Here’s the understatement of the century—panic attacks are not fun. When a single panic attack grows into panic disorder, it is downright depressing.
Initially, a person has a panic attack for any number of reasons (e.g. skipping meals and having low blood sugar, stress, bad reaction to pot use, etc.). People who are prone to panic disorder tend to be very sensitive to bodily sensations and a panic attack is one of the most intense and unpleasant physiological experiences that they have ever had.
Often people rush to the emergency room when they’ve had their first panic attack, believing that they are seriously ill. Because the panic is perceived as so horrific, the person then begins monitoring their body for any signs of another “attack”.
Because people who are panic prone tend to be sensitive to physical sensations to begin with, the constant monitoring for sensations brings up a continual parade of “triggers” (increased heart rate, dizziness, shortness of breath, etc.). In the absence of medical illness, these sensations are normal variations of physical experiences, but in the mind of someone with panic disorder they are heralds of disaster.
Once the feared sensation is noticed, the person with panic disorder has what I call the Oh SH*&! Response. Instead of normalizing what is happening in their bodies, they catastrophize their inner experience: I’m about to die, go insane, have a heart attack, humiliate myself, get stuck in a never-ending panic attack, etc.
After this massive misinterpretation of normative bodily processes occurs then the inner alarm bells (i.e. the fight-or-flight response) gets triggered and the bodily sensations greatly increase (think about how your body feels when you are startled or frightened suddenly). In the mind of someone with panic disorder, this further confirms their dire interpretation and anxiety skyrockets into panic. Again, the panic is feared and hated and leads to even further body self-monitoring and the cycle continues.
In order to treat their panic disorder, one needs to understand that the feared physical sensations are normal (that is why getting checked out by a physician is important in order to rule-out a medical problem) and although unpleasant their discomfort is normal and not damaging. This is accomplished by educating oneself as to normal variations of physical sensations and then beginning to face these sensations intentionally in order to prove to oneself that they can cope. For example, someone who is worried about the panic sensations leading to a heart attack would practice gradually increasing their heart rate through activities such as running in place. This is called Interoceptive Cue Exposure Therapy.
Eric Goodman, Ph.D.