Nothing to Fear, But Fear Itself

By: Natalie Rice-Thorp, Ph.D. | December 31, 2021

Understanding and Treating Panic Attacks

Have you ever experienced anxiety come on so quickly and with such intensity that you feared you were having a heart attack or that you were going crazy? Maybe your heart was pounding, or you were sweating or shaking. You might have visited the hospital or called your doctor only to be told that there is no medical explanation for your physical symptoms. If all of this sounds familiar, you probably experienced a panic attack.

Following a panic attack, it is common to have preoccupying thoughts like “what if it happens again?” In response to these worries, you may have started to avoid certain situations or activities like crowded places. Panic attacks have the potential to negatively impact our lives significantly and keep us from doing the things that we love. As scary as this all this seems, there is good news. Panic symptoms are very manageable with the right type of treatment, such as Cognitive Behavioral Therapy (CBT).

Before pursuing CBT for panic, see your physician to rule out possible medical conditions.

What is a Panic Attack?

There are many different forms of anxiety disorders that people experience. When Psychologists talk about “panic attacks” we are referring to Panic Disorder, which is a sudden and unexpected rush of intense fear/discomfort that quickly reaches its peak. During a panic attack, people can experience a variety of physical symptoms and catastrophic thoughts. Some examples of physical symptoms are increased heart rate, feeling too hot or cold, shaking, and nausea. During a panic attack, people may have thoughts such as “I’m going crazy” or “I’m going to die.” After the first experience with a panic attack, people may become very worried about having future panic attacks, and their worry and avoidance can start to impact their lives.

It Came Out of Nowhere

Many people say the first panic attack “came out of nowhere,” but when we look more closely, we can start to identify the sequence of events to better understand what happened. Our bodies are constantly busy doing things “behind the scenes.” Our breathing and heart rates, for example, fluctuate throughout the day in response to stressors and strain and we are usually too busy living our lives to notice. Sometimes, however, a series of events come together, and we suddenly take notice.

Imagine a scenario where you wake up late for work; you skip your usual breakfast and just have coffee; you race to work in traffic and arrive late to a meeting. You are sitting in the meeting when you notice that your heart is pounding, and you feel too hot. You worry that people are looking at you. You feel like you want to run out of the room, and you worry that you are going to lose control and embarrass yourself. In this example, you had caffeine in your system on an empty stomach, you were feeling stressed and exerting more physical energy than usual; you had more adrenaline and oxygen running through your system than you usually would in a staff meeting; you noticed your physical experiences, and you jumped to unrealistic interpretations. In response to the scary thoughts of losing control, your fight/flight/freeze response went into overdrive, your physical symptoms quickly intensified, and your worry thoughts continued to escalate.

During a panic attack, you aren’t in any actual danger, but your physiological and nervous system responded as if you were. You are, in effect, experiencing a false alarm.

How does Cognitive Behavioral Therapy Work for Panic Attacks?

Cognitive Behavioral Therapy (CBT) is a long-standing, empirically supported method for effectively treating anxiety symptoms, including panic. During the process of CBT, your therapist will help you identify and break down the pieces of the panic cycle. Your therapist will teach you how to identify and replace scary, catastrophic thoughts with more accurate thoughts about what is happening in the here and now. One of the goals of CBT is to help clients strengthen their self-soothing skills. You will learn the healthy range of physical sensations and experience them without panic, knowing that these sensations are not harmful and do not always indicate a real threat in your environment.

During CBT, your therapist will help you get back to your regular life by gradually approaching the activities you avoid such as driving, being in crowded places, or going places alone. A typical CBT protocol for panic disorder can be completed within a few months with weekly one-hour sessions. Unlike medications for anxiety, the effects of CBT continue after treatment has concluded.

You Are Not Alone

If you suffer from panic, or panic attacks, we know how scary and lonely the experience can be. You may feel like there is no hope and that things will never change. Know that you are not alone, and that panic attacks are a common experience among adults in the United States. Contact a professional San Diego Psychologist at Therapy Changes to learn more about your symptoms and how CBT can help.

The Team at Therapy Changes invites you to read our valuable resources on Stress Management and Relaxation as well as additional information on Cognitive Behavioral Therapy.



Photo by Anaya Katlego on Unsplash

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