Red Alert - Panic Attack in progress

Red Alert - Panic Attack in progress

Like so many other diseases, COVID-19 has symptoms that overlap with those of many other medical conditions. But given its potential severity and impact on the fate of each and every one of your family, it is perfectly understandable that a person, at the first suspicious signs, does not merely get that unpleasant feeling that there is a flu or a cold coming, days of bed and late work, a hassle? - but rather in a state of alarm, preparing for a much more difficult battle. The intensity of this alarm can be of level "Red Alert", throwing the person in a demonstration - also very abundant in confusing signals - known as "Panic Attack". It is important to recognise this situation as soon as possible and to regulate it effectively and quickly. To aggravate the scenario of our Red Alert, the panic attack, has symptoms that at first sight seem to juxtapose with the signs of the disease that we now fear so much - such as shortness of breath.

Panic attacks occur more often than you might think. Anyone can have them if at a given time they assess their ability to respond to a stressor as insufficient to meet the challenge it presents. This assessment is not conscious, but it always seems to be implicit, which is evident from the fact that panic attacks are prevalent at times of great transition in a person's life or at times when they face new and immense challenges. It is no wonder that it is particularly marked in young people, in the face of moving to another city, going to live alone, being on the verge of a first job, of marriage, of parenthood, in short, all undertakings, as we know, of cosmic proportions.

However, not only in these situations and in young people does the panic attack occur. No one is immune, although there are genetic, environmental and psychological predictors identified. And just to make it really clear, and devoid of any trace of stigma, it also happens to Psychologists, Psychiatrists, Psychology students - the Psis, therefore, are not immune, even knowing this phenomenon. No one is. But it is also important to underline that this article is oriented to the situation of an isolated, rare or circumscribed panic attack in a short period of time - because recurrent panic attacks after many months or years configure an anxiety disorder that requires a systematic clinical approach. In such cases, the following recommendations are helpful, but those who read will benefit greatly from a program of cognitive-behavioural therapy sessions, and the advice is no substitute for professional consultation and follow-up in psychotherapy. If this is a frequent occurrence, please make an appointment as soon as possible.

The most circumscribed situation that motivates my article today is the occasional occurrence of a panic attack - which can occur with greater probability in a frightening scenario such as ... a pandemic. Although fear, like all emotions, is adaptive because it puts us in an appropriate position to face situations that threaten our physical and mental integrity, the panic attack is not. First of all, it is not adaptive because it is paralysing; and secondly, because it generates even more fear, even reaching terror in many cases.

Nevertheless, we can do something to stop them - and the first step is to understand what is happening. Because even though it is generated by extreme anxiety, it occurs so abruptly that what the person realises is the physical symptoms. Typically, you experience a sudden increase in heart rate (very fast heart rate), arrhythmias (palpitations), dizziness, shortness of breath, shaking and chest pain. You may also feel chills or hot flashes, feel like you are going to suffocate, choke, tingling. Not necessarily all of this - combinations vary. Now, this sudden event generates conscious fear - fear of "what's happening to me?", "is that how a heart attack starts?", "and if no one comes to help me?", "and am I going to die?".

This "analysis" of the situation is not what is intended - for it initiates a dangerous escalation towards more and more fear, towards terror. The useful analysis is really another: it is a more objective interpretation, in stages - here goes:

1. If you are a healthy person, without any previous sign of heart disease, think that a very fast heart is proper and normal in many life situations, from running up the stairs, to preparing to face dangers and challenges - and that, thanks to its ability to regulate, the heart rate will return to normal - because this is one of the most controllable physiological responses we know, as we have been shown decades of successful biofeedback techniques and cognitive-behavioural therapy. People learn to control their heart rate, as well as to control their breathing. And they also take conscious command of their thoughts and actions. It's an exercise that is perfected with training. 

2. If, like most people, you fear infection with the new SARS-CoV-2 coronavirus, and you are in isolation to protect yourself, there is a serious chance that, being healthy and with the symptoms described in 1, you are having a panic attack.

3. If these symptoms arise from a small cough, or sore throat, or headache, think about this: fast heart rate, shortness of breath, and even less chest pain and palpitations are not symptoms that appear immediately with Covid-19 disease, i.e. right after the first cough, when they arise at all. Cardiac symptoms occur in people in a much worse state of Covid-19 disease, when the virus "attacks" heart tissue, and especially in people with previous heart or vascular disease. But the extreme fear of being infected does produce these symptoms, and such a cough may have been the trigger for their reaction at this time. 

4. Then recognise as a strong possibility that the panic attack may be happening to you. If you live alone, it is a good idea to call a good friend and tell them what you are feeling and your suspicion of the panic attack. Give him or her a detailed description of what is happening. By the time you finish, you will almost certainly have a lower heart rate, more normal breathing and less dizziness. If that's the case, it really was a panic attack! I say "was" because this phenomenon is usually short-lived, and when you ask for help sometimes it is already happening. Talking to someone is very useful at this stage and helps to ease the symptoms.

5. Take a deep, slow breath, it is passing... And now you know, from experience, how short the panic attack lasts. You also know that you can regulate your breathing, guide your thoughts, ask for help, control your fear.

6. Think you are released from this attack. Be proud of your ability to overcome it. And think no more of it; do not entertain the idea that there may be a next time, what a fright! That would be another switch to a panic attack. Whether you have it or not is up to you. And remember that nothing is scarier than fear itself. Courage at this time of such concern!

So, first of all, let me assert my firm belief that the only thing we have to fear is...fear itself— nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.         Franklin Roosevelt, Discurso inaugural, 4 de Março de 1933

Augusta Gaspar,

Coordinator of the Psychology Scientific Area of the FCH- UCP

Member of the Board of Directors of Católica Res. Centre for Psychological, Family & Social Wellbeing

Categorias: Faculdade de Ciências Humanas

Fri, 24/04/2020