Dr. Lerato Dikobe (Psychiatrist) and Shai Friedland (Clinical Psychologist and SADAG Board Member) provide expert commentary on how to distinguish between panic disorder and panic attacks and how to manage your symptoms.
People may feel stressed and anxious because there is so much going on in the world and they feel overwhelmed by the thoughts and emotions, stresses, and worries that surround them. Understanding how to control your episodes so they don't negatively impact your quality of life is crucial.
How does panic disorder differ from a panic attack?
A panic attack is not an illness or a disorder per se. It's a symptom of a panic disorder that also appears in other anxiety disorders, even in depressive disorders.
Panic is or feels like a very intense sharp feeling in which you experience all of the other types of symptoms such as chest pain, and so on all at once.
It is significantly more intense in short bursts and typically lasts between 5 and 20 minutes.
Anxiety is a future-oriented state, which means that we should be cautious because there may be a danger in the future, which causes our muscles to tense and your body to prepare for that fight or flight response mode.
A panic disorder, according to the DSM (Diagnostic statistical manual), is defined as having anxiety attacks followed by a constant worry of having another similar attack, and this constant worry is what causes a problem with functioning or disturbs ordinary social and occupational function. Those symptoms and functional disruptions must be present for at least two weeks or longer.
“A panic attack is similar to a fear response. A panic attack will result from a fight or flight freeze mode” describes Dr Dikobe.
“It’s your body’s way of trying to protect you but the symptoms aren't pleasant and they are very uncomfortable”.
Symptoms of a panic attack
It's important to note that symptoms differ from person to person no two people will feel the same symptoms of a panic attack.
You will within the duration of the panic attack get symptoms like a very fast heart beat, feel like someone is sitting on your chest, difficulty in breathing, almost feel like you're getting a heart attack, your chest will feel really sore.
Symptoms of diarrhoea, cramps, vomit, headache and lightheadedness and other symptoms like hot flushes or cold chills all of which ends up exacerbating the pain.
Common symptoms of panic attacks
- Feeling frightened or scared
- Racing heart
- Chest pain
- Dizziness, feeling light headed
- Nausea
- Difficulty breathing
- Tingling and numbness in fingers,
- Hot flushes, cold sweats
- Feeling disoriented
- Fear of losing control, going ‘crazy’, or doing something embarrassing
- Fear of dying.
Are panic attacks a once-off thing or recurrent?
Freiland details that panic attacks can be a once-off thing. Hence why it's a symptom of other mental health ailments; if you have mental health difficulties they become recurrent. If you suffer from panic disorder you are most likely to have recurrent episodes.
“Panic attack can subside once a person is out of the danger zone” he emphasises.
What treatments are available for panic attacks or panic disorders
Assisting someone who is experiencing a panic attack for the first time basically involves trying to quiet them down and teaching them breathing techniques that will help them become calmer.
Dr. Dikobe maintains that it's extremely unfair and unethical to immediately prescribe medication to someone who experienced a single panic episode.
She further renders that she's not too quick to prescribe medication as it's rather important to try and establish what are the triggers that might’ve caused the panic attack as well as finding out what may be going on in that person’s life at that particular moment.
“If it's a consistent thing and it is in the wake of diagnosis of panic disorder or diagnosis of any other condition like a mood disorder that's when medication is advisably prescribed”.
Panic disorders or anxiety disorders are treated with antidepressants.
Dikobe presses that it's always important to get checked out by a doctor before starting any type of treatment.
Freiland also reveals that one of the most effective techniques is to recognise that these are just symptoms that, while unpleasant, will pass and I will not be harmed by them. Although this fear leads to panic attacks, talking to yourself about your symptoms might help you control them.
“The difficulty comes when we start to judge ourselves”.
Experts agree that cognitive behavioural therapy (CBT) is beneficial for treating mental health issues in therapy, and that it allows you to expose a patient to their physiological symptoms, let them experience them, and then help them calm down.
The certainty that, despite the fact that they will reach a record high and then descend, you won't die. The laws of gravity dictate that when symptoms of panic are at their worst, they will inevitably subside as the brain begins to realise what is going on and develop better coping systems.
What can cause a panic attack?
Living in constant fear raises your adrenaline levels, which raises your cortisol levels (stress hormone), resulting in a state of constant hypervigilance that can easily lead to panic attacks.
If you do take medication for panic disorder or anxiety does it stop them or does it just manage them?
So the prescribed medication does not stop the attacks. It rather manages them.
It's knowing how to manage the symptoms but it's important to be in a safe space because sometimes they become so crippling. Get yourself in a safe space and sit down and breathe. Antidepressants just decrease the height of the symptoms they don’t particularly cure anxiety. “ride the wave they advise”.
“Panic Disorder can be a terrifying illness that can cause great distress, isolation, and limits your life. Don’t suffer in silence and alone,” says SADAG Founder, Zane Wilson.