Anxiety and panic attacks

Written by: Dra. Antonia Regojo Zapata
Edited by: Top Doctors®

anxiety and depression, types, symptoms and treatment Anxiety it is a psychological and physical reaction to an internal or external stimuli that triggers fear, because it is perceived as dangerous or threatening. It is normal that we respond with anxiety when there is a perceived threat. The threat can be real or imagined, proportioned to the situation or made bigger than it really is. 
Anxiety can be a very health response as it helps us to stay safe, out of danger. It makes us decide whether to fly (run away from) or fight the danger. However, when anxiety appears out of the blue with no real danger or threat or the anxiety is not proportioned to the danger, then we have to start to consider seeking help.

Anxiety can present in many different ways (symptoms) Some are physical (muscular tension, tightness in the chest, breathing difficulties, palpitations, aches, nausea and/or vomiting, tiredness, poor sleep, headaches, shakes) and some psychological (fear, apprehension, catastrophic predictions, worry, fear of ridicule, thought block, ruminations).


Types of anxiety

Anxiety can present itself in many different ways. For instance, Social Anxiety (fear of social encounters or meeting new people), Agoraphobia (anxiety of open spaces, crowds, public spaces), Claustrophobia (fear of being in closed or narrow spaces), Hypochondria (health anxiety or fear of suffering serious illnesses). It can also present in the form of Generalized Anxiety *anxiety most of the time and without clear trigger) or Panic Attacks (Short lived severe anxiety episodes). I will now explain some of them in more detail>

  • Social anxiety: It's what we commonly describe as shyness. Social interactions can often be a lot of fun but sometimes can involve risk taking. Some degree of anxiety when we meet new people is perfectly normal and shows a good survival instinct. If you are always too relaxed in front of strangers, you can end up taking unnecessary risks. However, those who suffer social anxiety perceive risk as bigger than it is and react to situations that are not in themselves dangerous. It is really about the balance between assessing the risk realistically and allowing ourselves to enjoy the benefits of social interactions. Social anxiety is not the same as being cautious. For instance, a sensible teenager may decide not to mix with certain friends if he always ends up drinking too much and getting into trouble when in their company. However, if he stops every social interaction and his life becomes restricted this means that the balance has been lost. 

The same occurs with other types of anxiety. In the case of Health Anxiety, certain levels of concern about our health can help us to seek help when alarm signs appear. If we didn't do this, we could end up with a serious or life threatening illness, undiagnosed and untreated. However, some people spend considerable amounts of time worrying about their health, fantasizing about possible illnesses or undergoing unnecessary medical tests. These patients are often sent home by their GPs, if no medical reason has been found. Some medical practitioners are more aware of the underlying emotional suffering and instead of sending them home they refer them to psychotherapy. Anxiety is a problem that needs treatment.


Panic attacks

Panic attacks are severe episodes of anxiety that are triggered by a known fear or appear just out of the blue. The person often freezes and can't react. The fear of the consequences or physical risks often make the person enter into a vicious cycle in which the anxiety exponentially increases. 


Symptoms of panic attack

The physical symptoms can be tachycardia, breathlessness and shallow breathing, muscular aches, chest pain, blurred vision, nausea and/or vomitting, dizziness, numbness, tingling, swating. These are often interpreted as very alarming illnesses such as a heart attack or a stroke.This often makes the anxiety worse. 

The psychological symptoms can be fear of dying, fear of loosing control, fear of fainting, fear of ridicule,  worry that anxiety will never ease and other catastrophic predictions, lack of concentration, irritability, restlessness, disorientation. Although these attacks are a source of stress and can be traumatic at times, it is also true that panic attacks rarely have any serious consequences and they tend to extinguish spontaneously after a few minutes. 


What to do in a panic attack

There are some techniques that can help us to overcome a panic attack. These techniques work on addressing the negative feedback loop. Keep in mind that it starts with an initial trigger and then feeds itself with worry about the symptoms and their consequences.

  • Breath Control. In order to stop rapid and shallow breathing (which can give you a chest pain) focus on deep and slow breathing. This also brings about a sense of calmness. 
  • "Body Scan" relaxation. It is a "step by step" relaxation exercise of all your body from head to toes. You can find audio guidance on YouTube or some Mindfulness Websites.
  • Keep Distracted. Some people find useful to have something that distracts from the trigger. For instance, if you are anxious traveling on the tube, you can try reading a book or listening to music. 

Often, people learn that there is nothing to fear about the panic attack by just waiting and know that it will go away. This often breaks the feedback loop and makes the anxiety milder and the panic attack shorter. 

In order to keep our minds healthy it's very important that we look after ourselves well and that we know when to ask for help. There are many ways in which us, professionals, can help someone with anxiety, from some easy tricks like the ones given above to more sophisticated treatments and sometimes, if necessary, medication. Other times it will be necessary to investigate its roots and understand the meaning of our fears. Don't forget that even our most irrational fears make some sort of sense somewhen in our internal worlds and that finding out is an essential step towards healing. 

*Translated with Google translator. We apologize for any imperfection

By Dra. Antonia Regojo Zapata

Dr. Regojo is a prominent psychiatrist and psychotherapist. It was formed in the British National Health System, and is currently undergoing consultation in Madrid and Majadahonda. She is an expert in psychoanalytic, psychodynamic and systemic psychotherapy for adults, couples, families and groups. It also performs based on mentalizing, applied personality disorders and food therapy.

*Translated with Google translator. We apologize for any imperfection

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