Understanding Panic Attacks

Panic attacks are an extreme flooding of the system with adrenaline. It is a natural process: there are heart palpitations, dizziness, shortness of breath, or feelings of unreality. A feeling that something absolutely terrible will happen is common and we feel a need to flee.

Paradoxically if we try to stop it continues but if we do nothing it passes. By the technique of flooding we can switch our panic attacks off.

It could be a very ordinary day and you could be doing a very ordinary thing, taking a train, going to a cinema or a restaurant when out of a clear blue sky you begin to think and feel, I’m going to die or completely lose it, as well as this there are physical symptoms such as shaking, nausea, cramps, weakness, hyperventilation and a feeling of being about to pass out.

The fear of fear is a common phenomenon. Those who have had a panic attack never forget the experience. It can be a life changing event. A situation of avoidance can then result – the person does not want a repeat of the experience, so they seek to avoid the situation where it happened: “It happened on the bus, so I won’t get on the bus again”, for example. If this avoidance continues, it can lead to agoraphobia. Many who experience panic attacks, will have depression as well, so which comes first?

The physical sequence of event is that adrenaline flooding brings about the ‘flight or fight’ response, when the body prepares for strenuous physical activity. This leads to an increased heart rate, rapid breathing (hyperventilation) which may be perceived as shortness of breath and sweating.

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, which can lead to other symptoms, such as tingling or numbness, dizziness, burning and light-headedness. In other words, this response to a threat makes sense to our body but is frustrated when it has “no place to go”. This can lead to feelings of terror, and desperation to never have this experience again.

We can manage panic attacks and make them much less significant in our lives by following some straightforward steps. There is a well-known technique for testing our beliefs and our actions called the ABC system. This allows us to examine our feelings and behaviour based on Activating Event, Beliefs and Consequences.

Dr. Harry Barry in his book Flagging Anxiety and Panic mentions the technique of flooding, letting the feelings flood over you , he says the symptoms be uncomfortable as they are not dangerous. We can sit down and let the symptoms flow over us, it is like a tide; it flows in and then flows out again. People’s fears that they are going mad, having a heart attack, that this never happened to anyone else, are not founded in reality. He has discovered that the more we try to bring on panic attacks in practice we cannot. We have in effect turned our anxiety down. This is a really good video clip which explains his thinking (external link):

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Could I Be Suffering From A Phobia?

Are you bothered by things or events that you think everybody else can magage with relative ease?

Do you think your fear is 'unreasonable'?

Does your fear make you avoid life?

A phobia (from Greek: phobos, "fear") may be considered an irrational, intense, persistent fear of certain situations, activities, things, or persons. The main characteristic of a phobia is the excessive desire to avoid the feared subject without objective evidence. Another factor is that the object or situation, in fact, poses little or no actual danger. When the fear is beyond one's control, or if the fear is interfering with daily life, then therapeutic help is needed.

There is a wide range of psychological and physical characteristics. These can include neurotic reactions: dread, horror, avoidance and palpitations, shortness of breath, nausea and outright panic attacks.

Heredity, genetics, and brain chemistry combine with life-experiences (including pre and perinatal) to play a role in the development of phobias.

Phobias may be divided into these categories:

Social phobia which can be:

Generalized Social Phobia which is characterized by long-lasting anxiety that is not focused on any particular object or situation, in other words, it is unspecific or free-floating.
People with generalized social phobia have great distress in a wide range of social situations. Those with specific social phobia may experience anxiety only in a few situations.

Specific Social Phobia, which includes cases of anxiety triggered only in particular social situations.
Common characteristics of specific social phobia are the fear of public speaking and the fear of performance (stage fright). Other examples are fears of writing or eating in public, attending social gatherings and dealing with authorities.
Specific social phobia may be classified into performance fears and interaction fears.
Social phobia is an extreme fear of public embarrassment and being judged by others. The characteristics often extend beyond the social anxiety to more prolonged psychosomatic manifestation in physical problems. Examples include, suffering from headaches or migraine, back or stomach pain, breathing & swallowing problems.

Specific Phobias Fear of a single specific panic trigger. Examples include: flying, entering lifts, spiders, catching a particular illness, etc. Many of the specific phobias are extensions of fears that a lot of people have. People with these phobias specifically avoid that which they fear.

Agoraphobia – is very common. It is a generalized fear of leaving home or a small, familiar 'safe' area, and of possible panic attacks that might follow.

Agoraphobia is a condition where the sufferer becomes anxious in environments that are unfamiliar or where they perceive that they have little control. Triggers for this anxiety may include crowds, wide open spaces, or traveling (even short distances). This anxiety is often compounded by a fear of social embarrassment, as the agoraphobic fears the onset of a panic attack and appearing distraught in public.

