In order to understand panic attacks, we must first understand our own nervous system.
How do you know when you’re having a panic attack? Today, we’re going over some of the physical signs of panic attacks and what to do if you frequently experience them.
Savvy Psychologist is hosted by Dr. Monica Johnson. A transcript is available at Simplecast.
Have a mental health question? Email us at psychologist@quickanddirtytips.com or leave a voicemail at 929-256-2191.
Find Savvy Psychologist on Facebook and Twitter, or subscribe to the newsletter for more psychology tips.
Savvy Psychologist is a part of Quick and Dirty Tips.
Links:
https://quickanddirtytips.com/savvy-psychologist
https://www.facebook.com/savvypsychologist
https://twitter.com/qdtsavvypsych
https://www.kindmindpsych.com/
Have you ever wondered what it’s actually like to have a panic attack? Today, I am going to break down the physical signs of a panic attack.
Welcome back to Savvy Psychologist. I'm your host, Dr. Monica Johnson. Every week on this show, I'll help you face life's challenges with evidence-based approaches, a sympathetic ear, and zero judgment.
In order to understand panic attacks, we must first understand our own nervous system. The sympathetic and parasympathetic nervous systems are two branches of the autonomic nervous system, which is responsible for regulating involuntary bodily functions. These two systems work in opposition to each other to maintain balance and respond to different situations. Understanding the relationship between the sympathetic and parasympathetic nervous systems is essential for comprehending their role in panic attacks.
The sympathetic nervous system is often referred to as the "fight-or-flight" response. It is activated in response to perceived threats or stressful situations. When the SNS is activated, it triggers a cascade of physiological changes that prepare the body for action to either confront the threat or escape from it. During our Neanderthal days this was super important because if you saw a saber-toothed tiger, you needed to be ready to evade or fight. However, these days, most threats aren’t life or death. Which is why I want to emphasize this idea of “perceived threat.” If you perceive giving a presentation for class as a threat, it’s possible for you to have a panic attack because your brain is going to interpret that data the same way it does a bear chasing you down.
During a threat or stressful event, the SNS releases stress hormones like adrenaline and norepinephrine. These hormones increase heart rate, dilate the pupils, raise blood pressure, redirect blood flow to muscles, and increase respiratory rate, among other responses. These physiological changes prepare the body to react quickly and effectively to the perceived danger. This is a lot happening within your system! Your body is full of energy, but the perceived danger is getting a B- on your presentation. Hopefully, you can begin to see how this can be discombobulating for you and your system.
The parasympathetic nervous system is often called the "rest-and-digest" response. Its primary function is to promote relaxation and conserve energy when the body is in a safe and non-threatening environment. The PNS works to counterbalance the effects of the sympathetic nervous system, restoring the body to a state of equilibrium after the stressor has passed.
The PNS slows down heart rate, constricts pupils, lowers blood pressure, enhances digestion, and promotes relaxation. It helps the body conserve energy, repair tissues, and engage in processes that are not essential for immediate survival.
Now let’s pull it all together. During a panic attack, the sympathetic nervous system becomes overly activated, leading to an intense "fight-or-flight" response even in the absence of an actual threat. The body is preparing for action, although there is no immediate danger present. The parasympathetic nervous system's role during a panic attack is to attempt to counterbalance the intense sympathetic response. However, the activation of the SNS is so pronounced that the PNS may struggle to restore equilibrium fully. This imbalance can contribute to the persistence of physical symptoms and overwhelming feelings of anxiety and distress during a panic attack.
Rapid heartbeat (Palpitations): Panic attacks can cause a sudden increase in heart rate, leading to palpitations. Individuals may feel their heart pounding or racing, which can be distressing and exacerbate anxiety. This is one of the reasons that people may believe that they are having a heart attack.
Shortness of breath: During a panic attack, individuals may experience rapid or shallow breathing, leading to a feeling of breathlessness or suffocation. This sensation can further heighten anxiety and contribute to overall discomfort. It is not uncommon for folks to hyperventilate during a panic attack. In fact, many times I explain to my patients that focusing on trying to slow their breathing will help. When you breathe shallowly, you’re not always allowing oxygen to flow through your body which will only panic your system further.
Chest pain or discomfort: Panic attacks may lead to chest pain or discomfort. Another reason why they are often confused for a heart attack. People will often describe feeling tightness, pinching, or pressure on their chest.
