Let's Talk About Panic Attacks

When we talk about panic attacks, we examine the medical and psychological aspects of the disorder.

The medical aspects:

Panic disorder is a problem that has a lot to do with the body. Certainly in terms of emotional problems, anxiety disorders are some of the most strongly physiologically- experienced struggles. Most of the symptoms you describe are felt in the body. While we do not know all the reasons why, we do now know there seem to be some very strong biological components in panic disorder.

There are basically two ways to attack them from the medical side. The first is simple tranquilizers, usually referred to as “minor tranquilizers.” They are very effective in giving immediate relief to the feelings. If the anxiety is keeping a person from functioning day to day, sometimes they are a good idea. But there are two problems with this approach.

Number one, the real reasons and problems causing the attacks are not being dealt with but are just being covered up by symptom relief. When used correctly, they calm a person down enough to function while he is working on his problems. When used incorrectly, they calm a person down so he does not have to deal with his problems. To give you tranquilizers without telling you to get good counseling to find out if there are other things causing the attacks is not good advice.

Number two, those medications can be abused and can become addictive. That is why they should only be used under the watchful eye of one who understands the need to face the issues that cause the attacks.

Another aspect of the medical side is that there are other medications which are not addictive and have been found to be very effective in the physical aspect of this illness. These belong to the newer classes of antidepressant medications. Sometimes, chemical problems in the brain can be part of the picture in panic attacks. These newer medicines have been shown to be very helpful for some people in your situation. I would get a second medical opinion, this time from a psychiatrist who deals with panic disorder all the time. These medications are not addictive, have fewer side effects than the older ones, and do more than symptom relief. They seem to address the underlying physical processes that are going on. But in general it is best to see a psychiatrist as these are in his specialty area.

The psychological aspects:

There is more to look at and work on than just “waiting for the panic attacks to go away.” Usually in panic disorder there are significant issues that need to be faced. I would get with a good counselor and see if any of these areas are areas of growth for you, for these can certainly be overcome. I would begin by looking at a few specific common struggles with panic attacks.

First, there can be underlying isolation. If someone is significantly isolated inside, panic comes when this isolation and aloneness is close to being felt. This can happen even when a person has a lot of friends if there is no one “abiding” on the inside, at deep levels the way the Bible talks about.

Secondly, there can be issues around boundaries and freedom. These are the most common in my experience. Panic attacks usually have some dynamic involved when a person feels powerless in some significant area of life, especially significant relationships. He feel like his choices are controlled by someone else or by guilt, and freedom is limited. So, at various times he feels the panic that comes from being powerless. Good boundary and assertiveness work can help this dynamic dramatically.

Thirdly, there are often patterns of perfectionistic or “all or nothing thinking.” Someone interprets his performance or experience in extreme forms, and severe anxiety accompanies that process. He has to learn to look at his thinking patterns and change them. And then there are often autonomy fears and fears associated with independence and adulthood. Sometimes family-of-origin issues need to be examined to get past those dynamics.

With the combination of good medical advice and good counseling, I have all the hope in the world that panic attacks can be helped. I have seen it happen successfully over and over again. So, go see a good psychiatrist and a good counselor. This could be one of the most growth-producing times of your life.