What is a panic attack?

Panic means a sudden spell or attack of feeling frightened, anxious or very uneasy. Typically
symptoms come on suddenly and escalate in severity over the next 5-10 minutes. A panic attack is
essentially a severe flight or fight reaction.
During a panic attack the following symptoms may occur:
· feeling short of breath
· pounding heart
· sweating
· trembling or shaking
· blushing
· trembling or croaking voice
· nausea or a fear of vomiting
· dizziness or light-headedness
· tingling fingers or feet
· tightness or pain in the chest
· a choking or smothering feeling
· hot or cold flushes
· feelings of unreality
· a feeling that you cannot get your thoughts together or speak
· an urge to flee
· a fear that you might die
· a fear that you might act in a crazy way.
You can see from the list of changes that occur during the flight or fight response how at least some
of these symptoms arise. Any or all of these symptoms may occur. Not every one with social
phobia gets panic attacks. Each individual tends to have their own pattern of symptoms in response
to anxiety, and to find some symptoms more distressing or unpleasant than others. In social phobia,
blushing, sweating and shaking are often seen as the most troubling symptoms.
When anxiety becomes severe, most people try to escape the situation in order to prevent the feared
consequences (the “flight” aspect of the flight or fight response). In other words, if an individual
fears that their anxiety will cause them to look odd, or say something inappropriate they will try to
escape the situation before this can happen. Once out of the situation the anxiety usually settles
quickly.
Most people rapidly learn to predict the situations in which the anxiety or panic is likely to occur.
Some people quickly begin to avoid such situations altogether. Anticipatory anxiety can be a severe
problem. Sometimes an individual really intends to go through with a social outing or performance
situation but avoids it at the last minute because their anxiety has escalated to the point where they
feel totally unable to manage the situation. Avoiding situations that cause anxiety may seem the
only alternative to the negative evaluation that it is feared may result if social performance is
adversely affected by anxiety.
But what if your performance wasn’t as badly affected as you thought? You would lose the
opportunity to learn this. Your anxiety would probably start spreading to other types of social
situations. Meanwhile, your level of confidence and self esteem would drop as you found yourself
more and more restricted in what you felt you could cope with. Hence, you would become even
more anxious about the situations you feared. When social phobia has been present for a long time
the individual often structures his or her life around the need to avoid certain situations or expends
considerable effort and anxiety planning what to do in case a panic should occur.
This program will teach you how to control your anxiety and panic and how to cope with situations
in which anxiety is likely to occur.
EXERCISE: MAKE A LIST OF SITUATIONS IN WHICH YOU WOULD FEEL VERY ANXIOUS
1. __________________________________________________________________________________
2. __________________________________________________________________________________
3. __________________________________________________________________________________
4. __________________________________________________________________________________
5. __________________________________________________________________________________
The Role of Hyperventilation
We now turn our attention to one particular aspect of the flight or fight response, namely, the
increase in rate of respiration, or overbreathing.
Efficient control of the body's energy reactions depends on the maintenance of a specific balance
between oxygen and carbon dioxide. This balance can be maintained through an appropriate rate
and depth of breathing. The flight or fight response triggers an increase in the rate of breathing in
preparation for taking flight. When this response is triggered by a social situation, you are unlikely
to respond by running away, at least, not literally! The increase in oxygen intake is not matched by
an increase in carbon dioxide production and an imbalance results.
Hyperventilation is defined as a rate and depth of breathing that is too much for the body's needs at
a particular point in time. The imbalance which results causes many physical symptoms, including:
· dizziness
· light-headedness
· confusion
· breathlessness
· blurred vision