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← What causes panic attacks, and how can you prevent them? - Cindy J. Aaronson

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Showing Revision 1 created 10/07/2020 by lauren mcalpine .

  1. The body becomes its own corset.
  2. Past, present, and future
    exist as a single force.

  3. A swing without gravity soars
    to a terrifying height.

  4. The outlines of people and things

  5. Countless poets and writers
    have tried to put words

  6. to the experience of a panic attack—
  7. a sensation so overwhelming, many people
    mistake it for a heart attack, stroke,
  8. or other life-threatening crisis.
  9. Though panic attacks don’t cause
    long-term physical harm,
  10. afterwards, the fear of another attack
    can limit someone’s daily life—
  11. and cause more panic attacks.
  12. Studies suggest that almost a third of us

  13. will experience at least one
    panic attack in our lives.
  14. And whether it’s your first,
    your hundredth,
  15. or you’re witnessing someone else
    go through one,
  16. no one wants to repeat the experience.
  17. Even learning about them can
    be uncomfortable, but it’s necessary—
  18. because the first step to preventing
    panic attacks is understanding them.
  19. At its core, a panic attack
    is an overreaction to the body’s

  20. normal physiological response
    to the perception of danger.
  21. This response starts with the amygdala,
  22. the brain region involved
    in processing fear.
  23. When the amygdala perceives danger,
  24. it stimulates
    the sympathetic nervous system,
  25. which triggers the release of adrenaline.
  26. Adrenaline prompts an increase
    in the heart and breathing rate
  27. to get blood and oxygen
    to the muscles of the arms and legs.
  28. This also sends oxygen to the brain,
    making it more alert and responsive.
  29. During a panic attack,

  30. this response is exaggerated
    well past what would be useful
  31. in a dangerous situation,
  32. causing a racing heart, heavy breathing,
    or hyperventilation.
  33. The changes to blood flow
    cause lightheadedness
  34. and numbness in the hands and feet.
  35. A panic attack usually peaks
    within 10 minutes.

  36. Then, the prefrontal cortex
    takes over from the amygdala
  37. and stimulates
    the parasympathetic nervous system.
  38. This triggers the release of a hormone
    called acetylcholine
  39. that decreases the heart rate
    and gradually winds down the panic attack.
  40. In a panic attack, the body’s
    perception of danger

  41. is enough to trigger the response we would
    have to a real threat— and then some.
  42. We don't know for sure
    why this happens,
  43. but sometimes cues in the environment
    that remind us
  44. of traumatic past experience
    can trigger a panic attack.
  45. Panic attacks can be part
    of anxiety disorders
  46. like PTSD, social anxiety disorder, OCD,
    and generalized anxiety disorder.
  47. Recurring panic attacks,
    frequent worry about new attacks,
  48. and behavioral changes
    to avoid panic attacks
  49. can lead to a diagnosis
    of a panic disorder.
  50. The two main treatments
    for panic disorder

  51. are antidepressant medication
    and cognitive behavioral therapy, or CBT.
  52. Both have about a 40% response rate—
  53. though someone who responds to one
    may not respond to the other.
  54. However, antidepressant medications
    carry some side effects,
  55. and 50% of people relapse
    when they stop taking them.
  56. CBT, meanwhile, is more lasting,
    with only a 20% relapse rate.
  57. The goal of CBT treatment for panic
    disorder is to help people learn

  58. and practice concrete tools
    to exert physical, and in turn mental,
  59. control over the sensations and thoughts
    associated with a panic attack.
  60. CBT begins with an explanation of the
    physiological causes of a panic attack,

  61. followed by breath and muscle exercises
    designed to help people
  62. consciously control breathing patterns.
  63. Next comes cognitive restructuring,

  64. which involves identifying
    and changing the thoughts
  65. that are common during attacks—
  66. such as believing you’ll stop breathing,
    have a heart attack, or die—
  67. and replacing them
    with more accurate thoughts.
  68. The next stage of treatment is exposure
    to the bodily sensations and situations

  69. that typically trigger a panic attack.
  70. The goal is to change the belief,
    through experience,
  71. that these sensations and situations
    are dangerous.
  72. Even after CBT, taking these steps
    isn’t easy in the grip of an attack.

  73. But with practice, these tools
    can both prevent and de-escalate attacks,
  74. and ultimately reduce the hold of panic
    on a person’s life.
  75. Outside formal therapy,

  76. many panickers find relief from the same
    beliefs CBT aims to instill:
  77. that fear can’t hurt you,
    but holding on to it will escalate panic.
  78. Even if you’ve never had a panic attack,
  79. understanding them will help you identify
    one in yourself or someone else—
  80. and recognizing them is the first step
    in preventing them.