What does a lemon have to do with fear? How to deal with panic attacks

“Suddenly I feel dizzy and sick. My knees give in and I fear I might fall over and lose consciousness. I might have a brain tumour. My heart is racing, my chest feels tight and I fear I’m having a heart attack.” This is how a client described her experience, which points to panic attacks.

Panic attacks are characterised by episodes of acute fear that start abruptly and pass after a short period of time. Usually panic attacks happen in a post-stress phase, after continuous chronic stress phases, after losses or strokes of fate. After having experienced the first panic attack, the fear of having another panic attack evolves, so-called anticipatory anxiety.

Symptoms of panic attacks

Panic attacks manifest on physical, emotional and mental levels as well as in our behaviour. Physical reactions are tachycardia, hot flushes, bouts of sweating, trembling, tingling, numbness in arms and legs, dry mouth and dizziness. On a cognitive level, the predominant feelings are a fear of dying, going mad or losing control. In terms of behaviour, there is a tendency towards avoidance behaviour (avoiding situations that triggered the first panic attack) as well as flight and the feeling to be ‘far away’ or ‘not here’. These symptoms suddenly appear out of the blue with no external trigger.

Vicious circle of fear

Fear of physical reactions that might be perceived as physical indisposition and interpreted as a threat can trigger panic attacks. We talk about a vicious circle that consists of the following spiral: harmless physical symptoms (e.g. tachycardia, dizziness, respiratory distress, nausea) are perceived and the person affected start to focus on them. The symptoms, which are normal stress symptoms, are interpreted as something dangerous (this dizziness will make me faint; my heart palpates so fast, I am going to have a heart attack). As a consequence of this assessment, there will be fear triggering physical changes (preparation for flight or fight). As a result of this fast process building up physical symptoms and their interpretation as a threat, ultimately the panic attack occurs.

Imagination triggers fear

The following exercise won’t trigger fear, it will however illustrate that mere imagination is enough for triggering physical reactions. Just take five minutes to do this exercise.

Imagine you have a table in front of you and on the table a cutting board and a lemon. Next to the board a knife. The lemon is mature, yellow and shiny. Take the lemon and cut it through the middle. Lemon juice is running onto the board and your fingers. Cut a slice off. Your fingers are sticky from the juice and you notice the intensely tart smell. Now take the lemon slice into your hand, have a close look at it. The fruit is juicy and shiny. Now fold it down the middle and take it closer to your mouth. Lemon juice is dripping on the table and running over your hands. Now bite into the lemon. At the very point in time your teeth go through the pulp, lemon juice unfolds in your whole mouth. You taste the tart juice and how it runs from the tip of your tongue through the whole mouth.

 
What did you notice? Maybe you felt your mouth watering and pulled a face because of the acidity?

This exercise shows that thoughts and imagination influence our bodies. Of course, thinking of a juicy lemon doesn’t trigger any fear, but physical reactions can trigger fear and feel threatening. You can learn to control your fears and change your thoughts in a way that helps you see reactions as less threatening.

How to deal with panic attacks

Please remember the following hints, should you find yourself in a situation of panic:

• During an acute panic attack – keep moving
• During a panic attack – use breathing techniques in combination with movement (abdominal breathing)
• During a panic attack – don’t observe your body but rather the environment
• Let the panic attack pass without any resistance
• Don’t interpret your physical symptoms as something threatening: you aren’t going to have a heart attack, or faint, or fall over, or suffocate during a panic attack
• • Learn to handle stress situations that foster your panic attacks

These tips should help you to learn how better to deal with panic attacks. The objective is not to cease having any panic attacks but to have some tools at hand that will help you to handle the attack. Whilst panic is a very unpleasant and intense feeling of fear, it doesn’t present any danger.

Reading material:
Morschitzky, Hans: Endlich Leben ohne Panik: Verlag Fischer und Gann

Fotoquelle: (c) iStock.com/Magone