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Why You REALLY Get Panic Attacks + How To Make 'Em Stop

Leslie Carr, PsyD
August 8, 2016
Photo by Stocksy
August 8, 2016

Do you know what a panic attack is?

For many people, it feels like shortness of breath, a racing heart, sweating, shaking, nausea, chest pain, and/or a sense of "depersonalization" — the surreal sense that you're no longer fully rooted in your body or its surroundings.

Sounds like a blast, right?

No. Not fun.

Beyond the symptoms, though, do you know what a panic attack really is?

There's a diversity of opinions about this, but the best explanation I've ever heard is that a panic attack is a ton of repressed emotion bubbling to the surface in full force. It's like taking the cap off a fire hydrant; all of the water that's been trapped underneath the surface comes bursting out with a vengeance.

Because the symptoms of a panic attack can be virtually identical to those of a heart attack, it's always recommended that you go to the emergency room for a physical evaluation if you're experiencing those symptoms for the first time — but beyond getting an electrocardiogram, do you know how to tell whether you're having a panic attack or a heart attack?

Hint: Just because there wasn't an obvious emotional trigger, that doesn't mean you're having a heart attack. It's easy to mistake a panic attack for a heart attack when the underlying emotional trigger is happening outside of your conscious awareness.

A lot of people think that panic attacks are purely physical. That's partially why many people want to take medication to treat them. It just feels so physical, right?

But panic attacks are not, generally speaking, brought on by issues in neurochemistry. They're brought on by the emotional content of our lives — they're actually an amazing example of the mind-body connection.

They're hard to understand because our minds like to play tricks on us. It's our brain's natural tendency to minimize emotional challenges. As they say, "Denial ain't just a river in Egypt." Well, neither is repression, projection, compartmentalization, or reaction formation — which means idealizing the people we love so that we don't have to acknowledge trickier feelings like anger or resentment.

Pro-tip: It's totally OK to feel angry at the people you love; no close relationship is sunshine and roses every day.

Furthermore, the culture that we live in feeds us messages that only make our emotions harder to understand. Focus on the positive; think about what you're grateful for; don't complain about First World problems. Don't get me wrong — I'm a huge fan of some well-deployed gratitude, but it's surprisingly easy to use it as a tool for self-flagellation, and that, I am not a fan of.

If I were to give you one tip that could lessen the possibility of you having a panic attack, it would be this:

Give yourself permission to feel your feelings — all of them. Don't question whether they're worthy. Don't judge yourself as self-indulgent.

Understand that almost everything in life is subjective and that your feelings are not necessarily the objective truth. Other people in your life can have differing opinions, and, believe it or not, that doesn't necessarily make either one of you wrong — but your feelings contain their own emotional truth, and they become decidedly easier to manage when we stop trying to make them go away.

Leslie Carr, PsyD author page.
Leslie Carr, PsyD

Leslie Carr, PsyD, is a licensed clinical psychologist (PSY 25306). She offers therapy and coaching, both in San Francisco and via Skype. More information can be found at