Dr. Cynthia Stonnington is the Chair of Psychiatry and Psychology at the Mayo Clinic in Arizona:
1. ROCK CENTER: How prevalent are panic attacks?
DR. CYNTHIA STONNINGTON: So panic attacks are very common. Actually, probably one in four people might have a panic attack in their lifetime. Now that’s separate from having a panic disorder, where people have recurrent episodes of panic attacks … But anxiety, in general, is extremely common. We need anxiety just to live and to function. And so it's not surprising that anxiety disorders can occur frequently.
2. ROCK CENTER: Can you explain what happens in the brain during a panic attack?
DR. STONNINGTON: It's a primitive part of the brain. Obviously back in the day, when you might come across a tiger, you had to be alert to get yourself out of there. It’s a survival mechanism we still have and it’s still something we use to focus our attention and alert us to things we need to do. But today there might be a lot of false alarms.
3. ROCK CENTER: How much control do you have when a panic attack occurs?
DR. STONNINGTON: So when you first experience a panic attack there's nothing much you can do to stop it from coming on. It comes on. And it goes into motion. You've got your heart rate going fast. You've got all the blood rushing from your head. You're breathing fast. All those kinds of things are happening before you can even think of anything to do about it.
4. ROCK CENTER: So even though a panic attack is an event that happens in the brain, it’s not imaginary, right? The symptoms are very real, correct?
DR. STONNINGTON: It is definitely not imaginary, but if it's coming out of the blue, it’s pretty understandable why people might think they're having a heart attack or going crazy or something really pretty ominous. Because it's this rush of adrenaline, and all sorts of physical symptoms are happening at once. And it's very scary.
5. ROCK CENTER: As significant, or perhaps more significant, is what’s going on inside someone’s mind during a panic attack …
DR. STONNINGTON: We jump to conclusions. And we can create this whole worldview that is based on a sort of primitive reaction. Part of it is probably because we are wired to respond to and believe whatever our body is telling us. So, if mentally you are experiencing extreme anxiety, if you're experiencing the physical sensations of anxiety, then it must be in response to something. Because you know you're not crazy, right? So therefore it must be attached to something absolutely real.
6. ROCK CENTER: Let's talk about remedies. Panic attacks are manageable, correct? What tools do you have, as a physician?
DR. STONNINGTON: There's two approaches that we like to do -- potentially together. So, first of all, is something called cognitive behavioral therapy, and then there are effective medications.
7. ROCK CENTER: Why is cognitive behavioral therapy effective?
DR. STONNINGTON: You can really shift your view about panic attacks and your approach to it. And that makes a huge difference. It really does. Like, for example, NOT avoiding situations that provoke extreme anxiety. Very, very commonly people will associate a certain environment with causing their panic attacks. So then they start to avoid that place or that situation. And then what happens is they’re creating this vulnerable person; like they suddenly have to be hyper-vigilant. They're looking for landmines everywhere. And they're restricting their lives. And, intuitively, they may think they're doing themselves a favor, but they're actually making the anxiety level rise. So we try to get people to gradually expose themselves to those situations. And, at the end of the cognitive behavioral approach, learn to actually bring on a panic attack and then reduce it.
8. ROCK CENTER: Which medications can be helpful?
DR. STONNINGTON: The types of medicines that tend to be prescribed … as the first line … are SSRI’s -- selective serotonin reuptake inhibitors. And those are the ones that probably you've heard of: Prozac, Zoloft, Celexa, Lexapro … or now, in generic form, fluoxetine, sertraline, citalopram, and escitalopram.
9. ROCK CENTER: Isn’t half the battle just understanding what this is, right? Knowing that information is power?
DR STONNINGTON: Yes. Absolutely. But it can be a little tricky. Once you’ve had a panic attack, depending on your symptoms, you may want to rule out a heart attack or other medical conditions, and have a reasonable workup to do so. But once you understand what it feels like, what it is, and then perhaps understand some of the things that may have led up to it occurring, then the key is not to keep rushing to the emergency room to rule out a heart attack. Because that's just going to make the panic attacks more frequent.
10. ROCK CENTER: As you’ve indicated, there are established ways for people to build their confidence and manage this condition, yes?
DR. STONNINGTON: And even if a panic attack comes on, you know you’ll survive. You know you’ll be okay. Because, truly, the most debilitating thing about a panic disorder is not necessarily the actual panic attack, but a person's response to it. That’s what tends to be disabling. The key in treatment really is to get people out of that mindset: that in order to be okay they have to never have a panic attack. So they have to get comfortable with the idea that it could happen and it may happen, and that thing that they can do is manage it skillfully. And you can really extrapolate that to pretty much anything that people experience that's recurrent. More often than not, it's their response to the symptoms or the disorder that gives them the biggest amount of trouble, rather than the actual symptoms, which can be managed.