Social phobia is an extreme fear of public embarrassment and being judged by others. The condition affects as many as 13% of people at some point in their lives (Anxiety Disorders Association of America)- making it the third most common psychiatric condition after substance abuse and depression.

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Could I Be Suffering From OCD?

Do you have concerns with contamination (dirt, germs, chemicals, radiation) or getting a serious illness?

Do unpleasant thoughts or images repeatedly enter your mind?

Are you overconcerned with keeping objects (clothing, shopping, ornaments) in perfect order, or arranged exactly?

OCD is characterised by unwanted thoughts or behaviours that seem impossible to stop or control, it is a combination of obsessive thinking and behaviours that make you feel driven to do something.

Obsessions are: intrusive anxiety provoking thoughts. Compulsions are repetitive rituals or mental actions performed in response to obsessions e.g. making lists or repeated hand-washing.

It makes people worry obsessively, compelling them to carry out rituals like repeated hand washing. It affects about one in 50 people and can take over their lives. Because sufferers get anxious if they can’t complete their rituals, OCD is usually treated as an anxiety disorder with talking therapies to relieve distress.

People suffering with OCD can experience considerable (sometimes total) relief from their symptoms, following therapy. Therapy can help when you have concerns about the link between OCD and your upbringing and also the consequences OCD is having on our personal, social and work lives.

An exposure and response prevention can often assist in the opening approach to dealing with OCD in the short term. This may be followed with a deeper exploration of the root causes and meanings of the condition to deepen your understanding of it and being able to place thoughts, feelings and behaviours in context.

OCD is similar to an addiction, in tests designed to measure decision-making, individuals with OCD performed much like gambling addicts, suggesting their underlying brain patterns may be similar. It may be considered a behaviour addiction.

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Fear and Anxiety?

Fear and anxiety are primal emotions. We often fear a specific thing, event or even person but even at our most relaxed there is a continuous level of vigilance, this is a function of our evolution and is an essential for our survival. Fear is amongst our most primal emotions.

Fear, in fact, has a vital life saving and protecting function and is a physical and psychological response to danger and threat. It has an immediate and a longer-term function that allows us to avoid a present threat and to plan for our future safety.

And yet fear and the slightly more vague anxiety often have negative effects on our lives. This is because the fear and anxiety may be in response to “threats” that others in society may not perceive, or because we have developed fear of things over which we have little or no control.

For example everybody seeing a bus hurtling towards them will jump out of the way instinctively. On the other hand, only a percentage of people have phobias. For example, in the case of lifts, darkened rooms (cinemas, churches etc.) while most others enter them without a thought the person with claustrophobia is restricted. People see the first as common sense and “what anyone would do” and the other as troubling and possibly irrational.

Yet to the sufferers of anxiety, one makes as much sense as the other, in this example subconsciously, the lift or cinema represents a dark cave where danger awaits.

So we can have phobia, generalised anxiety, OCD, panic attacks and many “unspecified” types of anxiety which cause us a lot of trouble publicly and privately.

I feel that understanding the nature of this fear and anxiety is of critical importance. In therapy we can explore and talk about our fears in a safe environment.

I hold therapy sessions in Ballybrack to work with clients on the roots of their anxiety but also on triggers, intensity and management of anxiety.

In our weekly sessions I assist people in coming to terms with a commonplace difficulty and learning to deal with anxiety in its many forms in an understanding way.

Further information:

Learn how to spot anxiety symptoms that can impact how you feel. Explore ways to overcome anxiety and the best ways for dealing with daily stresses by clicking: here (External Link)

Dr. Harry Barry “normalises” anxiety and makes panic attacks very understandable in this video he explains how panic attacks are not physically dangerous (External Link). Click on the video to play:

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Little Things


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Self Compassion

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The price of invulnerability: Brené Brown (External Link)

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Dear Anxiety Podcast

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Seven Ways to Change Your Behaviour for Good
Click here (External Link)

I Felt The Fear And Did It Anyway
Click here (External Link)

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About Me

Brian Naughton

I worked in the Public Service for 30 years gaining a BA and an MBA along the way. In 2006 I decided to change direction and became involved in Therapeutic Counselling in Dublin Counselling and Therapy Centre. I have been operating as a fully qualified counsellor for the last few years. My practice is strictly confidential and bound by the Code of Ethics laid down by the IAHIP - of which I am a fully Accredited Member. This may be viewed here:

The IAHIP is the longest established Association in Ireland for accrediting Psychotherapists