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What you need to know about Panic and related anxiety!



With an exponential increase in cases of the coronavirus all over the world, the medical fraternity is facing the brunt of the pressure head-on, now more than ever. However, it is common knowledge that fighting such an arduous battle does not come without its own consequences. Increased exposure to negative news, distressing events, and seemingly endless uncertainty about future events have prompted an increase in the number of mental health problems plaguing the general population.

However, we believe that the only thing worse than receiving negative news is misinformation. Worry not! We are here to sort out a few basic things to help you understand the situation more clearly.


Through this article, we wish to clear up certain myths related to Panic and related anxiety, give you a simpler picture of what these two concepts mean, and help you stay up to date with how you could help yourself and others in a similar situation.


What does Panic and a related attack mean?


It is very easy to misinterpret what panic means with all the information we derive coming from its portrayal in popular media.

In simple words, panic is a sudden onslaught of uncontrollable fear or anxiety, often leading an individual to take action without considering the consequences beforehand. It is a period of unbridled fear or anxiety that prompts the body to think it is dying; whereas in reality, it is the body’s fight or flight reaction to something that doesn’t pose an immediate danger. Our subconscious, having been fed a steady stream of danger warnings for weeks, is now using mental shortcuts that go back to our evolutionary roots of the survival of the fittest.


Now, most people often get confused between an anxiety attack and a panic attack. Let’s look at the major points of difference between the two.

It is important to note that more often than not, an anxiety attack is set off by a specific trigger (an event or object) that could range anywhere from a small insect to the coronavirus pandemic at large whereas a panic attack is something that comes on suddenly. Although it is rare for panic attacks to hit without an underlying reason, it is quite possible to witness a sudden and unexpected occurrence.


How can you identify if someone is having a panic attack?


"My teeth would chatter uncontrollably and my whole body would tremble, I’d hyperventilate and cry with panic as the feeling that I was going to fall unconscious was so convincing."


To put it into perspective, a person suffering from a panic attack at any moment may feel the following symptoms:

  • Palpitations, pounding heart or accelerated heart rate

  • Nausea or abdominal distress

  • Depersonalization (feeling detached from oneself) or derealisation (feeling of unreality)

  • Chest pain or discomfort

  • Chills or heat sensations

  • Paresthesias (numbness)

  • Fear of losing control or going crazy

  • Fear of dying

  • Trembling or shaking


  • Shortness of breath or feeling smothered, feeling of choking

  • Sweating

  • Dizziness, feeling unsteady, lightheaded or faint


The above-given list forms a part of the diagnostic criteria as stated by the DSM V (Diagnostic and Statistical Manual) used by Psychologists and Psychiatrists alike all over the world. Although it isn't necessary to witness every one of these symptoms, most of them will most likely be present in someone experiencing a panic attack. (a minimum of 4 of the aforementioned symptoms must be present in the person suffering from the attack)

As medical students or practicing doctors (or even otherwise), it is important to know the difference between a heart attack and a panic attack. While at a symptomatic level it may seem that these two are the same, they differ in ways that could be life-saving if identified quickly.

According to the BIDMC (Beth Israel Deaconess Medical Center), the primary differences between a heart attack and a panic attack are:


Here are a couple of myth busters to give you a little breather :)


Myth: Panic attacks last for a long time.

Fact: Panic attacks are often short but intense and die down in a matter of minutes (ranging from 5 - 10 minutes). In some situations, multiple attacks one after the other may make it seem like it lasts longer than it actually does.


Myth: Panic attacks are life-threatening.

Fact: While it may seem like your body is dying, panic attacks are NOT life-threatening. One CANNOT die from suffering a panic attack, however, having constant or regular panic attacks can take a heavy toll on both physical and mental health. It is highly advisable to seek help from a medical or mental health professional for long term solutions.


Causes of panic attacks/ situations that may increase the risk of suffering a panic attack:


"Never knowing when I was going to have a panic attack was the worst feeling in the world."

One of the most challenging aspects of panic attacks is that they typically occur without warning. They can swoop in from out of nowhere, with no oncoming symptoms to predetermine them effectively. While some people may have one panic attack and never experience another in their life, in unusual circumstances you might find that you have them regularly, or several in a short span of time. This is usually an indicator of a pre-existing Panic Disorder and it is highly advisable to consult a professional about the same.

"My panic attacks seem to come out of the blue now. But in fact, they seem to be triggered mainly at night when I want to go to sleep but cannot stop my mind racing, experiencing worry and panic about anything that may be on my mind."


It is important to note that not every person who struggles with anxiety also has panic attacks, but there can be a genetic predisposition to them. People with anxiety disorders and mood disorders find themselves at greater risk, and panic attacks do tend to run in families. In addition to this, panic attacks are also associated with major life transitions (graduating from college, changing jobs, getting married, having a baby), severe stress (death of a loved one, divorce, job loss), and certain medical conditions. One might notice that particular places, situations, or activities seem to trigger panic attacks. For example, it might be set off before a stressful appointment, a very difficult exam, or a drastic, stressful change in lifestyle. Apart from these, an attack could be triggered by stimulant use, including caffeine, and withdrawal from medication.

How you can help yourself or others in the event of a panic attack:

In the unlikely event that this may happen to you or someone you know, you must know the following things to be able to better manage yourself (or the other person) during the episode.


IMPORTANT: When such a situation arises, it is always a priority to determine whether it is a heart attack (pulmonary disorder, endocrine problem or essentially any other disease that might mimic these symptoms) or a panic attack (refer to section 2 of this blog) before proceeding with the suggestions given below.




In the event of a panic attack:


Step 1:

Take slow and deep breaths

Try breathing in and out of a paper bag to prevent hyperventilation. Doing this calms your sympathetic nervous system that is currently in overdrive and it brings your body to a state of relative restfulness.


Step 2:

Splash water on your face

This action serves the simple purpose of physically jolting you out of the state of raw panic. It helps you momentarily focus on something else.


Step 3:

Refocus on something else (like your feet, or an object or a thought)

Looking at your feet, thinking of something pleasant or simply starting a countdown from 50 aid in distracting your mind from the racing thoughts that led to the panic attack in the first place.


Step 4:

Remind yourself

(or if it is another person, reassure them) that these feelings aren’t dangerous and will pass soon.


Step 5:

Focus on self - care

It is important to pay attention to what your body needs after the attack subsides. Sit down somewhere peacefully and find something to eat or drink.


Step 6:

If you’re feeling up to the task, confide in someone you trust.

Mentioning your symptoms to someone could prove to be extremely useful in helping them notice it in the future.


Although we have mentioned a few steps one could take to manage a situation at hand, it is always advisable to get it checked from a medical or mental health professional once it is over. In addition to this, if you wish to know more about ways and means to calm a person suffering from a panic attack and know about long term solutions to avoid such an episode, we recommend you to go through the resources that we have carefully compiled for you! They include a couple of YouTube videos (whose links are given down below) and certain apps that one could use to calm oneself.


Videos!

According to Healthline, a health blog, the following apps are amongst the best to help with calming oneself, meditation, and mindful thinking:

  • Headspace (rated 4.9 / 5 by iPhone users)

  • Calm (rated 4.5 / 5 by android users)


The COVID – 19 pandemic has taught the world a tough, yet important lesson about staying mindful of their physical and mental health, especially in trying times. Reading up and staying up to date with ways and means to destress, relax, and self - care is of utmost importance, pandemic or not. We hope you walk away slightly better equipped in knowledge and spread the word about the same wherever you can!

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