Mystery of Panic Attacks and Anxiety Disorders

One of my dearest friends and an important mentor has suddenly been plagued by panic attacks. I was surprised! This is a person who has his “act together” better than almost anyone I know. If this could happen to him it can happen to any of us.
So I did a bit of research.
Below is what I came up with.

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Thanks for reading. Of course I have included a light hearted video on the subject.


Panic attacks also known as anxiety attacks can happen to anyone, often for unknown reasons. One of my mentors, a Harvard trained psychologist and one of the clearest thinking and wisest people I know was suddenly stricken with these attacks. Unlike many emotional and mental challenges that are subjective diagnoses these periods of intense fear or apprehension of sudden onset are usually accompanied by at least four or more bodily or cognitive symptoms (i.e. heart palpitations, dizziness, shortness of breath, or feelings of unreality). Panic attacks can last from minutes to hours. Usually beginning abruptly, they may reach a peak within 10 to 20 minutes, but may in some cases continue for hours. Most panic attacks subside on their own over the next several hours.
For many afflicted with these symptoms there may be significant anticipatory anxiety and limited symptom attacks in between attacks, in situations where attacks have previously occurred. There is no standard reaction to these attacks. Some may call for emergency services especially those experiencing an attack for the first time. Many of these individuals fear they are having a heart attack or a nervous breakdown.

Common psychological streams of thought associated with panic attacks include the fears of impending death or loss of sanity; depersonalisation is relatively common.
Panic attacks are of arrive suddenly and quickly and are especially terrifying for those of common sense and great intellect who tend to be good at controlling their environments and feel that they may be spiraling out of control when they experience symptoms that might include flashing vision, faintness or nausea, trembling,dyspnea (shortness of breath), heart palpitations, chest pain (or chest tightness), hot flashes, cold flashes, burning sensations (particularly in the facial or neck area), sweating, nausea, dizziness (or slight vertigo), light-headedness, hyperventilation,paresthesias (tingling sensations), sensations of choking or smothering, difficulty moving and derealization. numbness throughout the body, heavy breathing, loss of bodily control and hyperventilation. This merging of phsycial and psychological symptoms can be very confusing. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the sympathetic “fight-or-flight response”) in which the hormone causing this response is released in significant amounts. This response floods the body with hormones, particularly epinephrine (adrenaline), that aid it in defending against harm. Often a person having this attack may experience tunnel vision. This mostly due to blood flow leaving the head to more critical parts of the body in defense.

If one really wishes to understand the psycho and the somatic elements that lead to panic attacks one needs to explore the nervous system, specifically the sympathetic nervous system (SNS) for it is what is happening here that is the stimulus for the attack talking place.

The most common symptoms may include These physical symptoms are interpreted with alarm in people prone to panic attacks. This results in increased anxiety, and forms a loop of fear of an attack possibly precipitating and attack which creates expectations and fear of future attacks. More often than not the predominant symptoms of an attack include shortness of breath and chest pain. This may cause the sufferer to incorrectly appraises this as a sign or symptom of a heart attack. This can result in the person experiencing a panic attack seeking treatment in an emergency room.
In such a situation an electrocardiogram and a mental health assessment have been carried out.

Panic attacks are distinguished from other forms of anxiety by their intensity and their sudden, episodic nature.

These are so multifaceted and complex that even mental health professionals are resistant to labeling them a mental disorder. They are a combination of psychological and physical challenges with a variety of causes that can stretch from post traumatic stress disorder, hypoglycemia, hyperthyroidism, Wilson’s disease, mitral valve prolapse, pheochromocytoma, and inner ear disturbances (labyrinthitis) to environmental factors such as an overly cautious view of the world expressed by parents and cumulative stress over time.

There are many approaches to dealing with these attacks. For the very intellectually astute person I have always recommended more creative “non-thinking” approaches. Yoga, tai Chi, singing, dancing, painting, emotionally release bodywork and massage and such.

Also forms of therapy where a person communicates their needs and is more assertive without stress. This is because there is a growing body of evidence that supports the idea that those who suffer from panic attacks engage in a more passive style of communication or interactions with others. This communication style is polite and respectful, but also characteristically un-assertive. This un-assertive way of communicating seems to contribute to panic attacks and is also frequently present in people who experience them.

There is a yogic breathing technique that may also be helpful know as pranayam it may counteract yperventilation syndrome – Breathing from the chest and overbreathing. Technically what happens in hyperventilation is a person exhales excessive carbon dioxide in relation to the amount of oxygen in one’s bloodstream. Hyperventilation syndrome can cause respiratory alkalosis andhypocapnia. This syndrome often involves prominent mouth breathing as well. This causes a cluster of symptoms realted to anxiety and panic attacks including rapid heart beat, dizziness, and lightheadedness which can trigger panic attacks.

Associating certain situations with panic attacks, due to experiencing one in that particular situation, can create a cognitive or behavioral predisposition to having panic attacks in certain situations (situationally bound panic attacks). Because of this a mental exercise may be useful where a person focuses “mindfully” in the moment surrendering regrets about the past and expectations for the future.
Panic disorder and general anxiety disorders can be effectively addressed with a variety of interventions including various psychological approaches, hands on healing techniques, “energy medicine” like tai chi, acupuncture, acupressure, massage, pranayam, meditation, and Qigong therapies. In extreme symptomatic situation medication may also be appropriate.

Among psychological therapies cognitive behavioral therapy seems to have has the longest duration of effect, followed by specific selective serotonin reuptake inhibitors Psychoanalytic psychotherapy has also been found to be effective.
The key to the effectiveness of any approach is three part. 1.To reduce the frequency of attacks 2. To reduce the symptoms when those attacks take place 3. To reduce the number of relapses.

A great book on depression and anxiety is “Healing Depression Naturally” by Lewis Harrison


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