Psychosomatics of panic attacks
A panic attack is a sudden surge of fear with a racing heart, shortness of breath, trembling and a feeling that something terrible is about to happen. It is frightening but does no physical harm, and it usually passes in 5 to 20 minutes. Similar feelings come with other conditions, so the first time, see a doctor to rule them out. The Ladder method adds questions about anxiety and control.
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When to see a doctor
Book a doctor’s appointment if you notice:
- Sudden racing heart, shortness of breath, trembling
- Fear of dying or going mad
- Dizziness, numb hands, nausea
- A feeling of unreality, as if you’re not in your body
- Fear of another attack and a wish to avoid places where one happened
- Attacks keep coming unexpectedly
Start with a general practitioner, who will rule out other causes. Panic disorder is diagnosed by a psychiatrist or psychotherapist, who also chooses the treatment.
What medicine knows
Doctors treat panic attacks as part of anxiety disorders. The clinical protocol of the Kazakhstan Ministry of Health (2015) describes anxiety disorders as a group of conditions in which anxiety predominates, and lists panic disorder as a separate diagnosis.
During an attack bodily and mental symptoms build up fast: a racing heart, shortness of breath, sweating, trembling, dizziness, nausea, chest pain, tingling in the fingers, a feeling of unreality and a fear of dying. The NHS says most attacks last between 5 and 20 minutes, sometimes up to an hour. An attack is frightening but does no physical harm.
Panic disorder is diagnosed when attacks keep coming unexpectedly and are followed by at least a month of worry that they will happen again. A person starts avoiding places where they felt bad, which creates a “fear of fear,” the NHS explains.
Almost all these symptoms also occur with other conditions, for example very low blood pressure, so a doctor first rules out other causes. The protocol of the Kazakhstan Ministry of Health advises seeing a general practitioner, a neurologist and, for women, a gynecologist, to rule out physical and gynecological disorders.
A doctor chooses the treatment. According to the NHS, the main treatments are talking therapies, most often cognitive behavioral therapy, and medicine. Among non-drug methods the protocol of the Kazakhstan Ministry of Health names various kinds of psychotherapy.
In the Ladder method
In the Ladder method, panic attacks become a reason to look at anxiety and control. It is not an explanation of why the attacks happen but a question to yourself: what are you trying to keep under control, and what are you afraid of if you let go?
Sometimes the first attacks come in a period of big changes or long strain: a move, a divorce, losing a job, responsibility for everyone. That is not a cause, but a reason to look back. There is a second theme too: fear of the next attack narrows your life, and soon you no longer take the metro, stay alone or go out without your phone.
On the ladder anxiety stops being nameless: fears land on separate steps, and you can work with them one at a time. Diagnosis and treatment stay with the doctor, especially if attacks keep coming back.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
Frequently asked questions
Is a panic attack dangerous?
The NHS says a panic attack is frightening but does no physical harm, and most attacks last from 5 to 20 minutes. But the same symptoms occur with other conditions, so if it happened for the first time or your chest hurts, you need a doctor to rule out other causes.
Is a panic attack psychosomatic?
Doctors classify panic attacks as anxiety disorders, and they are treated by a psychiatrist or psychotherapist. Psychosomatics in the Ladder method looks at what stands next to the attacks: anxiety, control, fear of the next attack. These are questions to yourself, not a replacement for treatment.
What should I do during a panic attack?
Remind yourself that the attack passes, most often within 5 to 20 minutes. If attacks keep coming back, see a doctor: cognitive behavioral therapy, as the NHS writes, teaches you to stay calm during an attack.
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Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.