What is a Panic Attack?
A panic attacks come on in 5-10 minutes and involve five or more symptoms: numbing, tingling sensations, hot or cold flashes, sweating, shortness of breath, dizziness, light-headed, fainting, nausea, vomiting, diarrhea, headache, chest-ache, dry mouth, blurry vision, or ringing in the ears.
I lose focus and feel like everything is going crazy
I feel like the world will end and have a feeling of doom
My stomach is “tied up in knots.”
I have butterflies in my stomach.
The muscles tighten in the chest and the throat, and I can’t breathe.
It feels like a heart attack.
The physical symptoms of an anxiety disorder can be easily confused with other medical conditions and people think they are having a heart attack. Group therapy members talked about going to the hospital thinking they were about to die and later found it was a panic attack.
In the emergency department, doctors and nurses attend to the symptoms and determine what it is and how serious it is. After ruling out a medical illness, the doctor may recommend a person see a mental health professional to make a diagnosis of an anxiety disorder.
Observational Skills: My Anxiety Symptoms
Physical: Shaking, trembling, sweating, hot or cold flashes, tingling, numbing, nausea, throat, and chest muscles tighten, not connected to my body, observing myself.
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Emotions and Feelings: Fear, embarrassment, anger, shame, irritability, confusion, worry, dejected, hopelessness, jealousy, offended, abandoned, isolation, sorrow, distress, misery, discouragement, or frustration.
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Actions or Behaviors: Run, hide, vomit, faint, diarrhea, upset stomach, pain in chest, head, stomach, cannot breathe, or hyper-ventilate.
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Thoughts: Loss of concentration, fear that the world will end, fear of doom and destruction, racing thoughts, or inability to focus.
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Sensations: Nausea, light-headedness, dizziness, throat, chest, or stomach a tightness or pressure, pain in head, chest, throat, or stomach.
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Psychosis or PTSD: Flashbacks, paranoia, voices, images of trauma, disconnected from reality, intrusive thoughts, anger, irritability, de-realization (things do not seem real), de-personalization (not feeling grounded in the body).
other hallucinations increase in intensity.
I don’t feel like I am in my body.
Things around me don’t seem real.
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Images: flashbacks of trauma memories, increase in visual hallucinations, things or the walls and floors seem to move.
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Treatment
There are different types of treatment that a mental health professional may suggest. Common types of treatment that are used:
Psychotherapy
Medications
Complementary health approaches, including stress and relaxation techniques.
(Nami 2017)
My Notes
Thoughts _____________________________________________________________
Feelings _____________________________________________________________
Sensations _____________________________________________________________
Images _____________________________________________________________
Acknowledge Thoughts, Images, Sensations, and Feelings
The group therapy participants talked about the thoughts and feelings, worry and depression that are part of the shame and guilt, and how they noticed you do not have to keep them. One participant explained that you can choose to let them stay in the past and start over new today. You are a new person today with new choices to make for your life. You can choose to do things. You can change your thoughts by changing your environment.
The group practiced deep breaths and imagined how they could leave the past regrets stigma, and guilty feelings in the past.
Another participant talked about going outside and not watching violent or sarcastic TV shows or movies. Others agreed that going for a walk outside in nature would calm down anxiety.
Distraction Skills
The group discussed how to get away from the anxiety and came up with a list.
Play with a pet.
Watch calm movies about nature.
Listen to instrumental music, non-violent music with non-violent language, and no swearing.
Call or text a friend.
Dance or sing.
Do arts & crafts.
Do sports.
Take a shower or a bath.
Addictive Behaviors Can Be Used to Disguise Emotions and Feelings
gambling sexual partners pornography alcohol
street drugs overspending on the phone all the time electronic games
other _____________________________________________________________
One participant talked about a certain “high or drunk” feeling that was noticed with the use of street drugs or with stealing or shoplifting. This behavior can be a problem for a relationship or with other family members. People might become afraid to be around a person who has behaviors like this because they are illegal, and the person can be arrested.
Identify Feelings, Images, Sensations
Feelings can affect the way we think and act. The Mindfulness Response teaches us to become aware of emotions and feelings. By practicing mindfulness, we learn to notice, observe, acknowledge, and accept the intensity of our emotions and feelings. This gives us information about them and helps diffuse their intensity. It is one way to learn to manage them.
The ability to understand emotions and feelings helps us identify how they can affect the physical body. Emotions and feelings can influence thoughts and actions.
The first step in learning to manage difficult emotions and feelings is to identify them. Usually, there is one stronger feeling but there can be ten more feelings underneath the strong feeling. Try to notice and observe other feelings that you have. After identifying the emotions and feelings, notice if they influence any PTSD or psychosis symptoms.
Have you heard yourself say any of these statements?
It’s time to change.
It’s time to do things differently.
I can’t deal with this anymore.
I can’t accept this anymore.
I can’t do this anymore.
Thoughts
Acknowledge and recognize the thoughts. Identify the feelings that are associated with the situation. _____________________________________________________________
Feelings associated with the situation:
Sad embarrassed frustrated overwhelmed scared afraid anger ashamed shy
Despair guilty used by others let down abandoned neglected overlooked hostile overloaded _____________________________________________________________
Sensations that I feel in my body when I experience this.
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A Panic Attack: 4-5 symptoms that arise within 5- 10 minutes
Numbing, tingling, hot, cold, sweating, heartbeat jumps, races, skips; upset stomach, blurry vision, ringing in my ears, nausea, vomiting, light-headed, faint, shaking, trembling, crying spells, shortness of breath, pain in head, chest, throat, stomach, can’t swallow, heart-attack feeling, loss of focus, going crazy, feeling of doom, fearfulness
Other sensations
Images or Flashbacks of past trauma: _______________________________________________
Losing track of time, dissociation: __________________________________________________
Participants who experienced trauma in their past talked about triggers. The group discussed triggers from the five senses, where a strong sensation could start the memory. The use of mindfulness helped connect the strong emotion to the trigger by examining sight, sound, touch, taste, and smell. A participant experiencing PTSD and psychosis described negative thoughts about their current situation and feeling unsafe.
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