Panic attacks: How to detect them and what to do

Anxiety is a physiological, cognitive and behavioral response of the body. When it occurs we experience a series of physical symptoms, such as increased heart rate or sweating; a cognitive response, such as worry; and behavioral actions, mainly represented by the avoidance of certain situations that we find threatening and that can cause the appearance of the aforementioned symptoms. That, in general, is anxiety.

However, when we talk about an “attack,” we usually mean what in psychology and psychiatry is known as a panic attack (which in older classifications was called anguish crisis) or anxiety attack. It is important to note that a panic attack is not considered an anxiety disorder. What is true is that many people suffer from them: approximately 30% of the population has had a panic attack at some point in their life. And when it happens, many are not aware of the situation.

A panic attack is the sudden appearance of a series of symptoms, of which the most common are: increased heart rate, sweating, dizziness, a choking sensation and chest pressure. But there is also a cognitive symptom, which is the belief that something very bad is happening to you, that you are having a heart attack or facing certain death. This happens very quickly and does not last long, usually reaching its peak between seven and ten minutes before subsiding.

The physiological symptoms that occur during a panic attack constitute an alarm response from the body that is normally triggered by imminent danger. Those symptoms are what prepare the body to react and avoid that danger, either fighting or fleeing. In other words, it is an organic and adaptive response that serves to protect us.

The problem with panic attacks is that the body triggers that response at the wrong time, like a false alarm. The mechanism is activated with no real danger in sight. Exposure to chronic daily stressors like too much work, excessive responsibilities and economic hardship – to name a few – can increase our anxiety level, which sets off states of nervousness, unease, worry and poor or intermittent sleep. These high levels of anxiety can activate the alarm system in the absence of actual danger, causing a panic attack.

The main problem with panic attacks is the misinterpretation of the physical symptoms, as people tend to believe that they are dangerous and can cause death. When a person is capable of questioning these erroneous interpretations and becomes aware that the symptoms are neither dangerous nor fatal and that the chest pressure is actually muscle pressure and not a sign of a heart attack, the physical symptoms subside.

You are not having a heart attack

The main concern of people who suffer from panic attacks is usually the thought that they might be having a heart attack. So, how to tell one from the other? If when these intense symptoms appear the person questions their seriousness and consequences and they begin to subside in the next few minutes, it is indeed a panic attack.

It is useful to try to divert attention from the symptoms. In studies, people who have suffered panic attacks have said that things like playing a mobile game that requires concentration worked for them. That is, any activity that diverts the attention from the symptoms and the catastrophic feeling they produce. Focusing your attention on breathing soft and slow can also help.

Another important thing when it comes to preventing them, when it has happened to you before, is not to avoid the situations that have triggered it for fear of it happening again. This can heighten the problem. We also recommend daily exercises or activities that help you to relax; focusing on the moment, on the present and everything that surrounds you; and carrying out rewarding leisure activities. In other words, everything that helps to reduce the levels of anxiety that we suffer in our daily lives.

The risk factors identified in scientific studies that have been associated with anxiety problems, including panic attacks, are, among others: being young, being a woman, physical health problems, job dissatisfaction or economic difficulties.

Our research group has developed risk algorithms that, by answering a series of questions, estimate the probability of suffering from an anxiety disorder in the next year. We use these predictions to carry out personalized interventions with the goal of preventing the appearance of such problems. We are currently testing a personalized intervention online (in Spanish) for all types of population in a randomized clinical trial. Our goal is to curb a problem that affects many people.