Understanding Panic Attacks: What Happens Medically and How to Manage Them

What is a Panic Attack?

A panic attack is a sudden onset of overwhelming fear or discomfort that reaches a peak within minutes and can be extremely distressing. Unlike a heart attack or stroke, panic attacks are not typically associated with permanent physical damage, but they can trigger intense symptoms that may feel very similar to a heart attack or stroke. Recognizing the difference between a panic attack and more serious conditions is crucial for effective management and treatment.

Medical Conditions Triggering Panic Attacks

Panic attacks often stem from a physiological condition known as hyperventilation. Hyperventilation occurs when we breathe too deeply or too quickly, resulting in a rapid loss of carbon dioxide (CO2) from our blood. CO2 is a crucial part of blood chemistry, as it helps maintain the proper acidity balance. When CO2 levels drop, the blood becomes more alkaline, leading to a series of physical symptoms.

Hyperventilation and Blood Chemistry

The loss of CO2 in the blood does not only affect the pH balance but also impacts the solubility of calcium. This can lead to a variety of physical sensations, such as tightness around the mouth, pins and needles, and even cramping. These sensations can be extremely alarming and contribute to the fear experienced during a panic attack. Furthermore, a lack of CO2 can cause constriction of the arteries, mimicking stroke-like symptoms that are truly terrifying.

Managing a Panic Attack

The best way to stop a panic attack is to reestablish normal breathing patterns. Techniques such as "underwater breathing" can be helpful. In this technique, you pretend to be underwater, holding your breath until you absolutely need to breathe again. This method allows carbon dioxide to build up in your blood, helping to restore the normal acidity and calcium availability.

Alternative Techniques and Tools

For those who find it difficult to control their breathing during a panic attack, carrying a plastic bag to breathe into can be an effective alternative. By tightly sealing the bag around your mouth and nose and slowing your breathing rate, you can recycle the CO2 in your breath, helping to manage the symptoms. However, it's important to avoid putting the bag over your head, as this can lead to suffocation.

Recurring Panic Attacks and Stress Management

Recurring panic attacks can create a cycle of stress and anxiety, as individuals become increasingly worried about when the next attack may occur. Teaching individuals to manage their own hyperventilation puts them back in control and helps restore a sense of normalcy. This is often more effective than relying solely on medications.

Emergency Room Testing

If you ever experience a panic attack and need to visit the emergency room, an arterial blood gas test can provide valuable information. This test measures various indicators, including normal oxygen levels, low CO2 levels, and a slightly elevated pH. Understanding the test results can be empowering as it helps eliminate the fear that the panic attack was due to an underlying medical condition.

Treating Phobias and Avoiding Future Panic Attacks

Recognizing that panic attacks are often under the individual's control can be a powerful motivator. Desensitization therapy, which involves gradually exposing oneself to the feared situations while practicing controlled breathing, can be an effective strategy. By facing the circumstances that trigger panic attacks, individuals can work towards reducing their fear and anxiety.

Individuals who experience panic attacks should be aware of the underlying physiological mechanisms, such as hyperventilation, and understand the importance of managing their breath. By taking control of their breathing, they can regain a sense of control and reduce the frequency and intensity of their panic attacks. This knowledge and the strategies outlined above can be invaluable in managing fears and phobias related to specific situations.