Enrique is sitting in the cinema seat. He has gone to see a movie with a friend. Suddenly, he begins to experience distress, rapid heartbeat, and hot flashes; he feels very hot but at the same time he is cold and has chills. I’m having a heart attack or I’m going crazy, he thinks.
He leaves the room and drinks some water. He feels disoriented; later he would describe it as “being out of it.” He goes to the nearest hospital emergency room, where he tells the reason for his consultation: “I’m having a heart attack.” The movie was way behind. After two hours of testing and waiting, the diagnosis arrives. “You’ve had a panic attack,” says the ER doctor. Enrique feels disoriented, incapable and, above all, fearful that the situation will repeat itself.
This is likely to ring a bell. According to the WHO, 30% of the population has suffered or will suffer a panic attack. In fact, in 2019, 301 million people were diagnosed with an anxiety disorder; 58 million were children and adolescents.
A panic attack involves suffering from intense fear that triggers very alarming physical reactions for no apparent reason. One of its characteristics is the lack of control of the affected person over when, where and why. A stressed student can suffer from it days before the defense of his doctoral thesis, but also while taking a relaxing hot bath days after the event.
The short duration is another defining feature. While other anxiety disorders, such as generalized anxiety, are relatively long-lasting and require prolonged intervention, a panic attack lasts barely 10 minutes. In any case, the person can feel its consequences days later due to the anticipatory stress that implies not knowing when they are going to experience another similar episode.
Although not everyone experiences it the same way, the most common symptoms are rapid heartbeat, sweating, shaky hands, limp legs, nausea, abdominal discomfort, dizziness, headache, chest tightness, choking, and suffocating feelings. They are physiological manifestations that alert the body that there is a threat (in this case imaginary) against its physical or psychological integrity.
From a psychobiological perspective, it supposes the implementation of the processes involved in the organism’s fight for its own survival. In other words, the release of cortisol, adrenaline and noradrenaline and other hormonal mechanisms related to the autonomic nervous system and subcortical structures such as the amygdala and pituitary gland are activated.
This phenomenon is also associated with a cognitive deficit. Some research has shown that having one worsens performance in functions such as attention, working memory, and processing speed. This is mainly explained by the state of confusion and even “depersonalization” that the attacks bring about.
As noted above, during a panic attack the person feels that they are going crazy, that they are really going to die, or that something is threatening their own integrity. It is an imaginary threat.
This imaginary perception is what differentiates human beings from other species, as neuroscientist and writer Robert Sapolsky, author of the book Why Zebras Don’t Have Ulcers, would say. Many humans of the 21st century live in fear of what might happen because our basic needs (food, shelter, drink, affection…), which guarantee us survival with little cost, can be covered even before birth.
In fact, several epidemiological studies have shown that panic attacks are more common in Western countries with high incomes.
There is no cause-and-effect relationship between having a certain gene, character, or personality trait and the chances of experiencing a panic attack. However, there does seem to be a hereditary factor. Temperament also influences: highly sensitive people or with high levels of neuroticism and self-demand have more ballots to go through this distressing trance.
Gender is also a key variable. Numerous studies have shown that women are almost twice as likely as men to suffer from it throughout their lives. The explanation lies in the cyclical hormonal processes associated with the female gender: menopause is a period of maximum susceptibility.
The unpredictability of a panic attack makes it difficult to prevent it, although the patient who has suffered it at least once can reduce anticipatory stress levels at the idea of ??experiencing new attacks. He can also gain new abilities to handle the episode in the event that he appears again.
This is achieved by combining psychological therapy and taking specific medication, although there are alternatives such as manual therapy. The fundamental thing is that health systems are prepared from primary care consultations and emergencies with specific protocols and action strategies for these and other related cases.
Finally, I would like to highlight the importance of giving visibility to panic attacks and other anxiety disorders as part of good professional practice. Extrapolating the motto “information is power” to this context, it follows that if someone knows what a panic attack is, she will be able to act appropriately when she suffers it and, most importantly, she will be able to live without fear of its recurrence. And this work is as important as psychological evaluation and treatment.
This article was originally published on The Conversation.
María José García Rubio is co-director of the VIU-NED Chair of Global Neuroscience and Social Change – Professor of the Master’s Degree in Clinical Neuropsychology – Member of the Psychology and Quality of Life Research Group (PsiCal), International University of Valencia
