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Trying to remember the first time you had a panic attack is like trying to recall your first day of kindergarten. You know it sent you careening down a Slip 'N Slide of emotions, but you can't for the life of you drop yourself back there and re-experience the nuance.
There have been many panic attacks between my first and now, though attempts to remember the first cascade of accelerated heartbeats only grow foggier. I don't need to piece it all together, though, because every time I have one, it feels like the first time. It's just as scary, just as alarming, and just as awful.
What Is a Panic Attack?
Over a decade ago I sat face to face with a clinical psychologist in my college town of Santa Barbara, CA. Our session began with me describing unyielding symptoms that were peaking at night (sweats, shaking, and accelerated heartbeat — more to come on this), and the session ended with a pretty bow, a label with which I could identify my neurological adversary: panic disorder.
It was the first time I'd even heard of panic attacks and panic disorders. Mental health wasn't, at that time, omnipresent. The only disorders people talked about in school were of the eating and learning variety.
A panic attack comes on fast and hard.
According to the Mayo Clinic, a panic attack is "a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack, or even dying."
Though I never felt like I was dying, the most relatable word in the explanation above is sudden. A panic attack comes on fast and hard. Giulia Suro, PhD, a licenced clinical psychologist, said something similar. "It comes out of nowhere and is immediately intense; there is no gradual buildup," she told POPSUGAR. "The extreme physical sensations that come quickly and out of nowhere are at the root of what distinguishes panic from anxiety and can eventually turn a single panic attack into panic disorder."
However, Dr. Suro makes it clear that a panic attack or even a few panic attacks doesn't mean you have a panic disorder; there's a key distinction. "Panic disorder is determined by how someone responds to a panic attack or panic attacks. For some, experiencing a panic attack is so incredibly terrifying that they begin to alter their behaviour or make changes to their life to avoid having another one. At its worst, individuals with panic disorder begin to limit their lives out of fear of having a panic attack."
Symptoms of a Panic Attack
The panic experience can be hard to describe, in part because it all happens so fast, almost like an earthquake. The symptoms, however, are easier to pinpoint. "For most, a panic attack is characterized by a rapid heart rate and the feeling the heart is pounding in an unsafe way," Dr. Suro explained. "Many people actually think they are having a heart attack and go to the emergency room. Other common symptoms are shortness of breath, hyperventilation, dizziness, tingling of extremities, or numbness of arms and legs, as well as a fuzzy, dissociative experience that can feel very scary."
Additional symptoms I routinely experience include acute heat in my chest that feels like someone is heating me up with a pitchfork, uncontrollable shaking of my limbs, and intense gastrointestinal distress that sends me into the bathroom every few minutes.
What's the Difference Between Anxiety and Panic?
While anxiety and panic are certainly good friends (though perhaps your enemies), an easy way to think about the difference is that anxiety is a reaction to a stressor, whereas panic can appear completely unprovoked. "Anxiety is connected to some tangible fear; whether it's real or in our own minds, we can point to what is making us anxious," Dr. Suro explained. "Panic is not tied to any concrete threat; that is what makes it so disorienting. Panic represents the farthest, most extreme end of the anxiety spectrum in terms of the physiological symptoms. The level of fear and physiological arousal may feel as if someone has a gun pointed to your head." The important thing to remember is that with panic, the fear someone is experiencing isn't reasonable; it's not actually an appropriate reaction to the events around you. There is no gun pointed to our heads. "This mismatch between how you are feeling internally (high-level danger) and what is going on internally (no danger present) can contribute to the cognitive element of panic."