Modern society, living in conditions of increased activity and high demands, is exposed to numerous stresses on a daily basis. Every day you have to make decisions, stay in the center of events and quickly respond to changing conditions. Sometimes a person becomes a participant or witness of an emergency situation, faces severe emotional experiences, grief, loss, divorce, etc. All this, of course, provokes internal tension, fear and anxiety in response to a stressful situation. A significant role in the growth of emotional tension is played by information that a person perceives daily from TV screens, newspapers and magazines, and radio programs. A large amount of emotionally charged news about certain events related to tragedies and hardships can sometimes worsen the already difficult emotional state of a person. Often, the consequence of such stressful loads is the occurrence of panic attacks that block a person, prevent him from fully living and functioning.
Appeals related to complaints about panic attacks and asking for help to cope with them are regularly received on our phone number and on the website of emergency psychological assistance of the EMERCOM of Russia.
What is a panic attack? What are its manifestations? How does the life of a person in the power of the PA change? What role does family and loved ones play in maintaining the problem? How can I help myself if PA has started? What methods of psychological work are effective in solving this problem? All these questions can be answered in this article.
What is a panic attack? What are its manifestations?
A panic attack (hereinafter referred to as PA) is an unexplained, painful attack of severe anxiety accompanied by fear, combined with various vegetative (somatic) symptoms.
Palpitations, rapid pulse
Chills, tremors, internal shivering sensation
Feeling of lack of air, shortness of breath
Choking or shortness of breath
Pain or discomfort in the left side of the chest
Nausea or abdominal discomfort
Feeling dizzy, unsteady, light-headed, or pre-fainting
Fear of going crazy or doing something out of control
Fear of death
Sensation of numbness or tingling in the extremities
Confusion of thoughts (reduced randomness of thinking)
There are other symptoms that are not included in the list: abdominal pain, upset stools, frequent urination, a feeling of a lump in the throat, impaired gait, impaired vision or hearing, cramps in the arms or legs, and motor function disorders.
Almost every person at least once in their life has experienced a feeling of inexplicable fear and anxiety, accompanied by an increased heartbeat and trembling in the knees. This is how our body is used to reacting to an existing danger or threat. Moreover, the degree of response may vary significantly for different people. Someone has a slight anxiety, and someone feels a strong fear, panic, horror. These conditions, when repeated regularly, are a serious problem, which experts call panic attacks. The cause of this condition can be not only stress, but also various psychological conflicts that a person cannot resolve for various reasons. It is not superfluous to talk about the “secondary benefit” from the PA.
A 27-year-old girl complains of frequent and sudden onset of PA attacks. The occurrence of seizures has recently become more frequent. The client connects this with the death of her husband. PA first started when the client got married. Her husband often liked to spend time with friends, the girl felt lonely. To keep her husband at home, the client began to provoke signs of PA. Her husband stayed at home with her more often, and the client felt needed. In this example, you can see how the client’s PA symptoms helped her avoid conflicts with her husband and at the same time received a “secondary benefit” – her husband was gentle and attentive to her. If we talk further about this case, the events developed as follows: at first, the client was able to cause seizures if necessary, but later they began to occur spontaneously, out of her control. The circle was complete, and the client was trapped in PA.
What role does family and loved ones play in maintaining the problem?
On the one hand, PA turns a person into an important person. The whole family rallies around him. They adapt to him, take care of him, try to please and ease his situation, he is the center of attention. On the other hand, a person falls into a “trap” that forces him to receive the love and care of his relatives for as long as possible, while remaining a sick person for them, who must be protected, loved and cared for. And here we are talking about the secondary benefit of the problem. They are forgiven everything and do not expect much, they are released from any duties, reduce the level of requirements, protect them from stress and physical exertion.
In this case, overprotection of loved ones creates conditions for a person not to make every effort in the struggle for their recovery, but to shift responsibility to the shoulders of relatives and doctors. This position of the family makes it difficult for a person to recover and actively return to a healthy life. Only by realizing the benefits of PA, by giving them up, can you get rid of its manifestations and influence.
The occurrence of PA or its exacerbation can be traced in people who find themselves in situations involving a real or imaginary threat to life. The helpline receives more frequent calls from citizens who are at the mercy of an attack of PA, especially after receiving information about terrorist attacks, plane crashes, after the death of loved ones, etc.
Panic attack syndrome is most common in people with a weak stress defense system. As a rule, up to a certain time such people are able to maintain a psycho-emotional balance, but when the problems reach a peak, panic attacks fall on them like snow on their head.
How does the life of a person in the power of the PA change?
Panic attacks can lead to psychological and social consequences. Having experienced an attack of PA, a person may begin to fear the occurrence of repeated attacks, internally begins to wait for them. This often has a direct impact on their overall life. Such a person, as a rule, tries to limit their movement, tries to stay alone as little as possible, avoids noisy public places. Such people try to avoid any situations that can provoke a panic attack. Often he stops using public transport and tries not to go far from his home. In the event that there is still a need to travel somewhere, such a person asks to accompany him, he will never leave the house alone. Such a person always listens to his feelings, tries to control everything that happens inside. And this control further provokes the occurrence of PA. Prolonged panic attacks are sometimes complicated by depression, loss of interest in life, a sense of hopelessness and, as a result, can cause a person to lose their ability to work, complications in family and personal life.
How can I help myself if PA has started?
