Anxiety is Up: How to Know When to Get Support

by Beth Granet, PsyD

Almost all of us have had the experience of feeling worried, nervous, shaky, or tense before public speaking, attending an important event, or taking an exam. In light of Covid-19 and recent events, these feelings may have become more familiar to you. You or someone you know may have even said “I’m having a panic attack!” during times of high stress. When hearing the term “panic attack” many of us picture a person crying or hyperventilating into a paper bag. The truth is, despite the dramatic and sometimes funny depictions we have seen on TV, at the movies, or perhaps from our friends and loved ones, panic attacks can be quite scary. So, how do you know if you or someone you care for is having a real panic attack?

First, panic attacks happen quickly as a surge of powerful fear or discomfort. These feelings usually reach their maximum within a few minutes and almost always involve extreme distress. In fact, episodes of other high intensity emotions such as anger or grief, are usually not part of panic attacks at all. Panic attacks are also different from what we think of as anxiety because they happen in bursts as opposed to being ongoing. They typically include some mixture of both physical and psychological symptoms. Some people may even feel as if they are having a heart attack. Learning about and recognizing the signs of panic are the first steps to treatment. Below are some helpful examples of things we might experience during a panic attack:

Physical/Body Sensations:

  • Heart palpitations or sharp increase in heartrate
  • Excessive sweating
  • Shaking
  • Shortness of breath
  • Nausea/stomach discomfort
  • Feelings of choking
  • Dizziness
  • Headache
  • Uncontrollable screaming or crying
  • Chest tightness or distress
  • Chills or heat sensations

Psychological/Emotional Experiences:

  • Fear of losing control
  • Feeling “crazy”
  • Emotional numbness or intense apathy
  • Feeling detached or outside your own body
  • Fears of dying
  • Experiencing unreal or dreamlike surroundings

You might be wondering, who is more likely to experience some of these things? Although panic attacks can happen to anyone, they tend to occur in those struggling with other psychological concerns. Specifically, adults and teens that have difficulties with general anxiety, depression, PTSD, substance abuse, eating disorders, OCD, or mood issues such as bipolar disorder, can experience panic attacks as part of their other struggles. It is important to know that it is rare for children to have panic attacks before they have hit puberty, although it is possible.

Additionally, we should be aware of other risk factors for panic attacks such as extreme stress on either a personal or community level. Individually for example, sickness, a major loss, interpersonal problems, and even smoking cigarettes can increase our likelihood of a panic attack. Some medical problems such as heart, respiratory, gastrointestinal, or inner ear conditions can also cause panic attacks. We also need to know that watching loved ones suffer, a natural disaster or tragic event, a widespread illness, or even the cultural climate can trigger feelings of worry and loss of control. During these times such as now with Covid-19, be sure to gather facts from reputable sources and manage overwhelming thoughts by using your knowledge to keep a realistic perspective.

Now that you are more aware of how panic attacks happen and what can cause them, you may be even more nervous. Don’t be! Although these attacks are upsetting and uncomfortable, there are ways to treat them. Panic attacks can happen either expectedly or out of the blue like during calm times or even sleep. If you think you are experiencing them, you can talk to your psychologist or therapist to get a proper diagnosis. Your clinician will probably ask a lot of questions about the events, thoughts, environment, and feelings leading up the attacks to determine if there are specific triggers for them. Oftentimes, there are specific cues triggering a panic attack that can be identified to help prevent future attacks. An experienced therapist can work with you to develop strategies for handling these triggers as they arise. Whether having panic attacks predictably or unexpectedly, be sure to talk to your therapist or psychiatrist about them right away.

When it comes to treating panic attacks, the moral of the story is to learn more, talk to your doctors, and remember that help and hope are out there!