Panic attacks and panic disorder are different psychological problems. Panic attack, physical symptoms that occur unexpectedly, such as palpitations, sweating, dizziness, tremor, shortness of breath, chest pain, nausea or abdominal pain, numbness, derealization or depersonalization (self-alienation) as well as going crazy An intense fear that occurs in a calm or anxious moment, culminating in minutes, such as fear of death and death, is a state of inner distress suppressed. Panic disorder, on the other hand, is a disorder characterized by recurring unexpected panic attacks, constant worrying about the possible consequences of other panic attacks for at least a month after the attacks (anticipatory anxiety), and planned behavioral changes to avoid having a panic attack.
A panic attack begins with a catastrophic misinterpretation of an event, mood, or natural-normal bodily sensation. First of all, external and internal factors trigger panic attacks. Bodily sensations such as heart palpitations, shortness of breath, dizziness, sweating that occur in the body due to the presence of many external and internal factors such as cigarette, caffeine, exercise, hot weather, crowded environments, an exciting event, mild hyperventilation (frequent and superficial breathing), are catastrophic for the person. misinterpretations with thoughts. Physical symptoms such as heart palpitations caused by caffeine, increased pulse and fatigue with exercise, sweating caused by a crowded and hot environment, catastrophizes these bodily sensations of the person, “something bad is happening to me”, “my heart is beating very fast, my chest is beating. it hurts, I’m having a heart attack.’ causes interpretation with such thoughts. With these thoughts, the person’s anxiety level increases, he focuses more on his bodily sensations to understand what is going on in his body, and the level of anxiety continues to increase.
When the level of anxiety increases, physical symptoms tend to worsen evolutionarily. An individual’s fear, anxiety and stress in the face of any event activates the body to protect the body against the perceived threat. As in the past, when people encounter an animal larger than themselves, the body takes action to protect the person from threat with a primitive and innate response. Prepares the person for the fight or flight response. Against a possible threat, blood is directed to muscles such as calf and arm, which will provide movement. More blood flow is required for the oxygen demand of the tissues, so the heart rate increases and the blood flow accelerates. To reduce the risk of bleeding from any cut, blood is drawn from the fingers and toes, which causes numbness and tingling in the fingers. Pupils dilate, lung capacity increases. These symptoms occur to evolutionarily prepare the organism for the fight-flight-freeze response. Therefore, as the person becomes more anxious by focusing on their physical symptoms, the person actually increases the heart rate, which he fears because it increases.
In hyperventilation, which is the breathing process that he often does by thinking that he cannot breathe, the aim is to meet the oxygen need in the tissues. However, breathing quickly and superficially increases the oxygen level in the blood and decreases the carbon dioxide level. In this case, it causes narrowing and constriction of blood vessels, and the amount of blood and oxygen going to the brain decreases. As a result of this decrease, symptoms such as dizziness, blurred vision, drowsiness, shortness of breath, alienation from the environment and oneself occur. In response to more oxygen being taken, the amount of oxygen going to certain parts of the body also decreases. In this case, symptoms such as numbness and prickling in the arms and legs, increased heart rate, and numbness occur.
As a result, with the stress and anxiety that the person goes through by focusing only on a normal bodily change, ‘something bad will happen’, ‘I will have a heart attack.’ By activating catastrophic thoughts like the body, the body thinks there is a real threat and prepares the fight-or-flight response. The effects of this fight-or-flight response on our bodies are repeated, ‘my physical symptoms have increased, I will definitely have a heart attack’, ‘I will faint, I will go crazy.’ continues to perceive it as a vicious circle and puts itself in a vicious circle. The panic attack diagram below describes the chain of events.
During a panic attack, the fear of fainting that the person thinks is not a situation that can happen. For a person to pass out, their blood pressure must drop. This is one of the mechanisms of the brain to protect the organism. For example, in the event of an accident, the brain’s protection mechanism activates to slow down the bleeding in the person, reducing blood pressure so that the heart works more slowly and pumps blood more slowly. In a panic attack, the brain activates the body due to the fight-flight response triggered by anxiety. More blood is pumped for the needs of the tissues, so blood pressure rises. As a result, blood pressure must drop for fainting to occur, but blood pressure is high in a panic attack. Therefore, fainting does not occur.
The person’s attack, on the other hand, reaches its climax in an average of 10 minutes and lasts for an average of 30 minutes. The attack ends spontaneously or when the person performs escape-avoidance behaviors such as seeking a person who calms him or her during the attack, providing security or getting away from the environment. The point that should not be forgotten here is that after a while, the body will see the fight-flight response as sufficient and return the body to the relaxation-relaxation mode, even if the person does nothing. That is, the state of anxiety does not last forever.
First of all, confirming the absence of any physical disease should be the first step. Because some physical illnesses can cause panic attack symptoms. For example; low blood sugar, anemia, diabetes, thyroid diseases, high blood pressure, etc. In the second step, it is important for the person to learn the effects of the panic attack cycle and the dysfunctional catastrophic thoughts and anxiety on their body. It is aimed to be able to recognize the physical symptoms of the person in normal daily life, to be aware of the excessive focus on the changes in the body, and to control the anxiety without activating the catastrophic way of thinking when he feels any physical sensation. All of these steps can be solved with cognitive behavioral therapy applied by a clinical psychologist who is competent in the field.