From medication reviews to exposure therapy, explore expert strategies to manage the physical symptoms of panic.
Key Takeaways
- People with bipolar disorder experience panic attacks at a significantly higher rate than the general population.
- These attacks are temporary and usually subside within 20 to 30 minutes.
- Behavioral techniques can help you manage anxiety by teaching your brain that the panic is a false alarm.
- Frequent panic may indicate a need for a medication review or mood management adjustment with your provider.
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Experiencing a panic attack for the first time is one of the most terrifying moments you can face. It feels like you’re going to die. It’s all but impossible to breathe. There is chest pain, a hyper-awareness of your heartbeat, and tingling all over. It’s a “911 moment” if ever there was one.
Once at the emergency room (ER), around 20 minutes later, the experience is pretty much over. The pain and discomfort have subsided, but residual anxiety persists: What the heck was that all about — and is it going to happen again?!
What Exactly Is a Panic Attack?
A panic attack is your body’s way of sounding a false alarm. It’s somewhat like an electrical surge in a home circuit that cranks up the awareness of our bodily systems. The intensity is profound: You might experience profuse sweating, heavy breathing, heart palpitations, abdominal pain, and other physical symptoms of distress.
Typically, panic eventually washes over you, and you’re none the worse for wear (at least physically). A typical panic attack comes on quickly and lasts for a relatively short time, often around 20 to 30 minutes.
Panic attacks can occur in a wide range of circumstances. Healthcare providers talk about panic disorder when panic attacks happen more often, and you begin to change your activity patterns. For example, if you have a panic attack at the movies or at the hairdresser’s, you may become wary and avoid those situations.
Ironically, panic tends to feed on itself. Worrying about whether a panic attack will occur actually seems to increase the likelihood of one.
Are Panic Attacks More Common in People With Bipolar Disorder?
People with bipolar experience panic attacks and panic disorder at a significantly higher rate — around one-third more — compared with the general population. Sometimes these moments are predictable, but sometimes they can come out of the blue. Anxiety, combined with an ongoing sense of worry, vigilance, and preoccupation with anything that is stressful, can become incapacitating and can severely limit your daily activities.
Many with bipolar disorder report having anxiety before they were diagnosed. They may attribute their first depressive episode to being constantly worried and anxious, along with self-imposed social isolation.
How Can I Manage My Panic and Anxiety?
The approach to managing panic and associated anxiety can include medication and talk therapy. Often, panic attacks or panic disorder become a bigger challenge when the symptoms of bipolar disorder, especially depression, are significant.
If panic attacks start occurring, it’s wise to talk with your care providers about whether or not your underlying bipolar disorder is being sufficiently managed. For many people, unstable moods lead to anxiety and panic attacks. A medication review is important when panic becomes a problem.
The Role of Behavioral Therapy and Exposure
Behavioral therapy is an effective strategy to manage panic. Simply put, this involves exposure to the panic-inducing situation and learning to let the panic wash over you. The key is to never flee the circumstance — whether it’s the movie theater or the hair salon. Sticking it out teaches the brain that, while this is uncomfortable and scary, it always passes.
There are many self-help books that outline exercises in exposure and response prevention, the tenets of behavioral therapy. Talk with your provider about a strategy to manage panic. Ask a friend or family member to attend a provoking event with you and help you stay the course.
Know that anxiety is common, panic attacks are common, and both seem to occur more frequently in people with bipolar disorder. There are many things you can do, including adjusting medication or starting talk therapy. It’s wise to be sure that your provider is aware of the phase of bipolar you’re in and the direction you’re headed (up or down), as this will help in the discussion of your management plan.
UPDATED: Printed as “Ask the Doctor: Panic Attacks,” Winter 2021