WOMAN WISE™: The Fear Factor: How to Deal With Panic Attacks

By Susan Maltby

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: 0in 0in 0pt">For parents, occasional fear and worry simply comes with the territory. It’s normal to sometimes experience an array of anxieties, overwhelming worries and even occasional moments of sheer panic. Hopefully, these uncomfortable feelings don’t become part of everyday life.

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Having a Panic Attack? 
Tips to Help You Cope

Anxiety and panic disorders affect more than 19.1 million Americans between the ages of 18 to 54, or about 13 percent of people in that age group, according to statistics from the National Institutes of Mental Health (NIMH).

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The NIMH reports that women are twice as likely as men to suffer from panic disorder, a serious condition marked by repeated episodes of intense fear as well as the persistent fear of future panic attacks.

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“Although there is a genetic component to anxiety disorders, the statistics are higher for women partly because they’re more likely to seek help for their problem,” says John Tsilimparis, director of the Anxiety and Panic Disorder Center of Los Angeles. “Men who suffer from excessive fears may be more reluctant to talk to their doctor about it.”

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Most people will experience one or two panic attacks in a lifetime. Here are some basic facts to help you cope if your worries get out of whack.

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: 0in 0in 0pt">Am I Having a Panic Attack?

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More than just the usual feelings of worry or stress, a panic attack is an acute and intense episode of fear. Generally, attacks occur suddenly, during harmless situations with no apparent cause. Common symptoms of a panic attack include:

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• Chest pain, racing heartbeat or heart palpitations.

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• Difficulty breathing or the sensation of not being able to get enough air.

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• A feeling of fear beyond proportion of the situation, an almost paralyzing feeling of terror or dread.

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• Trembling, shaking or sweating.

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• A sense of unreality or disconnection, dizziness or lightheadedness.

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• Thoughts that you’re going “crazy,” losing control or about to die.

N: 0in 0in 0pt">Intense fear sets off a dramatic chain-reaction of physical responses.

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“Through evolution, our bodies have developed the ‘fight or flight’ survival response to prepare us for escape from sudden danger,” says Tsilimparis. “When faced with immediate threat, the fear center in our brain reacts by adjusting our adrenaline levels, heart rate, breathing and other functions so that we can either defend ourselves from harm or run away.”

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It may be helpful to know that scientists have discovered that even insects possess this primal response as a means of self-preservation, explains Tsilimparis. “Without the ‘fight or flight’ response we’d be dead,” he says.

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When our body tells us that it’s time to freak out, the surging feelings can be terrifying in themselves.

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 Am I Going Crazy?

Panic attacks are not abnormal experiences. “In the vast majority of cases, panic attacks are transient, stress-induced incidents,” says Stuart Shipko, M.D., an anxiety-panic expert and author of Surviving Panic Disorder (1stBooks Library, 2003).

“If you’re just wondering if you have a panic disorder, you probably don’t,” explains Shipko. “When you can’t go to work or leave your house because of it, you aren’t wondering, you’re there.”

Often, panic-attack victims will seek help at a hospital emergency room.

“It can be a complicated issue,” Shipko says. “Panic is being both over-treated, under-treated.”

Shipko says that doctors are under pressure from patients and drug companies to write more prescriptions than are really necessary.

“Medication is effective, but most medications used to treat anxiety are addictive, have serious side effects and can actually worsen symptoms,” Shipko says. “People go to their doctor and they want that pill. They don’t want to be told that they need to look at their life and take responsibility for reducing stress.”

Your doctor can rule out other health conditions that may be causing anxiety symptoms. Unless you’ve suffered several repeated panic attacks and live in constant and continuing fear of having another, you probably don’t have a panic disorder. Shipko urges people to do their research and carefully weigh the possible benefits of any medication against its side effects.

“If your panic symptoms aren’t incapacitating, you have time to read books and look around on the Internet,” says Shipko. “The first step may be to go see a psychologist who can make a less-biased diagnosis about whether you need to embark on a course of long-term medication.”


When to Worry About Worry

In addition to panic attacks, experts list several trademark behaviors to watch for that often accompany a panic or anxiety disorder, such as:

• Repeated visits to hospital emergency rooms.

• Alcohol or substance abuse – “The majority of patients have a history of using
alcohol or drugs to treat their anxiety,” says Tsilimparis. “Alcohol works immediately, but in the long term it can make symptoms worse.”

• Catastrophic thinking – Unrealistic focus on negative and worst-case scenarios.

• Rigid limits and controlling – Unrealistic boundaries such as never allowing the children to play outside, avoiding freeways or manipulating other’s behavior to try to reduce anxiety. Setting extremely high expectations on children or overly strict rules.

