What Is A Panic Attack?

Here is a recent email we received from a soldier who returned home from a deployment in Afghanistan:

“Two days ago I went to the Emergency Room because I thought that I was having a heart attack. They told me that I was fine, and that it was anxiety. This has happened to me twice before. I’ve had a full medical workup and they are trying to tell me it’s all in my head, but I just know that it’s physical. Can you help?”


And we emailed him back:

Dear Andy:

If medical reasons for your symptoms have been ruled out, what you thought was a heart attack may have actually been a panic attack, which is a type of anxiety. In fact, many people with panic believe that they are suffering from an undiagnosed medical condition, even when a medical doctor has determined that there isn’t any physical illness. Why? Because anxiety and panic are emotional states which are experienced in our whole bodies. So what is a panic attack? A panic attack is a sudden episode of extreme fear that is accompanied by physical symptoms. Because the physical symptoms are so strong, people often confuse their body’s anxious panic reaction with physical illness. The following list provides some of the psychological and physical symptoms that may accompany a panic attack:

  • Nausea or abdominal discomfort
  • Sweating
  • Rapid breathing
  • Dizziness
  • Fear of losing control
  • Palpitations
  • Sweating
  • Shortness of breath or smothering sensations
  • Choking sensations
  • Tightness or pain in the chest
  • Dry mouth
  • Shaking or trembling
  • Sense of doom or danger
  • Fear of dying
  • The need to escape
  • Feelings of unreality
  • Numbness or tingling sensations
  • Hot flashes or chills

Panic attacks can be terribly frightening and can cause extreme physical discomfort. An attack can happen unexpectedly, with no apparent cause, or can occur more predictably, in certain situations. Someone can have an attack ‘out of the blue,’ or have them consistently, such as when driving over a bridge or being in a crowd, or occasionally, when there is a specific trigger event.

Even when panic attacks can seem like they are out of the blue, there typically is an initial trigger event, when someone reacted with the fight/flight response. Fight/flight is a basic animal (and human) physiological reaction that occurs whenever we feel threatened. It can be a physical threat, such as someone about to hit you, or an emotional threat, such as your commanding officer being upset with you. It can also be an imagined threat, when you wake up in the night and imagine all kinds of possible threats that might have happened when on deployment. Your body reacts to these threats by pumping stress hormones so that you can respond immediately (in case it is a life-threatening event). Those stress hormones linger in your body, and that’s what causes all of the feelings listed above. If there is no ‘real’ threat, you don’t understand why your body is overreacting so much, so your brain sometimes interprets that as a heart attack. Panic can be a component of mild to severe PTSD—Post Traumatic Stress Disorder.

Your body can become conditioned to going into a fight/flight response in a particular situation (such as the battle field) and some soldiers can then become conditioned to respond that way just by thinking about the situation. After a while, for some soldiers, a full panic attack can occur if there is just an obscure mention of the triggering situation. This is what happens when someone feels as if a panic attack has occurred “out of the blue.”

People who have panic attacks worry over having another attack. This concern can lead to a heightened state of anxiety, which then leads to another panic attack, and so a vicious circle begins. A person with panic disorder may begin to avoid the places where he or she had previous attacks. For example, if someone has a first panic attack in a movie theater, he or she may then avoid returning to a movie theater for fear of another attack. This change in behavior is more likely to lead to a panic attack if that person is confronted with the feared situation. He might then have another attack in another setting, such as a restaurant, and begin to avoid restaurants. So his horizon becomes smaller and smaller. This behavior pattern can lead to increasing restrictions on where a person can go, thus leading to increased isolation.

Panic disorder can begin in adolescence or adulthood. The causes are both physical and psychological. Your chances of developing panic are higher if you have family members with anxiety problems. Stressful life events, such as the loss of a job, having a child, participating in combat, serving in a war zone abroad, or losing someone you love, can trigger panic. The good news is that panic disorder is treatable. With counseling, and medication if necessary, you can learn to cope better and symptoms will diminish over time. Lifestyle changes can increase your stress hardiness and decrease your physical reactivity. Learning about anxiety,

decreasing caffeine and sugar from your diet, quitting smoking, exercising, learning relaxation techniques, and adopting positive “self-talk” are just some of the ways you can help yourself.

Some suggested books to read:

  • Hope and Help for Your Nerves, by Claire Weekes
  • Finding Serenity in the Age of Anxiety, by Robert Gerzon
  • The Anxiety and Phobia Workbook, by Edmund Bourne
  • Overcoming Panic, Anxiety, & Phobias: New Strategies to Free Yourself from Worry and Fear, by Carol Goldman & Shirley Babior

Our coaches and counselors at the Guard Your Buddy program are available to speak with you about any concerns relating to panic, anxiety or PTSD. Call us at 855 HELP GYB (855-435-7492), 24/7. This is a private, no cost and confidential program for you and your family.

©copyright, Sobel & Raciti Associates, Inc., 2011