This week I was thinking about the feeling of panic. I don’t necessarily want to write about panic attacks because I don’t think that everyone is able to relate to having one. Plus, I tend to think that this term can be, at times, overused and misunderstood within the general public. I’m also not gearing this blog to people who’ve been diagnosed with panic disorder, which is when panic or panic attacks reach a level that it drastically interferes with one’s life. If you look up information about panic attacks you may find differing definitions about what they are and the symptoms involved. This is interesting to explore, but today I’ll be writing about panic in a more general sense.

Some people will certainly say that they’ve never had a panic attack, but I think everyone has had moments of feeling panic. While anxiety may be a term that characterizes a spectrum of low to high intensity feelings, Panic is extremely intense and completely dysregulating. If anxiety is like the volume dial on the stereo allowing the music to be anywhere from quiet to loud, panic is an air horn–only incredibly loud. If we’re in panic, we don’t really think. Instead, we just react.

It has been challenging to find good information for this blog because most of my searches brought up articles about panic attacks, which again, not everyone has experienced. I saw some links for Reddit feeds, like, “What is the evolutionary advantage of panic?” These were a little closer to what I was looking for, but Reddit isn’t exactly a great scientific resource. Then I finally found a great article* on Psychology Today about how panic can be a life saver. They start off by saying that many experiences of panic are a “false-positive,” and they compare this to Covid screenings where a false-positive (testing positive when someone isn’t infected) would mean that you had to stay home when you didn’t actually have Covid. A false-negative, on the other hand (testing negative when someone does have the virus), would mean that you might have allowed yourself to be in situations where you infected others. Given these two possible mistakes, a false positive is probably better than a false negative in many situations. Dr. Rosmarin, who wrote this article, points out that experiencing panic is an indication that someone has a fully functional fight-or-flight response. This is exactly what they need in the event of a life-threatening emergency. He wrote about an encounter with a client who was experiencing frequent panic, and he asked her to share a time when she was truly unsafe. She reported a time in which she was playing catch with her kids and went to retrieve the ball as it rolled toward the street. As she reached the road, a car was barreling directly toward her that she hadn’t previously seen. Her body reacted immediately and she jumped out of the way before she could even process what was happening. Afterward, her stomach was in knots and she was dealing with the after-effects of an adrenaline burst. Dr. Rosmarin pointed out to his client that if she didn’t have a fully functioning panic response, she probably would’ve been hit by the car.

The article* mentions the body’s fear response to a life-threatening situation as:

Dilated pupils which increase the field of vision.
Digestion slows so that energy is available in the muscles.
Blood flow is pulled into the torso so that the organs are functioning at their peak.
Muscles become tense and ready for increased strength.
The heart beats faster and breathing increases in order to flood muscles with oxygen.

When we experience* panic, all of these threat responses occur, which are actually physically uncomfortable, and the panic may not involve life-threatening situations. Dr. Rosmarin recommends that people try to view feelings of panic as a false-positive and an indication that their body is responding exactly the way it should in order to protect them. In this way, it becomes possible to make peace with the reaction because it means that their bodies are trying to protect them. This runs counter to what I often hear from clients who are dealing with intense panic. They tend to worry that it means something is wrong with them. By understanding that their bodies are trying to protect them (but getting the wrong message about the level of danger they are in) people can learn to work on calming the body back down without unnecessarily shaming themselves.

I think that for most people panic is unpredictable. It just sort of happens when something really awful happens and we have to respond to it. Panic attacks are often reported that way too, and sometimes people will say that nothing bad happened prior to the attack…the feelings just came out of nowhere. In any case, panic is undeniably uncomfortable. We can’t get rid of panic because doing so would be to get rid of our entire fear-response, and this is responsible for keeping us alive in dangerous situations. We can start to teach ourselves to understand and embrace this (potentially) life-saving physiological response. In doing so, we can realize something very important about panic, which is that the feelings themselves are not dangerous. They are a system of reactions designed to save our lives.

*https://www.psychologytoday.com/us/blog/thriving-anxiety/202208/how-panic-represents-inner-strength-can-save-us

Sometimes I hear from new clients that they are starting therapy because their anxiety has gotten out of control. A common fear that they have typically revolves around two central questions: “Are my anxious feelings going to continue to get worse” and “Will I have to deal with this for the rest of my life?” The answers to these questions, unfortunately, aren’t very straightforward.

Let’s go ahead and tackle that first question, “Are my anxious feelings going to keep getting worse?” The answer isn’t great because my response is, “That depends.” There is a quote of questionable origin (but might have come from Jessie Potter): “If you always do what you’ve always done, you always get what you’ve always gotten.” Our behavior impacts our levels of anxiety; specifically regarding whether we feel anxious and do something anyway or if we avoid the things that make us anxious. When we feel anxious there are a variety of sensations that people feel to greater or lesser degrees: increased heart rate, sweating, fast breathing, muscle tension, racing thoughts, nausea, digestive problems, and a deep sense of overwhelm and dread.

Let’s use being in crowds in an example to explore this topic. There are people who feel the anxiety sensations listed above when they think about going to a crowded place and decide to go anyway. These people teach themselves that the anxiety sensations they’re feeling aren’t dangerous. Even though they may feel uncomfortable with the crowds, they never start to think that this is actually dangerous. There are also people who experience these sensations about crowds and decide to stay home. Unfortunately, this action tells the person that crowds are dangerous. Furthermore, it tells them that these feelings, themselves, are dangerous. The anxious feelings are then reinforced, and often spread beyond the specific fear. Unfortunately, when people avoid things that make them anxious, the feelings will tend to grow and the anxiety will get worse…often until the point that they decide they can’t let this go on any longer, and this is usually when people seek counseling, medication, or both. With the help of a professional (especially if the individual is willing to do their inevitable counseling homework assignments) they can start to gain control and reduce the symptoms of their anxiety.

The next question, “Will I have to deal with this for the rest of my life?” In short, everyone will have to deal with having anxiety for the rest of their lives. I think there is a major misconception regarding anxiety, in that some think that there are people who don’t experience it. There are definitely people who don’t appear anxious when it seems like they should, that part is true, but we all experience anxiety. Just because someone seems cool under pressure doesn’t mean that they don’t feel it. Most likely, they just acknowledge it and move forward anyway. Anxiety, along with all feelings and emotions, is a gift from our ancestors. Never experiencing it would actually be super dangerous. Anxiety causes us to consider matters of safety for ourselves and our loved ones, and it warns us that we need to take precautions against potential danger. It also pumps us up to prepare for something important. Anxiety can be helpful when we learn to use it and stop fearing it. I remember one of my psychology professors (long ago) told the class about a study that found that in situations where someone was supposed to perform a task, anxiety had the ability to help them perform better as long as they had prepared sufficiently. The research suggested that those who had practiced their task enough actually performed better in a test or performance due to the added anxiety they were experiencing. On the flip side, it found that those who were underprepared did worse on the test or performance when the pressure was added. This could sound like a deterrent to doing anything big, but it is actually meant to show that if we prepare ourselves sufficiently, the anxiety we naturally feel can improve our skills and make us sharper.

Fearing fear and worrying about worry is a very real thing for many people. However, it doesn’t have to be. Really think about how successful you’ve ever actually been at pushing down a feeling or emotion. Most likely you know that it is only a temporary fix because, just like a dirty diaper, you can only ignore a feeling for so long before it creates a giant mess. If these concerns feel familiar to you or someone you care about, know that counseling can help people learn how to face down their fears and worries. In the course of doing this, people come to understand that they are no longer controlled by their anxiety; their anxiety can be used to benefit their lives.