For more information, click here to visit the Mayo Clinic's site.
Leave a Comment:
great story on Charlie Beljan. I would love to give Charlie an idea of why he gets panic attacks. every video shot of Charlie shows that he is a 'mouth breather'. So what? Mouth breathing is the main cause of panic attacks. Mouth breathing creates a big problem in the breathing process and prevents oxygen from getting to the brain, thus the 'panic'. I am a 'Breath Retrainer'. What I teach is based on the teachings of Dr. Konstantin Buteyko of Russia. 'Mouth breathers' always have health issues and anxiety and panic attacks are very common. I would love to get this info to Charlie. If someone can forward this to him or refer him to my website: shutyourmouth.ca
Thanks,
Craig Moeller
Good correlation!! Not thought of it before. Many persons with panic attacks have a type of anxiety disorder stemming from many different events or issues in their lives. Anxiety can be genetic. You are predisposed if someone in your family has panic attacks/anxiety disorder. I will visit your site for more information. My best tip is to let your system work through the panic attack, the more you fight the worse it may seem. To those of us that suffer, it is real.
I appreciated the story on Panic Tonight. But I still get frustrated when the stories don't discuss the depth of the severity of the gasping for air, getting no air, hyperventilating and feeling like you are going to OR want to die because you can't get air. While everyone's symptoms are different, there are some terrifying and real effects the panic attacks bring on. I know, I have been living with them for 12 years now. I had to recreate myself so that I could function as best as possible while trying to find a way to gain control over managing them, Debilitating, life altering severe panic disorder. Exposure therapy helped a little, but the thing that is now helping me be brave enough to start to get back into life is my adventure with a my new service dog MILO. Watch how he is helping me be more independent and get back into life at www.unwrappingpanic.com and www.pawsforpanic.com.
Bless you for your struggle. I totally agree. This clip was not about people like us. I look at someone golfing while supposedly having a panic attack and shake my head. That is not any type of panic attack I ever experienced. I would love one like that. Good luck to you.
One thing to remember is unless you are having an asthma attack or something like that you will get over/thru them. One problem with people addressing the situation is it seems so overwhelming. From my experience you have to identify the problem and its beginning and then deal with the problem. Now if it has become chemical that goes into a different area which happens sometimes with prolonged problems. Otherwise imo you shouldn't depend on medicine, you should depend on yourself. We are made to deal with problems and issues. That is what emotions are for. So many times we are taught to repress them. When that happens when you feel an emotion you not only feel it but every repressed motion too. When those are dealt with you have same reaction as everyone else. I put up with this for decades and now I feel completely normal. I wish everyone in this situation would just get over it like I did. It wasn't easy. It took years but it was well worth it.
Sometimes I feel that we get locked into what American doctors and experts say. When I lived in China I experienced this kind of imbalance. A little acupuncture and herbal medicine and 3 weeks later I was fine. Rarely have relapsed. But when I do, a trip to the local Chinese Medicine doctor really does the trick. I feel that too often we focus on controlling the symptoms and never look to the root cause. If more experts put their ego aside and were willing to learn from traditional methods of healing maybe we could learn to cure some things.
bingo. but I think unless they have experienced this problem they have no idea about it. Sometimes they want to force you to be in situations like group therapy. If you could do this you wouldn't need to be there. That is one thing they just don't understand.
Thank you! Thank you! Thank you! I have suffered from Panic Attacks since I was 27. I was so glad to see that a reputable news program allowed others to know that this is a serious illness.
I'm so disappointed in your choice to portray panic attack syndrome as some sort of OCD offshoot. I am a 53 year old female who has suffered on and off for 30 years with random yet persistent panic attacks. They are very real, adrenaline pumping, terrifying episodes that consist of both physical symptoms and emotional confusion. While there may be some triggers (exhaustion, caffeine, everyday stress) it is NEVER about salad dressing, crossing bridges or any other obsession - that is the most frustrating part of this disorder. More than anything, I am offended by your choice to consult with three different men on the subject when this syndrome effects females twice as often as men. As a sufferer, I feel you have completely failed to represent the true aspects of panic attack disorder.
Beautifully said Andrea!
