COVID-19, Panic and The Perfect Storm: Part 1, Panic

The media is chock full of stories about the corona virus pandemic and its impact on mental health. I find that the terms fear, anxiety, and panic are often used interchangeably these days, so let’s start with a few distinctions, taking fear first.  Fear is best described as response to a threat, and today we have all too much to fear, from lost income, to concern about our own or our loved ones’ health, to uncertainty about how long this crisis will continue.  Fear eases when the threat eases or we find positive actions to handle the threat (for example, social distancing, wearing a mask, revising a personal budget to account for financial changes).  Fear is not a symptom or a mental health condition.

Anxiety, on the other hand, can range from a transitory experience that we all have from time to time to an unrelenting and distressing mental state. Anxiety can be situational, which is the state of the world we live in now.  Anxiety becomes a mental health concern when it overwhelms our capacity to cope or it persists when the real threat diminishes. We can hope that will be soon.  We see anxiety as an exaggerated and persistent state, both mental and physical.  On the mental side, common reactions include difficulty concentrating, belief that the worst will happen, and distress about uncertainty. Physically, anxiety can take the form of restlessness, muscle tension, nervous stomach, tremulousness, and sleep disturbance.

Panic, we’ve come to learn, is distinct from fear and anxiety.  Panic attacks are characterized by sudden intense fear, with a combination of physical and psychological features, usually peaking rapidly and lasting 10 to 30 minutes.   The physical features can include rapid, pounding heartbeat, shortness of breath, chest pain, trembling, and dizziness. The psychological features of a panic attack include fear of dying or loss of control, fear of impending doom, and feelings of unreality. About 30% of Americans have at least one lifetime panic attack and just over 10% had a panic attack in the prior year, according to research.  While just about everybody is fearful and anxious, at least to some degree, during the CV-19 pandemic, only a subset of the population is likely to have formal panic attacks.  The combination of genetics, developmental factors including exposure to trauma, and respiratory physiology create the risk for development of panic attacks.

So now let’s turn to panic in the time of a pandemic.

No big surprise, we are in strange times. Some people with persistent panic attacks are coping pretty well. Those whose panic attacks are triggered by crowds, driving, airplane travel, or other external stressors are sometimes feeling better than usual, since triggering events are officially unavailable! Avoiding stressful situations is common and can be debilitating, and those panicky reactions are likely to return once social distancing is eased.  Another source of panic triggers, unfortunately, is getting much worse. Hypersensitivity to bodily distress and symptoms is a hallmark feature of panic, even for medically healthy panic sufferers in ordinary times. Our daily news is full of sad and distressing news about illness, death, and a growing list of CV-19 symptoms. For those who fearfully tune in to their bodies in the best of times, sensations of shortness of breath, racing heart, or other new or distressing physical sensations can rapidly escalate into panic.

So, what are options for individuals with panic in these extraordinary times?  A focus on maintaining a regular schedule, controlling what we can control and letting go of what we can’t can be useful. Getting regular exercise is crucial, and a safe, socially-distanced walk outside daily can be very helpful. Daily exposure to sunlight helps regulate our sleep cycle.  Staying connected to those we care about is essential, and thankfully we have Skype, Zoom, and Facetime to help us stay in touch with those we can’t see in person.

Freespira is a proven treatment option for people with recurrent panic attacks, and is also available for use completely from home, which is vital in a time when in-person health care has essentially been shut down.  Authorization can be done via telehealth, as can training and follow up visits. In addition to normalizing respiratory patterns, Freespira use over the recommended 28-day period also develops important self-management skills that can be employed regularly after the system is returned.  Most clients learn to recognize when their breathing gets irregular when stressed and can readily shift back to the Freespira breathing style, which can help manage anxiety symptoms and prevent panic attacks from mounting.

If you think that #panicattacks are psychological, think again. New research suggests they might be caused by receptors in the body. Find out more here.

Panic disorder is a syndrome characterized by spontaneous and recurrent episodes of incapacitating anxiety. It typically emerges during adolescence or early adulthood and can take an exhausting emotional and physical toll on the body. Physical symptoms can include heart palpitations, sweating and/or chills, trouble breathing and dizziness, nausea and even chest pain.

While significant progress in both diagnosis and treatment has been made with panic disorder, a lot is still not known about what triggers these panic symptoms. There is evidence that a pH inbalance disruption in the body, known as acidosis, can unexpectedly cause the panic attack.

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Prince Harry opens up about terrifying panic attacks

In yet another first for a senior member of the royal family, Prince Harry has given an extensive TV interview in which he described in excruciating detail the panic attacks he suffered following the death of Princess Diana.

In the interview for the Army channel Forces TV, Harry says that he would suffer appalling panic attacks that made his body feel like “a washing machine” every time he found himself in a room full of people.

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This puppy was adopted and returned three times — then he met Morgan, who needed a service dog to help her cope with panic attacks. They are so perfectly matched to each other, it’s unreal.

This puppy was adopted and returned three times — then he met Morgan, who needed a service dog to help her cope with panic attacks. They are so perfectly matched to each other, it’s unreal.

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After years of panic attacks, Charyn finally tamed the #anxiety beast. Here’s exactly how she did it. And you can too.

I don’t remember when I had my first panic attack. Oddly, it didn’t coincide with the loss of my mother at the age of 17 or the deep-seated spells of major depression in my mid-20s. These mood-crushing moments seemed to rear their debilitating powers a decade or so later.

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From time to time, Palo Alto Health Sciences (Freespira) will share articles or blog posts from guest authors. Some of the information presented may not be consistent with the science-based and clinically-proven method behind Freespira. In such cases, we share the article or blog post for general informational purposes only, without any endorsement or recommendation.