anxiety attack

How to deal with an anxiety attack: the symptoms and what to do and what not to do

It’s hard to breathe, you’re short of air, your heart is racing, you feel pressure in your chest, dizziness, heat, sweat, tingling, trembling, chills, numbness, the space around you is distorted, you feel like ‘unreality… It happens to you all of a sudden, with no apparent cause or real danger.

The body’s physiological reactions are triggered and the head looks for a reason, an explanation. The brain goes into a spiral of catastrophic thoughts, fear, panic, and despair.

It is a crisis or an attack of anxiety, distress, or panic. They are synonymous with the same sudden, brief, and intense discomfort that in various degrees can become paralyzing and brings many people to the emergency services.

Almost 7% of the population suffers from it, according to estimated data from the Ministry of Health, and it affects twice as many women, 8.8%, than men, 4.5%, especially in productive ages, from 35 to 65 years old. An incidence that after the pandemic is seen to be increasing, also — especially — in teenagers, and even in children, who according to psychologists suffer differently.

Although it is being talked about more and more openly, it is suspected that these numbers may be higher. Socially and culturally, the false belief that associates anxiety crises with a personal weakness still weighs heavily. This leads many people who suffer from it to hide the problem for fear of being looked down upon, or because they don’t want to recognize an aspect of themselves that they consider negative.

What brings us to the anxiety crisis?

Anxiety is often talked about as one of the evils of our time. We are exposed to the rush, the pressure, the stress, to thousands of external stimuli, family, social, cultural, work… and managing it all is not easy.  

Everyone is exposed to having an anxiety attack throughout their life. But having one or not depends as much on each person’s personality as on the tools we have to manage feelings and emotions.

“Anxious or more rigid personalities have more numbers, but it is a complex equation in which many factors are involved, such as the family structure and the cultural and social context”, says Carol Palma, member of the Official Association of Psychologists of Catalonia ( COPC) and professor at Blanquerna.

“Sometimes it’s unexpected and in situations of absolute calm, even sleeping. The trigger can be a simple physical sensation, a thought, a smell, a noise… and the person doesn’t connect it to anything,” adds Palma. Another trigger can be the use of drugs and alcohol, which are often used to soothe discomfort when an anxiety problem or predisposition is already present.

According to psychologist and publicist Pablo Palmero, “anxiety crisis occurs because we have a bad relationship with ourselves”. ” We don’t agree with the ideal we have of ourselves,” he says.

However, specialists consider that the anxiety crisis is not a disorder in itself, but a symptom, a “red light”, says Palma, which alerts us that something has changed, and it can be treated.

Read also: “Burnout” or the syndrome of being burnt out at work: how to prevent it and distinguish it from depression

What causes it?

When you suffer for the first time an anxiety attack is so shocking that it triggers the fear of having one again.

“The main trigger is the same symptoms, sensations, and emotional reactions. It has nothing to do with the situation you live in, but how you live,” says Pablo Palmero.

“The main factor that causes anxiety attacks to grow into a state of extreme discomfort is a spiraling escalation due to fear of fear .”

The fear of losing control, going crazy, or dying are fears that most patients refer to. These intense sensations are associated with scenarios and contexts, so that when we return to a place or a similar situation is repeated, the whole alarm system is activated again. In addition, “anxiety tends to anticipate a future danger — even if it has never happened –“, says Carol Palma.

It is what is called “anticipatory anxiety”, “the fear that another crisis will occur”, which can lead, according to Palmero, to develop ” avoidance behaviors and rituals “, which leads us to stop doing certain things, of going to certain places or exposing ourselves to certain situations. And this can “end up leading to an aggravated and more persistent anxiety pattern over time.”

Carol Palma considers that avoidance does not help to overcome the problem, since “we are confirming in our brain that the danger is real”.  

What do I do if I have a crisis?

Once the spiral of physical and mental symptoms of the anxiety crisis is triggered, psychologists make several recommendations. Given that physiological activation leads to hyperventilation, one tool is to monitor breathing.

– Breath slowly: contrary to what is often said, you should not breathe deeply –which activates the spiral even more because the feeling is of not being able to take in enough air and this generates more fear–, but to breathe more slowly, says Palma.

Paying attention to our breathing rhythm also helps us connect with reality. To do this, Palmero recommends describing the experience.

– Acknowledge what we feel: “I feel my heart pounding”, “My breathing is interrupted”, “I feel tingling in my right leg” and distinguish between physical sensations and interpretations, recommends Palmero.

“It is not a matter of stopping the thought but of redirecting it towards the body and the emotions. It may seem contradictory to focus on the manifestations that want to disappear, but it is crucial to stop the spiral dynamic. Because we do not accept to feel- us wrong.

– Open the focus: Look around and see that those around us are not scared, that they have no sense of danger. “Broadening the focus helps to have more perspective when we feel like we have no way out and we have tunnel vision,” says Carol Palma. For Palmero, it’s about “changing the attitude, and not doing it out of desperation”.

– “This ends…”, “It’s happened to me before…” Crisis episodes are short in time and, therefore, it’s good to remember this, as well as to recognize the symptoms, to reduce the despair that this experience entails, and limit it in space and time. It’s an unpleasant or very unpleasant episode, but it will pass. They usually last for a few minutes, when a peak is reached from which the sensation goes down until it disappears within an hour.

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