0:00:07.035,0:00:09.825
The body becomes its own corset.

0:00:09.825,0:00:13.640
Past, present, and future [br]exist as a single force.

0:00:13.640,0:00:18.314
A swing without gravity soars [br]to a terrifying height.

0:00:18.314,0:00:22.295
The outlines of people and things [br]dissolve.

0:00:23.125,0:00:26.355
Countless poets and writers [br]have tried to put words

0:00:26.355,0:00:28.880
to the experience of a panic attack—

0:00:28.880,0:00:33.941
a sensation so overwhelming, many people [br]mistake it for a heart attack, stroke,

0:00:33.941,0:00:36.841
or other life-threatening crisis.

0:00:36.841,0:00:40.060
Though panic attacks don’t cause [br]long-term physical harm,

0:00:40.060,0:00:44.371
afterwards, the fear of another attack [br]can limit someone’s daily life—

0:00:44.371,0:00:46.961
and cause more panic attacks.

0:00:46.961,0:00:49.357
Studies suggest that almost a third of us

0:00:49.357,0:00:52.730
will experience at least one [br]panic attack in our lives.

0:00:52.730,0:00:55.379
And whether it’s your first, [br]your hundredth,

0:00:55.379,0:00:57.967
or you’re witnessing someone else [br]go through one,

0:00:57.967,0:01:00.717
no one wants to repeat the experience.

0:01:00.717,0:01:04.937
Even learning about them can [br]be uncomfortable, but it’s necessary—

0:01:04.937,0:01:09.166
because the first step to preventing [br]panic attacks is understanding them.

0:01:10.166,0:01:13.276
At its core, a panic attack [br]is an overreaction to the body’s

0:01:13.276,0:01:17.127
normal physiological response [br]to the perception of danger.

0:01:17.127,0:01:19.547
This response starts with the amygdala,

0:01:19.547,0:01:22.627
the brain region involved [br]in processing fear.

0:01:22.627,0:01:24.537
When the amygdala perceives danger,

0:01:24.537,0:01:27.392
it stimulates [br]the sympathetic nervous system,

0:01:27.392,0:01:30.087
which triggers the release of adrenaline.

0:01:30.087,0:01:33.317
Adrenaline prompts an increase [br]in the heart and breathing rate

0:01:33.317,0:01:37.339
to get blood and oxygen [br]to the muscles of the arms and legs.

0:01:37.339,0:01:41.835
This also sends oxygen to the brain, [br]making it more alert and responsive.

0:01:42.882,0:01:44.312
During a panic attack,

0:01:44.312,0:01:48.269
this response is exaggerated [br]well past what would be useful

0:01:48.269,0:01:50.326
in a dangerous situation,

0:01:50.326,0:01:55.115
causing a racing heart, heavy breathing, [br]or hyperventilation.

0:01:55.115,0:01:57.805
The changes to blood flow [br]cause lightheadedness

0:01:57.805,0:02:00.819
and numbness in the hands and feet.

0:02:00.819,0:02:03.869
A panic attack usually peaks [br]within 10 minutes.

0:02:03.869,0:02:07.289
Then, the prefrontal cortex [br]takes over from the amygdala

0:02:07.289,0:02:10.639
and stimulates [br]the parasympathetic nervous system.

0:02:10.639,0:02:14.140
This triggers the release of a hormone [br]called acetylcholine

0:02:14.140,0:02:19.273
that decreases the heart rate [br]and gradually winds down the panic attack.

0:02:19.273,0:02:22.223
In a panic attack, the body’s [br]perception of danger

0:02:22.223,0:02:27.351
is enough to trigger the response we would[br]have to a real threat— and then some.

0:02:27.351,0:02:30.151
We don't know for sure [br]why this happens,

0:02:30.151,0:02:32.910
but sometimes cues in the environment [br]that remind us

0:02:32.910,0:02:37.060
of traumatic past experience [br]can trigger a panic attack.

0:02:37.060,0:02:39.688
Panic attacks can be part [br]of anxiety disorders

0:02:39.688,0:02:46.664
like PTSD, social anxiety disorder, OCD, [br]and generalized anxiety disorder.

0:02:46.664,0:02:50.374
Recurring panic attacks, [br]frequent worry about new attacks,

0:02:50.374,0:02:53.350
and behavioral changes [br]to avoid panic attacks

0:02:53.350,0:02:57.120
can lead to a diagnosis [br]of a panic disorder.

0:02:57.120,0:02:59.522
The two main treatments [br]for panic disorder

0:02:59.522,0:03:05.374
are antidepressant medication [br]and cognitive behavioral therapy, or CBT.

0:03:05.374,0:03:08.614
Both have about a 40% response rate—

0:03:08.614,0:03:12.410
though someone who responds to one [br]may not respond to the other.

0:03:12.410,0:03:16.300
However, antidepressant medications [br]carry some side effects,

0:03:16.300,0:03:20.110
and 50% of people relapse [br]when they stop taking them.

0:03:20.110,0:03:25.983
CBT, meanwhile, is more lasting, [br]with only a 20% relapse rate.

0:03:25.983,0:03:29.893
The goal of CBT treatment for panic [br]disorder is to help people learn

0:03:29.893,0:03:34.385
and practice concrete tools [br]to exert physical, and in turn mental,

0:03:34.385,0:03:39.657
control over the sensations and thoughts [br]associated with a panic attack.

0:03:39.657,0:03:44.706
CBT begins with an explanation of the [br]physiological causes of a panic attack,

0:03:44.706,0:03:48.636
followed by breath and muscle exercises [br]designed to help people

0:03:48.636,0:03:51.825
consciously control breathing patterns.

0:03:51.825,0:03:54.265
Next comes cognitive restructuring,

0:03:54.265,0:03:56.825
which involves identifying [br]and changing the thoughts

0:03:56.825,0:03:58.753
that are common during attacks—

0:03:58.753,0:04:02.885
such as believing you’ll stop breathing, [br]have a heart attack, or die—

0:04:02.885,0:04:05.675
and replacing them [br]with more accurate thoughts.

0:04:07.065,0:04:11.684
The next stage of treatment is exposure [br]to the bodily sensations and situations

0:04:11.684,0:04:14.654
that typically trigger a panic attack.

0:04:14.654,0:04:17.857
The goal is to change the belief, [br]through experience,

0:04:17.857,0:04:22.307
that these sensations and situations [br]are dangerous.

0:04:22.307,0:04:27.512
Even after CBT, taking these steps [br]isn’t easy in the grip of an attack.

0:04:27.512,0:04:32.209
But with practice, these tools [br]can both prevent and de-escalate attacks,

0:04:32.209,0:04:36.378
and ultimately reduce the hold of panic [br]on a person’s life.

0:04:37.518,0:04:39.208
Outside formal therapy,

0:04:39.208,0:04:44.615
many panickers find relief from the same [br]beliefs CBT aims to instill:

0:04:44.615,0:04:50.116
that fear can’t hurt you, [br]but holding on to it will escalate panic.

0:04:50.116,0:04:52.676
Even if you’ve never had a panic attack,

0:04:52.676,0:04:57.429
understanding them will help you identify [br]one in yourself or someone else—

0:04:57.429,0:05:01.419
and recognizing them is the first step [br]in preventing them.