The Student Panic Attack Survival Guide (Part 1: Understanding Panic Attacks)

Hey kiddos, it’s Serious Post time, so forgive the lack of zany gifs and suchlike.

Today is Bell Let’s Talk Day, and all across the country conversations are being had about mental health and the challenges we face in addressing what is, essentially, a society besieged by mental illness. I’ve seen enough real-life examples in my life and around campus to know that I’m not exaggerating; student mental health is at an all-time low. York University actually issued a mental health survey, and the results are horrifying. Of the 6000 students who were surveyed:

• 89 per cent felt overwhelmed
• More than half found their academic life traumatic or very difficult to handle
• Almost 62 per cent felt very lonely
• More than 36 per cent felt so depressed that it was difficult to function
• More than half felt overwhelming anxiety
• About seven per cent seriously considered suicide and more than one per cent acted on those thoughts
• Only about seven per cent sought professional treatment for any mental health issues (info from this Metro article)

You can look at the results of the survey here, alongside what York U is planning on doing about it.

From statistics and my own personal experience, depression and anxiety are by far the two most prevalent mental health issues in the student demographic. To that end, I’m doing a three-week series on one of the most common manifestations of anxiety: panic attacks. This week I’m going to talk about what a panic attack is, what it feels like, what’s happening in the brain/body, and so on. Next week I’ll be covering coping strategies, the mechanics of how to a) prevent panic attacks and/or b) minimize your discomfort with them. The last post will be a list of resources for people who suffer panic attacks, or who know someone who does, who want to deepen their knowledge base.

Please know that I’m not officially trained in the mental health field, and that the opinion of one well-read student shouldn’t replace that of a professional. If you’re sceptical of anything, please cross-reference my info for yourself, and absolutely seek out the advice of a counselor or your doctor if you feel your panic attacks are severe enough to warrant additional help!

Without further ado:

Baby’s First Panic Attack

I had my first panic attack when I was thirteen, and I owe it wholly to my best friend.

I have never liked scary movies, something which she and I disagree on. I’m a very sensitive critter with a very overactive imagination. So when she pressured me into watching “more of a thriller than anything!” with her, I was already pretty nervous. I watched the whole thing out of the corner of my eye–which, later, I would recognize as A Terrible Decision–and that night, after she’d gone home and I was lying alone in bed in the dark, it started.

First, I couldn’t shut my thoughts off–they just kept going, louder and faster than usual but also less coherent, less clear. Then came the sense of wariness and unease about nothing in particular, which quickly grew into fear and then into all-out dread. My body felt too hot and then too cold and then back again; my heart was pounding so hard I could feel it in my fingertips; nausea was clinging to the back of my throat. Invisible weight was pressing down on my throat hard enough to smother me. I was too tired to keep my eyes open, but every time they closed the feeling spiked to unbearable intensity.

Having never experienced this before, I reasonably assumed I was dying. (Or, less reasonably, that whatever I had seen in the movie had also seen me and was coming to find me. Which would lead to dying, so it’s pretty much the same.) Instead, I went to the bathroom and got sick and spent the whole night curled up shaking in a corner with my back against the bathtub. By the time the sun was up, I was finally tired enough to collapse in bed.

This continued for three nights in a row.

Once it was finally over, I had panic attacks once a month for a good 3-4 years. They thinned out for a while, then resurged (albeit way less severely) about two years ago. Nowadays I have maybe 3-4 panic attacks in a year.

(A Note: although scary movies will give me panic attacks–and, to my UNENDING FRUSTRATION, so will Hannibal–I don’t consider them my trigger because of the simple fact that I don’t put myself anywhere near scary movies and I still get panic attacks regardless. Honestly, I feel that my life at the time was so stressful that the movie was just the tipping point, and that one way or another I would have started having attacks sooner or later. PS: I LOVE YOU SOPHIE.)

My parents, bless them, have utterly no experience with mental health problems. After explaining what I’d experienced, the only thing they could think to do was to let me stay home sick to sleep and recover. Although I’m always grateful for their allowing me time to rest (even though, knowing what I know now, it actually would have been better for me to go to school the next day), I wish they had been informed enough to be able to mention panic attacks as a possibility, because honestly? That shit is the scariest shit in the world if you don’t know what it is or that it’s not just you who experiences it.

So to anyone who relates to any part of the story I just told–specifically the symptoms, a proper list of which can be found here–congratulations and condolences, you’ve probably experienced a panic attack. Don’t worry, they’re (sadly) more common than you think. And (more encouragingly) they’re a lot more easy to handle once you understand them.

What Is a Panic Attack?

Believe it or not, your body is not trying to kill you. It’s actually trying to help.

Panic and anxiety (a lot like stress in general) is the body’s natural response to danger; panic attacks are meant to prepare your body to “deal with a physical threat“. It’s perfectly healthy: we evolved this response as part of the fight/flight/freeze response back in good old hunter-gatherer days as a means of keeping alert and motivated and, of course, ready to run or to fight when the need arose. You’ll actually notice that some of the physical symptoms of panic attacks, like a pounding heart and shortness of breath, are perfectly normal sensations to be had during or after a good workout. That’s the point: the body is anticipating a massive physical effort and is pouring in the energy to deal with that effort.