I have been suffering from Panic Attacks for 17 years.(I couldn't leave my house for almost 3 years) They are very real and can be very frighting. Every one has different triggers Andrea. For some one to have a panic attack over the choice of salad dressing is REAL. Think about it there is a moment where your body could be under some sort of stress.. decision making isn't easy for every one. My triggers are going out in public but some times I can just be laying in bed doing nothing and one will hit. I will suddenly hear my heart beat and think some thing is wrong. BOOM panic. Also my husband who is a man also suffers from panic attacks. He started to have him last year. Maybe I have a little OCD since once the anxiety kicks in I will get stuck on a thought usually a negative thought. I have been on every medication possible including ativan. Ativan was the only thing that that helped me but after being on it for 10 years I decided it was doing more harm then good. Worse 5 months of my life!! (weaning then going off of it) I am really happy that they did a segment on Panic. So many people think it is just "stress" Oh just breath through it. It is not that easy!
My heart goes out to you Trish. Have had some of the same problems in the past. Was not able to leave my house for a time also. Thought I was going to die while driving my kids to school etc. Just hang in there hun and keep going. Am 61 now and for the most part don't have the attacks any more. (but never know it one will hit again) at least if one hits me now I know what is going on and that makes them not quite as bad.
Thank you Susan. Right now they are under control thanks to Celexa. Knowing that it is "panic" does lessen it some. I am no longer running to the ER every time I have one. Its a stroke no a heart attack no I am losing my MIND!!! Glad to hear that your panic has calmed down.
However, everything is different. OCD is not and has never been my problem. Maybe wanting things to be perfect has but that is a result of having parents etc who want you to be perfect and you are criticized for not being perfect. However, after a while I realized that perfection really doesn't exist and if someone wants you to be perfect that is their problem not yours. And it also aggravates me that when they are using their perfection standard, they don't apply the sane standard to themselves.
I have sleep apnea, and i had a bad week and it brought on a attack for the first time and ER Bobbi Ann Sipes MD was clueless and all she did was make it worse.. getting more information on my health but if the doctors dont care or stay current what do you do?
You read up on the subject and go inward and try to figure out what the root cause is. Then you can have someone help you get over it. If one don't help you go to another. don't give up because these are completely solvable issues.
Thank you for this report. Am a 61 year old female that has suffered panic attacks since highschool. At one point in my mid twenties I could not even leave my house. While my panic attacks are no longer much of a problem to me, I know the show last night helped so many. Knowing that we are not alone or completely crazy helps. Thank you.
While I like that the condition is getting some attention, I do not like how this segment was laid out. I totally agree with what Andrea said. As a sufferer, I am appalled that this is what is portrayed as "Panic Attacks". These look to be anxiety attacks. Sure, some doctors don't differentiate between the two, but I can tell you there is a huge difference. In my experience there is no mental trigger for a panic attack. 95% of mine came during deep sleep when I wasn't thinking or deciding anything (no sleep apnea, I was tested). Salad dressing choice may trigger anxiety, not a panic attack. I have had incidences that have caused great personal anxiety but no panic attack occurred as a result. I am not making light of the sufferers in the segment or elsewhere, my heart goes out to you. I do however think this segment does not do justice to many people who have panic attacks. If it is all one in the same then these guys (fortunately for them) are mildly afflicted. There should have been some coverage of the moderately and severely afflicted as well.
I agree. There are panic attacks triggered by something and there are Anxiety diaorders where panic attacks happen at most random and inappropriate times. I have learned to live with anxiety disorder for over 40 years. As you all say, some years are good and some not so good. we should all talk, where is there a forum we can converse?
There is no doubt that the report helped shed some light on such a common ailment (2.4 million Americans suffer from panic attacks, woman twice as often as men) and that it will help many, many people identify with this disorder. There is also no doubt that OCD and panic attacks may often go hand in hand as the obsession/compulsion triggers panic. That was the case in all three of the men that were interviewed (the report featured food touching, crossing bridges, too many salad dressing choices). However, panic attack syndrome is a disorder all it's own with completely random attacks, no figuring out what is causing them, how to avoid them, when they will hit. 30 years ago, I was lucky enough to have a full blown attack in front of a trusted doctor who was able to "put a name" on what was happening - it was the first time I had ever even heard the term. I was pleased that the show portrayed the very real physical side of an attack, complete with brain imaging, but I do feel like the rest of the segment was misleading. The title suggested that it was about panic attacks but the report seemed to focus more on OCD. Either way it was good exposure for this silent epidemic - they say any press is good press, right? @Susan, researchers don't know why but women rarely suffer past the age of 60 suggesting that panic attacks may be hormone related. I am 53 and have definitely noticed a gradual decline in the frequency and severity of attacks.
