Welcome to my first publication of Living With Gusto!

I'm Lori Little, MA,Psychotherapist, and as you may or may not know, anxiety is my foremost specialty. To embark on our journey, I thought I would begin by unraveling the mysteries of panic attacks.

What are they? Many people do not have any idea what panic attacks are even when they are experiencing them. Panic attacks, for most who experience them, are pretty scary. Not to mention having them and not knowing what they are. But, even for those who are experiencing them and know what they are, many of those people still have no idea what is happening to them. What I mean is they know they're having a panic attack, but have no idea why or what their body is doing physically. They just know they hate what is happening to them and want it to stop.

According to the DSM IV, which is the diagnostic manual all mental health providers and physicians use as the standard of diagnosing mental health disorders, a panic attack consists of, "a discrete period of intense fear or discomfort, in which 4 or more of the following symptoms developed abruptly and reached a peak within 10 minutes:"

* heart pounding, palpitations, or accelerated heart rate
* sweating
* trembling or shaking
* sensations of smothering or shortness of breath
* feeling of choking
* chest pain or discomfort
* nausea or abdominal distress
* feeling dizzy, unsteady, lightheaded, faint,or virtigo
* derealization,ie.feeling like everything is surreal or unreal or depersonalization, ie. feeling detached from yourself.
* fear of losing control or going crazy
* fear of dying
* paresthesias, ie. numbness or tingling sensations in the body.
* chills or hot flashes

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That is what a person needs to be experiencing to qualify as having a panic attack, but what does it all mean? Why do people have panic attacks? The answer is really very simple!

No, I mean, that is the answer. Your body is telling you to take some notice; there is something going on in your life that is not good for you, so to speak, or something that has happened to you that was hurtful and you are now just beginning to heal from it. You know the old saying, "it gets worse before it gets better", well it's something like that. Some can only ignore the things that bother them for so long before their subconscious and their body gets in cahoots to get their attention and says heal me, take care of this now!

Just like nightmares, panic attacks alert us to pay attention something is amiss. Ok, obviously you know something is wrong, because your having panic attacks and they are extremely uncomfortable and frightening, but what else is wrong? That is to be determined. If you can't find an answer, it's because you are so used to ignoring the problem and telling yourself there isn't one.

That is where therapy can be a wonderful tool! Helping people to decipher all the confusing emotions and sift through the defense mechanisms to identify what really needs to be addressed and what really is not serving you.

While a person is sorting through their baggage and trying to unload it, what is a person to do if they are still experiencing panic attacks during the healing process???

There are a few techniques that are taught during therapy to address panic attacks, but in the interim, here are some facts about panic attacks that might help to diffuse the fear and discomfort.

When a panic attack occurs there is fear, when fear rears it's ugly face, our bodies are gearing up to either fight off the enemy physically or to physically run away from the impending danger. Either way this response floods the body with epinephrine or what we call good ole adrenaline. Remember the story of the woman who lifted a car off of her child, the adrenaline coursing through her body aided her to have super strength at that moment, it was very useful to her, but what happens when there is not a car to lift, a person to fight, or a danger to run away from?

The adrenaline has no use and no where to go, so to speak. It courses through your body and as a result your left feeling shaky, dizzy, scared, feeling like your going to die, or that your going crazy. Often you feel disconnected from yourself and your surroundings and that primarily is what contributes to the person feeling like they are going crazy. That weird, swimmy, tingly, lightheaded, spinny, disconnected feeling is complimentary of the adrenaline and those feelings lead to feeling like your going crazy or your dying. The feeling of dying and what takes many people to the emergency room is also chest pains or tightening of the chest which can occur as symptoms of a panic attack, which people misinterpret as a heart attack.

Wikpedia does a great job describing the physical components of a panic attack and does so in a much more technical manner for those of you looking for that type of description here it is...

While the various symptoms of a panic attack may feel that the body is failing, it is in fact protecting itself from harm. The various symptoms of a panic attack can be understood as follows. First, there is frequently (but not always) the sudden onset of fear with little provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the so-called fight-or-flight response wherein the person's body prepares for strenuous physical activity. This leads to an increased heart rate (tachycardia), rapid breathing (hyperventilation) which may be perceived as shortness of breath (dyspnea), and sweating (which increases grip and aids heat loss). Because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood. This leads to shifts in blood pH (respiratory alkalosis or hypocapnia), which in turn can lead to many other symptoms, such as tingling or numbness, dizziness, burning and lightheadedness. Moreover, the release of adrenaline during a panic attack causes vasoconstriction resulting in slightly less blood flow to the head which causes dizziness and lightheadedness. A panic attack can cause blood sugar to be drawn away from the brain and towards the major muscles. It is also possible for the person experiencing such an attack to feel as though they are unable to catch their breath, and they begin to take deeper breaths, which also acts to decrease carbon dioxide levels in the blood.

I hope this gives you a better understanding of what panic attacks are and in having more information about what is happening physically and why, you may feel less frightened. You now have a better understanding that feeling like your going crazy or dying is one of the defining features of a panic attack and all the physical sensations are due to the excess adrenaline in your system at that time. There are explanations, it is not something random because your going crazy! Although, it is there to get your attention, So, PAY ATTENTION!

I hope this issue of Living With Gusto! finds you well!

To contact Lori Little, MA, Psychotherapist to answer any questions you may have or to schedule an appointment call 248-722-2653 or Contact Us.

Living With GUSTO! E-Zine compliments of Lori Little,MA, Psychotherapist and Full Circle Behavioral Health,PC.

I hope you enjoyed this month's issue. Until next month when more pertinent mental health issues will be discussed!

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