Sweating: Profuse sweating is a common physical symptom of panic attacks. Sweating can occur even in cool environments and may be accompanied by feelings of heat or chills. I have even had patients wake up from sleep in the middle of a panic attack and their sheets are wet from sweating.
Trembling or shaking: Uncontrollable trembling or shaking of the hands, limbs, or entire body can occur during a panic attack. This physical symptom can be visible to others, adding to the distress of the individual experiencing the attack.
Nausea or upset stomach: Panic attacks can lead to gastrointestinal distress, causing symptoms such as nausea, upset stomach, or even diarrhea.
Dizziness or lightheadedness: A feeling of dizziness or lightheadedness is common during panic attacks. Individuals may feel unsteady or as if they are going to faint. This can often be an extension or exacerbated by some of the other symptoms of a panic attack like shortness of breath and heart palpitations.
Tingling sensations: Some individuals may experience tingling sensations or numbness in their extremities during a panic attack. This symptom is often referred to as "pins and needles." So, if you notice that your hands or feet are numb or notice a sensation that is similar to your foot waking up after falling asleep then this may be a sign of a panic attack.
Feeling of choking or throat tightness: Panic attacks can give rise to a sensation of choking or constriction in the throat, which can further escalate anxiety.
Body flushing or pallor: Panic attacks can cause changes in skin color, leading to flushing (redness) or pallor (paleness) of the face.
Muscle tension and pain: Muscle tension is common during panic attacks, and individuals may experience muscle pain or soreness, particularly in the neck, shoulders, or jaw.
It is essential to note that individuals experiencing panic attacks may not necessarily have all of these physical symptoms during every episode. The presence and severity of physical symptoms can vary from person to person and may also change over time. When it comes to techniques for panic attacks, I encourage you to focus on prevention as much if not more than you focus on managing panic attacks. Having a consistent self-care routine utilizing techniques that help to better manage anxiety on a day-to-day basis is your best bet for reducing your frequency of panic attacks. You may not completely eliminate panic attacks, but I have seen folks who experience panic attacks regularly reduce the frequency to occasionally. That’s a massive improvement.
Watch your thoughts: Remember what I’ve been saying about perceived threats—this also relates to your panic attacks. If you begin to have a panic attack and your thoughts are “OMG I’m going to die” or “Why is this happening to me again!!!” then all you’re doing is throwing logs on the panic attack fire and it’s likely that the symptoms will persist for longer. Now that you are aware of the signs of a panic attack, it’s important that you coach and cheerlead yourself through it. Positive self-talk is your best friend here. Encouraging and compassionate self-talk can be powerful in reducing anxiety during panic attacks. Reminding oneself that panic attacks are temporary and manageable can help individuals maintain a sense of control and reduce fear.
Breathing exercises: Deep breathing exercises can help individuals regulate their breathing and reduce the intensity of physical symptoms during a panic attack. One effective technique is diaphragmatic breathing, also known as belly breathing. It involves inhaling deeply through the nose, allowing the belly to expand, and exhaling slowly through the mouth. Practicing this regularly can promote a sense of relaxation and calm.
Progressive muscle relaxation (PMR): PMR involves tensing and then relaxing various muscle groups throughout the body. By systematically releasing muscle tension, individuals can experience a reduction in overall anxiety and physical symptoms associated with panic attacks. Regular practice of PMR can promote a sense of physical and mental relaxation.
Grounding techniques: Grounding techniques help individuals stay connected to the present moment during a panic attack, preventing them from becoming overwhelmed by anxious thoughts and sensations. Techniques may include focusing on the physical sensations of an object, deep breathing, or naming objects in the environment to bring attention back to the here and now.
Imagery and visualization: Guided imagery and visualization techniques can help individuals create calming mental images during a panic attack. For example, they can imagine being in a peaceful and serene place, focusing on the sensory details to promote relaxation and reduce anxiety.
Exposure therapy: Exposure therapy involves gradually and safely confronting feared situations or triggers associated with panic attacks. Over time, repeated exposure can help individuals desensitize to their triggers and reduce anxiety. If you are a person that has many panic triggers, I strongly encourage meeting with a therapist who can aid you in better managing your panic attacks.
What is your least favorite physical symptom of a panic attack? Let me know on Instagram @kindmindpsych. You can also reach out to me via my email at psychologist@quickanddirtytips.com, or leave a voicemail at (929) 256-2191.