It is worth noting that during an attack, a person is covered by the fear of death, or the fear of losing your mind and committing uncontrolled actions and deeds. The body responds to panic with stressful symptoms, including rapid heartbeat and breathing, blood flow, weakness, and dizziness.
A person begins to listen to their inner feelings. And the one who seeks, finds. And the more a person finds signs of ill health in his body (tachycardia, shortness of breath, trembling in the body and muscle tension, etc.), the worse he begins to feel physically. The more fear grows. A vicious circle appears. What should I do?
First, you should try to calm down and direct your control to stop a panic attack. Perhaps the idea that no one dies from a panic attack will help you pull yourself together and start actively helping yourself.
Pay attention to your breathing. In a situation of stress, panic, a person’s breathing becomes shallow, short shallow breaths, frequent, which leads to hyperventilation of the lungs. This alone can provoke a panic. So take control of your breathing. Breathing is regulated by the nervous system and, with a certain cycle of inhalation and exhalation, can control it. According to physiologists, inhaling is associated with the excitation of the nervous system, and exhaling is associated with its inhibition, so if you inhale shorter and exhale longer, you can achieve a calming effect. Calming breathing consists of relatively shortening the inhalation, lengthening the exhalation, and pausing after it. In practice, the exhalation lengthens until it is twice as long as the inhale, and then the pause lengthens. It is usually half an inspiration.
In these formulas, the first digit indicates the duration of inspiration, the second – the duration of exhalation, the third-the breath retention after exhalation. This type of breathing will help you quickly restore your emotional state during stress or during a panic. To do this, it is recommended to breathe with your stomach, pay attention to how your stomach inflates during inhalation and how it retracts during exhalation. Breathing can be combined with rhythmic, unhurried walking. First, stick to the rhythm – two steps inhale, two steps exhale. Then increase the duration of exhalation – two steps inhale, three steps exhale.
Focusing your attention on bodily sensations and unpleasant thoughts can only make your panic attack worse. There are several techniques that help distract the mind from panicked feelings. You may already know some of them:
The rubber band method. Wear a rubber band around your wrist. If you feel a panic attack approaching, pull it back and let it flick your arm with enough force. A sharp painful sensation will distract attention from the symptoms that are coming up and give you time to apply other techniques to control fear, such as slow breathing. And sometimes the sensation itself is enough to stop the attack.
Account. For some, it helps to distract from the impending attack if they start counting some items. For example, how many red cars passed by, or how many buttons the person next to you has on their clothes. In extreme cases, you can always just multiply the numbers in your mind. This method provides many opportunities.
“On the contrary.” Try to read the thought that scares you on the contrary, if necessary, repeat this procedure exactly 10 times.
Talk to a stranger and ask them to tell you how to get to the nearest bus stop or metro station. The main thing is to focus on another task.
You can create a special notebook in which you will write down information during an attack: time, place, where you are, who and what is around you, the situation in which you are, thoughts and feelings that arise, your reaction in this case).
To cope with panic attacks more easily, you need to learn how to relax. To do this, you can master any method of relaxation, for example, progressive muscle relaxation according to Jacobson. When you learn how to quickly release muscle tension, you can easily reduce your anxiety levels. The fact is that anxiety and relaxation are directly opposite states, they cannot be at the same time, so relaxing the muscles in situations that cause tension can reduce the level of anxiety, get rid of negative feelings, it is easier to perceive stressful situations and prevent panic attacks.
The main thing is not to run away from the situation: the next time the panic will be more difficult to survive. If the attack caught you in a shopping center or subway, then, having coped with it, continue to do what you were doing, even if you were just walking slowly. If you give in to the urge to run away, you risk perpetuating your fear of this place, and later it will be very difficult for you to return there. Reward yourself for this victory with something, or at least praise yourself for doing the right thing and wisely.
What methods of psychological work are effective in solving this problem?
Often patients, their relatives, and sometimes doctors believe that panic disorder should not be treated, but ” just pull yourself together.” This is absolutely the wrong approach. It is absolutely necessary to treat, and the earlier treatment begins, the faster it is possible to achieve normalization of the condition. Panic disorder responds well to treatment. Before going to the doctor, you can independently use some psychological techniques aimed at reducing the level of anxiety. But to get rid of panic attacks, restore a normal lifestyle, and learn how to calmly overcome various stressful situations in the future, you need to consult a psychologist or psychotherapist, in some cases a psychiatrist.
In most cases, the combined use of medication and psychotherapy is most effective. Among the methods of psychotherapy used in the treatment of panic disorder, the effectiveness of methods of psychological relaxation, behavioral and cognitive-behavioral psychotherapy, neuro-linguistic programming, short-term strategic therapy, Erickson’s hypnosis and other methods of suggestion has already been proven. These forms of therapy aim to help people with panic disorder identify and reduce the number of self-defeating thoughts and actions that increase panic symptoms. Behavioral techniques often used to reduce anxiety include relaxation and gradually increasing the patient’s exposure to panic situations that may have previously caused anxiety. Helping the patient understand the emotional issues that may have contributed to the development of symptoms is called psychodynamic psychotherapy, which has also been found to be effective. Often, a combination of psychotherapy and medication gives good results. The choice of psychotherapy method depends on many variables (patient characteristics; causes, nature of the course and duration of panic disorder; presence of concomitant diseases). Research shows that psychotherapy alone or a combination of medication and psychotherapy is more effective than just medication in overcoming panic attacks.