Ten Minutes of Terror: Anatomy of a Panic Attack

Enrique is sitting in a cinema chair. He went to see a movie with a friend. Suddenly he begins to experience depression, tachycardia, flushes; You are very hot, but at the same time you are cold and chilly. I’m having a heart attack or going crazy, he thinks.

He leaves the room and drinks water. You feel disoriented; He later described it as “out of my mind”. He goes to the emergency room of the nearest hospital, where he reports the reason for the visit: “I’m having a heart attack.” The film is far behind. After two hours of testing and waiting, the diagnosis comes. “You had a panic attack,” says the ER doctor. Enrique feels disoriented, incapable and, above all, afraid of repeating the situation.

This will probably be a wake up call. According to WHO, 30% of the population has suffered or will suffer from panic attacks. In fact, 301 million people were diagnosed with an anxiety disorder in 2019; 58 million children and teenagers.

unpredictable and short

A panic attack involves suffering from intense fear that causes very disturbing physical reactions for no apparent reason. One of its characteristics is the lack of the victim’s control over when, where, and why. A tense student may suffer from it in the days leading up to the PhD, as well as while taking a relaxing hot bath a few days after the event.

Short duration is another defining feature. While other anxiety disorders, such as generalized anxiety, are relatively long-term and require long-term intervention, a panic attack only lasts 10 minutes. In either case, the person may feel its effects after a few days due to the preemptive stress of not knowing when they will experience another similar episode.

What happens to the body when we tolerate it?

While not everyone experiences it in the same way, the most common symptoms are palpitations, sweating, trembling hands, sluggish legs, nausea, abdominal discomfort, dizziness, headache, chest tightness, feeling of choking and suffocation. These are physiological manifestations that alert the body to the presence of a threat (in this case, imagined) to its physical or psychological integrity.

From a psychobiological point of view, it involves the implementation of processes associated with the struggle of the body for its own survival. In other words, the release of cortisol, adrenaline and norepinephrine and other hormonal mechanisms associated with the autonomic nervous system and subcortical structures such as the amygdala and pituitary gland are activated.

This phenomenon is also associated with cognitive deficits. Some studies have shown that having one impairs the performance of functions such as attention, working memory, and processing speed. This is mainly due to the state of confusion and even “depersonalization” that attacks cause.

More common in wealthy countries

As noted above, during a panic attack, a person feels that he is going crazy, that he really is about to die, or that something threatens his own integrity. It’s an imaginary threat.

This imagined perception is what distinguishes humans from other species, as neuroscientist and writer Robert Sapolsky, the author of the book, would say. Why don’t zebras have ulcers?. Many people in the 21st century live in fear of what might happen because our basic needs (food, shelter, drink, affection…) that guarantee our survival at low cost can be met even before we are born.

In fact, several epidemiological studies have shown that panic attacks are more common in high-income Western countries.

Who is most at risk of being harmed by it?

There is no causal relationship between having a particular gene, personality trait, or personality trait and being more likely to have a panic attack. However, there appears to be a hereditary factor. Temperament also influences: highly sensitive people or with a high level of neuroticism and self-demanding have more bulletins to go through this painful trance.

Gender is also a key variable. Numerous studies have shown that women are almost twice as likely as men to suffer from it throughout their lives. The explanation lies in the cyclicity of hormonal processes associated with the female sex: menopause is the period of maximum susceptibility.

Can they be avoided?

The unpredictability of a panic attack makes it difficult to prevent, although a patient who has had one at least once can reduce the level of anticipatory stress at the thought of new attacks. You can also gain new skills to deal with the episode if it comes up again.

This is achieved through a combination of psychological therapy and certain medications, although there are alternatives such as manual therapy. The key point is that health systems are prepared in consultation with primary health care and emergencies, with specific protocols and strategies for dealing with these and other related cases.

Finally, I would like to stress the importance of drawing attention to panic attacks and other anxiety disorders as part of good professional practice. Extrapolating the motto “information is power” to this context, it follows that if someone knows what a panic attack is, he will be able to act accordingly when he experiences it, and, most importantly, he will be able to live without fear of a panic attack. repeat. And this work is as important as psychological assessment and treatment.

Maria José García Rubio, Co-Director of the Department of Global Neurology and Social Change at VIU-NED, Professor with a Master’s Degree in Clinical Neuropsychology, Member of the Psychology and Quality of Life (PsiCal) Research Group, International University of Valencia

This article was originally published on The Conversation. Read the original.