The problem is that most of our panic attacks don’t come in the midst of being chased by lions or escaping war zones. They come while studying for exams or preparing to give a presentation to your peers or being stuck in traffic or waiting for a date at the coffeeshop or late at night before bed or anywhere else for absolutely no reason at all. There is no threat; there is no danger. And yet the signal goes off and we’re sweating and shaking like we’ve had 10 cans of Red Bull in about as many minutes.

More than the reaction itself, it’s the incongruity between how your mind/body feels and the perfectly ordinary situation around you that makes panic attacks so disorienting–a truly massive dump of restless energy and nowhere reasonable to put it. So where does that energy actually come from?

Your Brain on Anxiety: The Chemistry of a Panic Attack

Nothing like a good bit of science to calm you down.

In a post on calming stress and anxiety through breathing, I explained the body’s nervous system–essentially it’s divided into two parts, sympathetic and parasympathetic. The sympathetic system hypes the body up for action, and the parasympathetic system calms it down. A panic attack occurs when the parasympathetic system doesn’t kick in when it’s supposed to. (See here for further discussion!)

Basically, when a human brain perceives a threat, it releases the neurotransmitters epinephrine and norepinephrine into the body. (I’m not sure quite where the signal comes from to release those transmitters, but I’m guessing it’s the amygdala.) Those neurotransmitters go straight to the adrenal glands and tell them to release a good dollop of adrenaline into the body’s bloodstream.

amygdala.png
The location of the amygdala, the area of the brain responsible for emotional processing and especially for the fear response. Panic attacks are basically this little guy throwing a fit. (Click through for more panic attack biochemistry!)

Once the adrenaline is circulating, it triggers the physical symptoms associated with panic–temperature change, numbness or tingling, tight chest, restricted breathing or hyperventilation, increased heart rate, and so on. The emotional symptoms, such as that looming feeling of dread/impending catastrophe, are actually mostly your own reaction to the physical symptoms.

20 Minutes or The Rest of Forever: The Life Cycle of a Panic Attack

Want some good news?

This panic-inducing adrenaline spike can’t be maintained indefinitely. It peaks after about 10 minutes and then just as slowly dissipates as the neurotransmitters are reabsorbed, meaning that panic attacks physically cannot last more than 20-25 minutes. Hooray!

Of course, people experience panic attacks that are much longer than that–my very own three-day experience is proof. What’s happening in this case is that panic attacks are stacking on top of each other, daisy-chaining one 20-minute episode to the next until the body totally exhausts itself. It’s not that I had an attack which lasted a whole night, it’s that (yikes) I had like 30 of them one after another.

Here’s the tricky part: the anxiety that you get from the sensations of the first panic attack are overwhelmingly likely to set off another one, if you don’t understand what’s happening. Think about it: if panic is the body’s response to danger, and you’re sitting there terrified that you’re having a heart attack or going crazy, then of course it’s going to pump a fresh volley of adrenaline into the system to cope with what is now perceived as a new or continued threat. Oftentimes, the fear of having another panic attack is what sets off another panic attack: you’re basically freaking out about freaking out, which is a very uncomfortable vicious circle to be caught in. Luckily, it can be broken off at the end of any one panic attack–all you need to do is remain calm mentally until the physical effects have run their 20-minute course and the adrenaline has been burned up.

We’re going to cover precisely how to do that next week, but for now, feel free to click through to any of the links in this post for suggestions, or to do some research of your own!

Self-Awareness Is Key

At the end of the day, the old adage still holds true: knowledge is power. When it comes to something as frightening and mysterious as panic attacks, it pays off to understand the beast you’re dealing with in order to tame it. If you know a) what you’re experiencing and b) how/why it’s happening, then you’re more likely to figure out c) how to prevent it or soften it or make it as comfortable an experience as possible.

I know students at Glendon who have been having panic attacks since their young teens and who only realized what it was they’re experiencing once they came to GL and heard about it. I’ve actually been the person to break the news before, and while it’s amazing to see the relief wash over someone’s face when they realize there’s nothing wrong with them, it’s still heartbreaking to know that so many humans are walking around totally unaware that this terrifying thing they experience doesn’t have to be so terrifying at all.

The solution? Self-awareness. Conversation. No problem ever resolved itself without being addressed, and the harsh reality is that mental illness is a part of all of our daily lives right now. In the student body especially, it is overwhelmingly prevalent–the fact that anxiety has reached epidemic proportions among York U students is, itself, anxiety-inducing. But being aware of the different forms it takes in your own life or the lives of your peers, and being well-informed about the how and the why, makes it less like mass demonic possession and more like something tangible and treatable, something that can be observed and worked with and ultimately healed from.

Let’s heal together.

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