What Is a Panic Attack?

A panic attack, or panic episode, is a period of intense fear that starts suddenly and grows increasingly severe. A panic attack is not a disorder in itself, but a sign that accompanies a psychological condition. In panic disorder, we often see spontaneous, recurring attacks.

In this article I'll explain the more physiological side of things. In the way I work and make sense of human psychology, a panic attack is really a symptom, and finding its underlying causes matters more than the symptom itself. In other words, your body is trying to tell you something through these attacks, and as we work in therapy and the client begins to understand themselves better, these symptoms fade over time. Still, panic attacks can make life very distressing and lead a person to panic even more out of fear of the next attack. So I'd like to give you an exercise that can help you calm down a little, and to explain the panic system simply.

How Does the Panic Attack Mechanism Work?

When we talk about panic attacks, we're really talking about a chain reaction in which anxiety turns into unreal catastrophic scenarios. The sympathetic nervous system, which normally keeps us alive by helping us avoid danger, gives a false alarm, as it were: when it switches into fight-or-flight mode in situations that aren't dangerous, a panic attack appears along with many bodily symptoms. In other words, panic attacks are false alarms our body gives us.

Why Does Breathing Matter?

A person who feels a worrying change in their body starts to worry and begins breathing fast. They then come to expect many other symptoms to follow one after another, so much so that they may end up thinking they'll collapse and faint, lose control or their mind, or even die.

What we need to notice here is that panic attacks are a vicious circle that moves forward as a chain reaction.

– Attacks are triggered by starting to breathe fast.

– Faster breathing usually forms the first link in this chain. Breathing rapidly lowers the carbon dioxide level in the blood, upsetting the pH balance, which in turn reduces the oxygen reaching the tissues.

– The disrupted pH balance in the blood sets the stage for many bodily signs such as dizziness, palpitations, cold sweats, light-headedness, unsteadiness and blurred vision. These put the body on alert, pull the person into a possible catastrophic scenario, and the attack happens.

– The logic of the "breathing into a paper bag" method, which I imagine many of you know, is to breathe in a way that is rich in carbon dioxide. At the same time, by seeing their breath concretely, the person sees that the belief "I can't breathe, I'm going to suffocate" isn't true.

So with breathing training, through a simple intervention on the breath, we aim to break the first link of the chain. By replacing fast chest breaths with healthy, steady diaphragmatic breaths, and turning our attention from the body to the breath, we prevent the attack. A person who learns diaphragmatic breathing will have learned to use breathing exercises to calm down when they feel a worrying change in their body, and to keep the fear of further attacks under control.

How Do You Breathe from the Diaphragm?

Besides being a psychologist I'm also a musician, so I use diaphragmatic breathing in my daily life. From what I've seen, many people only use chest breathing and never learn to breathe from the diaphragm. Years ago, when I was in a children's choir, our teachers taught us diaphragmatic breathing with the image of smelling a flower, and I'd like to teach it to you the same way. Imagine you're holding a flower and breathe in as if you were smelling it.

Normally, when we breathe from the chest, the belly is pulled in and the chest expands. In diaphragmatic breathing it's the opposite: as we breathe in, the belly should swell outward. To observe this, try lying down and breathing in through your nose; the breath you take lying down is a diaphragmatic breath. Diaphragmatic breathing is beneficial not only for people with anxiety and panic disorder, but for everyone.

Breathing Exercise

When an attack comes, or feels like it's coming, you can do this exercise to calm down:

• Breathe in from the diaphragm for 4 seconds
• Hold for about 1 second
• Breathe out through the mouth over 8 seconds
• Repeat this for 3 minutes.

Using diaphragmatic breathing, doing breathing exercises and understanding the physiology of the panic attack mechanism can relieve you and help you feel more in control. But if your complaints continue and have started to make your life difficult, then, as I said at the start of this article, your body may be giving you a signal. In that case I sincerely recommend getting therapy.

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