High Anxiety

“I had pains in my chest, rapid heartbeat, felt worked up, scared that something was happening to me, broke into a sweat ... I didn’t know what to do with myself and wished I could run away ...”

This was Lorraine Cyopick’s first panic attack. It began with the onset of her father’s debilitating struggle with cancer. “It was too much stress and strain,” she says.

During her second attack—years later—she felt like she was going to pass out or throw up, was having harmful thoughts, and didn’t understand what was happening.

What is a panic attack?

Panic attacks are distinct periods of acute fear. According to the Canadian Mental Health Association (CMHA), “Panic attacks are terrifying episodes during which the person is convinced they are about to die or collapse. Without warning, an individual is suddenly overwhelmed by emotional and physical sensations that signal imminent death.”

A sense of unreality, fear of losing control, and dreaded anticipation about the return of physical symptoms are characteristic of these attacks. Not being able to predict the onset of an attack causes dread about when another one will happen.

Attacks happen suddenly, often reach their peak in about 10 minutes, and can occur during the night, rousing a person from sleep. But the experience varies, as does the type of attack.

Types of panic attacks

Unexpected: Happen “out of the blue”—not related to specific situations.
Situationally bound: Predictable and occur while in a specific situation or anticipating it, such as public speaking
Situationally predispos.ed: Attacks are similar, although they don’t always happen during a situation, and if so, not directly after being exposed to it,

Who suffers from them?

According to Statistics Canada, 1 million Canadians have experienced panic attacks at some point in their lives. Women are affected almost twice as much as men: the lifetime prevalence of panic disorder was 4.6 percent for women and 2.8 percent for men.

The onset begins between late adolescence and early adulthood—a significant period for major life transitions—with many diagnoses of the disorder occurring by age 33 and decreasing by age 55.

What causes them?

Panic attacks often strike during stressful periods, such as college or university, starting a new job, or illness or death of a loved one. The situations vary, but the common denominator remains the same.

Fear is at the root of this anxiety-based disorder, according to the CMHA. People become struck by fears they know are irrational and illogical, yet which are so powerful and unpredictable that they drastically change their lives to avoid feared situations.

Avoidance of people and situations, self-blame, and wishful thinking with less likelihood of a problem-solving view or approach is a common characteristic among people suffering from panic disorder.

Dr. Pamela Frank, licensed naturopathic practitioner in Toronto, indicates there are areas that can provoke this excessive anxiety. She attributes some of these problems to home environment; work stress; personality traits; imbalances in neurotransmitters such as GABA, serotonin, and dopamine; vitamin/mineral or essential fatty acid deficiencies; and trauma such as that related to marital separation, job loss, or car accidents.

Seung ah Kim, age 36, was in her first labour when her attack hit. A new doctor and environment, combined with worrying about complications, contributed to feeling a loss of control, feeling as though she couldn’t breathe and was going to die, and provoked her to threaten her doctor. It wasn’t just hormones that ailed her.

Anxiety can turn into a vicious cycle. Stress increases your anxiety, thus increasing demands on your body’s ability to cope with it. “This further depletes your coping resources, and so your ability to deal with stress goes even lower, and your anxiety level goes even higher,” indicates Frank.

If a situation provokes anxiety to the extent that you begin to avoid the feared objects or situations, hindering your ability to lead a normal life, it can become chronic and disabling.

How to cope

CMHA encourages people to understand their panic episodes, explore exactly what triggers panic, and develop styles of coping with the sensations. Once you understand what’s at the root of your panic attacks, you can learn ways to cope with them. Fortunately, panic is one of the most treatable of many anxiety problems.

Cognitive behavioural therapy (CBT)
This is a systematic type of therapy that can help change thinking patterns that provoke anxiety. Cyopick’s therapist recommended journalling and reading books to inspire a more positive outlook—information about dealing with life challenges, setting boundaries, and restoring faith. She said these books helped her mindset and inspired her to read more of them.

Anxiety management training is a type of CBT that teaches techniques such as relaxation, deep breathing and breathing exercises, yoga, tai chi, massage therapy, and meditation in order to control anxiety. Aerobic exercise has also been shown to have a calming effect.

Dietary recommendations
There is evidence that diet choices can help control panic attacks:

• avoid caffeine and sugar
• reduce salt intake
• maintain stable blood sugar
• increase dark green leafy vegetables, legumes, eggs, nuts and seeds, chicken, and fish

Supplements and herbs
Other remedies for controlling anxiety include nourishing the brain with B vitamins, magnesium, essential fatty acids, and amino acids, such as l-tyrosine and zinc.

Based on a long tradition of use, there are some herbal remedies Frank suggests that may also offer relief:

• Anxiolytic (anti-panic or anti-anxiety) herbs include St. John’s wort, oatstraw, lemon balm, camomile, skullcap, and brahmi.
• Adaptogenic (rejuvenating) herbs include ginseng, licorice root, schisandra, rhodiola, and Centella asiatica.

As with all medicines, it is important to consult a qualified health care practitioner to determine dosages and to ensure you get remedies that suit your individual needs.

Common symptoms

• heart pounding/racing
• chest pain/discomfort
• shortness of breath
• nausea/abdominal distress
• dizziness/fainting
• sweating
• shaking
• choking feeling
• fear of losing control/going crazy
• fear of dying
• numbness/tingling
• hot flushes/chills