By Margarita Tartakovsky, M.S.
When you feel panic washing over you, the sweat collecting in your palms and dripping down your knees, heartbeat blaring through your chest, the inner shakiness and shallow breathing, the butterflies stomping inside your stomach, all you want to do — desperately — is to make it stop.
In those moments anxiety feels dangerous. It feels like something is terribly wrong. Or maybe we know that we’re not in real danger, that we’re experiencing a panic attack, but our bodies are in such a state of terror that we don’t care. The panic is too persuasive, and we yearn to escape. We yearn for anxiety to go away forever.
In reality, “anxiety and panic symptoms are harmless,” said L. Kevin Chapman, Ph.D, a psychologist and associate professor in clinical psychology at the University of Louisville, where he studies and treats anxiety disorders. Below, he and other anxiety experts debunk common misperceptions about anxiety and panic.
A big myth about anxiety is that it’s negative and something we can — and need to — eliminate, said Chapman. Anxiety, like all emotions, is adaptive. “Anxiety is a cognitive, emotional, and behavioral process that alerts us to potential future threat,” he said. When it isn’t excessive, anxiety prompts us to take healthy action, such as studying for an exam, he said.
When people become anxious, they tend to feel dizzy or lightheaded. Understandably, many people worry that this means they’re going to pass out.
But fainting is actually very rare, said Simon A. Rego, PsyD, director of psychology training and the CBT Training Program at Montefiore Medical Center/Albert Einstein College of Medicine in New York.
“Remember, fainting most often occurs with low blood pressure or for people who respond to stressful situations with a drop in blood pressure, and when anxious, most people experience a rise in their blood pressure, not a drop in it.”
We feel dizzy and lightheaded because our bodies start breathing more rapidly and intensively to prepare us for danger, Chapman said. (This produces a feeling of breathlessness, which is harmless.) This is “the body’s way of sending more oxygen to bodily tissues.”
“In other words, panic attacks do not cause one to pass out, the adrenaline and noradrenaline in the body eventually go away, and the feeling doesn’t last forever. In a weird way, these symptoms indicate that your body is doing what it is supposed to, in the event that real danger exists.”
A prominent belief of all people with anxiety disorders (and anxiety) is that once they’re in an anxiety-provoking situation, the anxiety will last forever, said Edna Foa, Ph.D, professor of clinical psychology and psychiatry and director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania.
They worry that they won’t be able to tolerate the anxiety and will “fall apart” unless they escape the situation or avoid it (or any other situations that spike anxiety), she said.
Even though it feels like you won’t be able to tolerate your anxiety, you will. You may need to learn different techniques and practice them on a regular basis. Working with a therapist can help. According to Chapman, “Cognitive-behavioral therapy (CBT) is one of the most effective, time-limited treatments for anxiety disorders.”
It helps individuals better understand bodily processes, restructure anxiety-fueling thoughts, and gradually learn to tolerate physical sensations and the situations that may trigger anxiety, he said.
It’s a common belief that panic arises out of the blue. I can feel just fine, and yet the symptoms strike! However, according to Chapman, there are three components to anxiety and panic:
- Cognitive component (your thoughts): “Anxiety involves thoughts of uncontrollability and unpredictability of future events; panic involves thoughts of present danger, which include viewing symptoms as dangerous, such as ‘I’m having a heart attack!’”
- Physiological component (physical sensations): This may include symptoms such as dizziness, shallow breathing, sweating and heart palpitations.
- Behavioral component (your behavior): This may include restlessness, pacing and escaping or avoiding situations.
When uncomfortable bodily sensations arise, we interpret them as, “uh oh, here comes a panic attack [or] danger.” This further boosts arousal, which triggers other negative thoughts and a strong urge to escape, he said.
Chapman likens our bodies to a “gentleman,” who responds to what he’s told. “In the case of panic, interpreting normal bodily sensations as ‘dangerous’ communicates danger to your body, which ultimately prepares you for the ‘danger.’”
This is why it’s helpful to identify the thoughts that fuel your anxiety and panic. Then you can revise those triggering thoughts “to more evidence-based thoughts, such as ‘These symptoms are normal’ or ‘I can tolerate this.’”
In other words, the physical symptoms of a panic attack may appear out of nowhere, Rego said. Thus, the key is in how you react to those symptoms or interpret the physical sensations, he said.
So if your heart is racing or you’re experiencing palpitations, instead of assuming you’re having a heart attack, he said, you may consider: “Hmmm. My heart seems to be racing. Isn’t that interesting? Perhaps it’s the hotdog I had for lunch? I’ll just observe it for a while and see what happens…”
When you’re struggling with anxiety and panic, you might feel embarrassed or ashamed. You might feel alone. You’re not. “[A]nxiety disorders are the most common mental illness in the U.S.A, affecting nearly 1 in 5 adults age 18 and older, with about 6 million American adults experiencing panic disorder in a given year,” Rego said.
Again, fortunately, anxiety disorders are treatable. Consider seeking professional help.