- Hi, I'm Dr. Tracey Marks, a psychiatrist
and I make videos on mental health education
and self improvement.
Today I'm talking about panic attacks
and how to recognize it
and what are some of the typical thoughts
and behaviors that come with it.
Panic attacks are a sudden onset of intense anxiety.
Sometimes when you get anxious
you can feel uptight or on edge
or you may even worry about things,
but panic is different.
You have a surge of intense fear or physical symptoms
that come on suddenly
and reach a peak intensity within minutes.
With a panic attack
you experience four of the following symptoms
and this is as defined
by the Diagnostic and Statistical Manual
of Mental Disorders fifth edition.
Palpitations or pounding or racing heart.
Palpitations are when you feel your heart beating.
At any given time
you should not feel your heart beating in your chest,
especially if you're at rest.
It's different if you just stop running
or being very active.
But if you do feel your heart beating when you're at rest,
it's considered palpitations
and is usually related to anxiety.
You can have sweating, trembling or shaking.
Sensations of shortness of breath or smothering.
Feelings of choking, chest pain or discomfort.
Nausea or abdominal distress.
Feeling dizzy, unsteady, lightheaded or faint.
Chills or heat sensations.
Numbness or tingling sensations that we call paresthesias.
Derealizations and this would be feelings of unreality
or depersonalization
which is feeling detached from yourself.
I did a video talking more about these experiences
and you'll see it linked in the corner
and I'll have a description or I'll have a link to it
referenced in the description as well.
Fear of losing control or going crazy.
Fear of dying.
You can have other ways that you show anxiety
like crying or screaming,
but you would still need to have
four of the other symptoms as well.
Panic disorder occurs when you have regular panic attacks
and this is your main problem.
And you can get to where you don't wanna leave the house
or be around people because you fear having a panic attack
and not being able to escape.
But anyone can have panic attacks or attacks of anxiety
without it being the full panic disorder.
Panic attacks can be experienced as unexpected or expected.
Expected would be when there's an obvious trigger
like needing to speak in public
or waiting for a scary procedure or experience to happen.
Unexpected panic attacks happen when you're calm
and you can't attach the anxiety to anything specific
and you can even wake up from sleep in a panic attack.
Why would you have panic attacks?
Sometimes they come along with other disorders
like depression, generalized anxiety disorder for example
and sometimes they can result from a medical condition
or a medication side effect.
Panic attacks tend to last for just a brief period
like several minutes,
but you can remain anxious and unsettled
for much longer than that.
People who are more sensitive to anxiety
and the way it feels
can be more vulnerable to having panic attacks
and we call this body vigilance
when you're hypersensitive to every body sensation
and that you worry that your physical symptoms
are a sign of a serious physical problem.
For example, if you feel your heart beat,
you don't just think about it.
You obsess that you're on the verge
of having a heart attack.
Or if you feel heat on your face, you're convinced
that you're getting ready to have a seizure.
I talk about this kind of body vigilance
in a video that I did on health anxiety.
One of the approaches to addressing panic attacks
is to look at how you think about them
and what you do because of them.
So let's first look at what you think.
We can all have distorted thoughts about things
and what you think affects how you act.
People with anxiety and panic
tend to have three kinds of distorted thoughts.
Catastrophizing, fortune telling and jumping to conclusions.
Catastrophizing is when you blow a situation
out of proportion and focus on the worst outcome
to the exclusion of the lesser outcomes.
Fortune telling is predicting
what's gonna happen in the future.
And jumping to conclusions is making assumptions
about the final outcome
without taking everything into consideration.
Here are five common distorted thoughts
we see with panic disorder.
I'm gonna have a heart attack.
This is a catastrophic conclusion that you can draw
from feeling your heart race.
And it might be reasonable
to fear this the first time it happens,
but with panic disorder you can think this
each and every time.
Even though you have panic daily
and it's always been anxiety and not your heart,
you can still think that this time
it's gonna be different and it will go too far
and become a heart attack.
Number two is I'm going to faint.
It's common with panic to feel lightheaded
and it's easy to conclude
that any time you're lightheaded or dizzy
you're going to faint.
Another common thought is that I'm gonna suffocate.
When you start hyperventilating,
you can think that you're on the verge
of being unable to breathe at all,
but you really can't hyperventilate yourself
into not being able to breathe.
Breathing is involuntary and if you stop trying to breathe,
your brain takes over and breathes for you.
I'm gonna go insane.
First of all, what's insane?
Psychosis?
That's usually what we associate
with the most severe form of mental illness
because you have a break from reality,
but psychosis is a completely different problem
and you can't worry yourself into it
or hyperventilate yourself into it.
I'm gonna lose control and just go berserk.
I get an image in my head of the android
in the old alien movie that started malfunctioning
and just running around the room.
That's not what it looks like
when people have a panic attack.
You may fear that you're gonna embarrass yourself
with some wild behavior, but it just doesn't happen.
It's more of a silent suffering in your head
that causes you to take action
and that segues
into the typical behavior scene in panic disorder.
There's escaping the situation, just leaving the room.
Avoidance.
This would be not allowing yourself
to be around the things that you think trigger you
and sometimes that's a good thing,
but it can also cause problems
if it's the only way that you manage your anxiety.
And then there are safety behaviors
and these are things that you do
to keep yourself safe from the feared behavior.
These safety behaviors can make you feel better temporarily,
but they keep the panic response going
because when you do the safety behavior,
you don't get a chance
to test how realistic your assumption is
and then you don't learn to manage the situation
because you avoid dealing with it.
So these are some of the factors
behind the scenes of panic.
In another video I'll put this all together
and talk about the non-medication ways
you can address your panic.
Subscribe to the channel so you don't miss it.
See you next time.