• Perfectionism – Fear of embarrassment or failure can drive anxiety sufferers to always seek to impress others and avoid mistakes at all costs.

• Depression - Over time, untreated panic disorders can affect quality of life and cause feelings of hopelessness and depression.


Panic Buttons

A panic attack is frightening enough in itself to cause further complications. Often the scariest part of panic disorder is that the attacks can happen without an obvious cause. Phobias can develop as an attempt to avoid panic attack triggers.

“Usually, people who suffer panic attacks begin to set up control strategies to prevent further attacks,” says Tsilimparis. “For example, they may avoid a certain room or situation where a panic-attack occurred.”

Janet Williams, a 32-year-old Los Angeles mom who didn’t want to use her real name, began experiencing general anxiety and panic shortly after she finished college when she was just 22 years old.

“I was in a movie theater the first time I had a panic attack,” Williams says. “The best way I can describe it is it’s like the way you feel when someone comes up behind you and says ‘Boo!’ and your heart jumps and you feel scared for a minute. But in a panic attack you get the same feeling for no rhyme or reason,” she explains. “The panic isn’t brought on by anything specific, and it’s such a strong physical reaction.”

Panic disorder can affect different people in different ways, and specific fears can vary for each individual. “For me, the worst part was that I just felt so very alone," says Williams. “I needed to be out with people. It was the worst when I was by myself.”


Treating Anxiety and Panic

Anxiety and panic disorders are highly treatable. With the right help, including medicines, therapy and support groups, many people recover almost completely.

Common drugs prescribed to give immediate relief from panic attacks include Valium, Klonopin, Xanex and Ativan. These fast-acting drugs are known as benzodiazepines and are addictive for some. You should not take them if planning to get pregnant, while pregnant or while breast-feeding. Drinking alcohol while on these medications can lead to increased intoxication effects and drowsiness.

For more long-term relief and prevention of panic symptoms, doctors usually prescribe Paxil, Zoloft, Lexapro and Celexa. These drugs take up to six weeks to take effect and have recently made headlines as being linked to an increased risk of suicide.

“Once the medication built up in my system to correct the imbalance and I learned more effective coping skills, I was fine for about eight years,” says Williams.

But when she and her husband wanted to have their first child, Williams stopped taking her anxiety medication.

“It didn’t take long before my anxiety came back. I got pregnant right away, but I also began feeling more anxious than ever,” says Williams, who now has a healthy 2-year-old son. “I went back on my medication as soon as I could, but it took a long time before I felt better again.”

Tsilimparis, a licensed marriage and family counselor who specializes in panic disorder, offers confidential screenings, diagnosis and treatment at the Anxiety and Panic Center of Los Angeles.

“Unfortunately, there is a stigma attached to being on medication. Some people don’t want to take pills the rest of their lives,” says Tsilimparis. “But you have to realize that it’s a real illness. Be compassionate with yourself and get help. If you had diabetes or asthma, you wouldn’t refuse medication. Panic disorder is real, and you need to get treatment.”

He also urges panic sufferers to educate themselves and explain their illness to loved ones. “Often, spouses who don’t understand the disorder will tell you that you just need to calm down, get some rest or drink some herbal tea,” says Tsilimparis. “But it’s not that easy. It’s a serious illness. If you take your illness seriously, then it’s more likely that your spouse will learn to be understanding.”

With therapy and medication, Williams has been panic-free for many months. She says she is grateful for the support of her therapist, family and friends.

“The most important thing to know is that it does get better,” she says. “When I was in the midst of it, that’s something I needed to know really badly. You will feel better.”

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On the Web

; font-family: Verdana;">• Anxiety Disorders Association of America -  – National organization dedicated to providing information, awareness and reducing stigma surrounding anxiety disorders.

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; font-family: Verdana;">• Anxiety Busters! - – An anxiety outreach organization with a natural health focus offering a free anxiety help line and a self-help tape program.

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; font-family: Verdana;">• - – A free, step-by-step, self-help guide for those suffering from panic attacks, fear of flying, OCD, social anxieties and generalized anxiety disorder. Developed by Reid Wilson, Ph.D., author of Don't Panic and Stop Obsessing.

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; font-family: Verdana;">• Living With Panic Disorder, by John Tsilimparis, MFT. PublishAmerica, 2003. Includes stories written by courageous individuals whose lives were forever changed by panic disorder.


Surviving Panic Disorder, by Stuart Shipko, M.D., 1stBooks Library, 2003. Covers the psychological, psychiatric and medical aspects of this frequently misunderstood condition.


Don’t Panic: Taking Control of Anxiety Attacks, by R. Reid Wilson, Ph.D. HarperCollins Publishers, 1996. This is an authoritative book on overcoming panic and anxiety.