trigger a panic attack).
In some cases, there can be a predisposition in certain situations (a person who is habitually anxious when speaking in public can have a panic attack in this context). It is, in fact, an intense unfortunate experience, equivalent to how the body would react when preparing to face great danger. A continual occurrence is called a panic disorder.
Panic attacks are an increasingly common condition and a hyper-reactive response of the nervous system when faced with a threatening situation. In the great majority of cases, they happen as a consequence of a traumatic or stressful experience, causing brain alterations, giving rise to an “alarm” which is triggered and reactivated by the slightest provocation, altering thoughts, feelings and behaviour.
Anyone who suffers from panic attacks or has suffered one for the first time is left with many queries as to what is happening to them. A person in panic strongly believes that there is something physically wrong. They relate the symptoms to a serious, undiagnosed illness. The palpitations are associated with heart problems or numbness in the head with a severe brain disorder.
Due to the intensity of the symptoms experienced, panic attacks cause an inevitable loss of quality of life, due to the constant worry that another episode might occur, along with its consequences. When associated with agoraphobia, they also give rise to the fear of related situations such as being in closed or open spaces, anticipating difficulty in escaping and the need of never being on their own. The fear is disproportional or unfounded in relation to the situation and has a strong influence on the person’s social, professional and personal life.
With current advances in understanding brain function, new therapeutic methodologies and new ways of looking at the disorder have arisen in parallel. Consultations in clinical psychology offer distinct approaches in the treatment of panic disorder. We have witnessed specific treatment with a traumatic focus, inasmuch as an experience can be considered traumatic when it threatens the health and wellbeing of an individual, subsequently conditioning and controlling the way a person organises his or her subsequent perceptions.
One of the neurobiological approaches that can be used in the treatment of panic disorder is EMDR (Eye Movement Desensitisation and Reprocessing), which consists in desensitising and reprocessing traumatic episodes through eye movement or bilateral brain stimulation, with a very significant impact on thought level, feelings and behaviour.
Brainspotting is another successful approach, which activates the brain through the reflexes observed by the psychologist, or physical sensations felt internally by the patient and which permit the neuropsychological release of pain, whether physical or emotional.
Neurofeedback is another strategy which is based on the electrical activity of the brain, consisting in training the brain to function in a more stable and controlled way in situations where disruption of the brain function is observed, as in the case of anxiety-depression. It is a gradual process of self-regulation that allows for an improved functioning of the central nervous system.
One to three people in 1,000 suffer from panic disorder. If not treated correctly and timely, it can become chronic, which is why the sooner treatment begins, the less prolonged it will be.
By Dr. Suzana Guedes
Dr. Suzana Guedes, PhD in Health, Personality and Individual Differences, is a Clinical Psychologist at Hospital Particular de Alvor