Mine were at there absolute worse when I was pregnant. Happened more frequently during PMS. I agree with a possible hormonal connection.
Thank you for this article. Finally, someone is shedding light on real, blown-out Panic Attacks. Everyone seems to go through the attacks in a different way. I had panic attacks from mild to severe for two years before giving in to a medication to relieve such. At first, I thought I was going to die and told my supportive husband as much. My search for the root cause is why I waited two years before taking prescribed medication. This article gives me hope that I can finally remove the medication from my daily life! Like many people who do have real panic attacks, when the attacks occurred inside buildings, I had to "escape." I would give any reason to get outside in the fresh air. I still cannot drive on interstate highways because there is that old feeling that I must leave that road and drive across the fields to escape all the traffic. I don't think I would but I'm not taking chances.
Bellout,your escape is common,its the flight to flee.i did it all the time,and now i try and stay in the situation.except....driving as you said on highways,thats a no no for me.the speed is too fast and there is no where to pull o ver fast enough before i loose control and hyperventilate.but so what i can take the other roads,so dont be so hard on yourself.keep a paper bag with you,if an attack happens breathing into it,puts your breathing regular.
Ive been suffering with anxiety and panic attacks for 30 years.From what i seen on the video,it seems he suffered an anxiety without hyperventalation,and no full blown panic attack as i get.the Ocd is not my problem either,but is perhaps one of his triggers.After seeing so many dr's thru the years,they dont have a reason to why this happens,since the brain is so complex.i was told this by my neurologist.I to have attacks during sleep and during surgery.I take,paxil cr for many years,didnt see this on the list of meds unless i missed it.and i also take xanax.I was housebound at the beginning for almost a year,and it took baby steps and i mean it,to get myself to the car and drive,driving was a big problem since alot of my attacks happened while driving.behavior pt was good at that time,getting me back to work.but unfortunately i wasnt treated with well at all there,andwas demoted and called horrible names like your crazy,oh you had a nervous break down.how horrible people can be.Since im in cronic pain with physical ailments,it makes the anxiety worse,since pain makes me anxious.so many illness can trigger anxiety,so do many medications,caffein etc.Hormonal,yes.remember this is a chemical imbalance in the brain.yep ive been in anxiety situations to and no attacks to.like my neuro dr said the brain is so complex we have no real answer.I just do the best i can.Driving is my worst,since most of my attacks started in the car,havebeen in accidents caused by others.we all have our stories,and sharing is good,knowing you are not alone.ty all for sharing and god bless!
sorry this is my 2nd comment,didnt know the first took,not use to doing this,and cant delete it.dont want to get an anxiety attack over this!lol....
omgit didnt go thru lol.....
I was surprised that there was no mention about the large percentage of people who are actually misdiagnosed as having a panic disorder, when in all actuality, have a circuitry problem in the heart that can be fixed permanently. I was 54 years old when I finally found out that my racing, pounding heart, tunnel vision, and profuse sweating was due to atrial fibrillation, not a neurological disorder! I met with an electrocardiologist, had a cardiac ablation procedure performed to prevent the electrical path in my heart from jumping the track ever again, and have been symptom-free ever since. This segment could have been instrumental in informing sufferers about the possibility of ANOTHER cause for their symptoms and where to go for testing. For some of us, it's not all in our heads.........
I used to have panic attacks, until I discovered that I have celiacs disease. Now that I am on a gluten free diet I never have panic attacks any more. If I have accidentally eaten gluten my first symptom is anxiety and an increased heart rate!
I don't suffer from panic attacks, but someone close to me does. Thank you for sharing this insightful info that could actually help people suffering from anxiety and panic.
I used to have panic attacks and there is something you can do. Change your location. One time is was very hot at work and I had an attack but I couldn't go outside because it was hotter. I went into the restroom which was slightly cooler and I got over it. And besides I used to have social phobia. I got over it without one lick of medicine. Mine I believe was caused by unreleased emotions over the years. When they were "let out" over a period of time, the social phobia and panic attacks disappeared.
Have you experienced a panic attack in the form explained above? It is real. Happened to my four other brothers in my family, a nephew, and a cousin(my father's side). For me, the worst experience is the depression that followed. Without my medication, Lorazepam, I would probably wrap myself in my blanket and hide from the outside. Thank you for bringing this condition out. I feel comforted that I am not the only one with this disorder.
A panic attack is nothing more than FEAR. Fear of being alone or abandoned brings mine on. It stems from my childhood. I would rather be whipped with a belt than have a panic attack.!! Sometimes at night I have nightmares of being left all alone and I go into a full blown attack.