Panic mode: How anxiety affects us

According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults age 18 and older, or 18.1 percent of the population. The manifestation into physical symptoms – shortness of breath, chest pain, etc. – can often mean an unwanted visit to the ER. To understand why anxiety elicits this unsettling set of issues, we asked Tom Gutwein, MD, FACEP, Medical Director Parkview Emergency Department, to answer a few basic questions about our body in panic mode.
What triggers a panic/anxiety attack?

Anxiety or panic attacks can be triggered by many different things for different people, but they are most commonly triggered by stress, fear, or not sleeping and eating well. This can be fear or stress in many types of situations. It can be fear of an upcoming task, uncomfortable conversation, anticipation or thoughts of a claustrophobic scenario such as a crowded area on an elevator or in a large sports arena, not sleeping well because of social situations, or even concern about potentially hazardous situations like having to make a long drive in poor weather conditions or busy roads.

What are the most common symptoms?

Symptoms can vary, but are commonly chest pain, shortness of breath, tingling and numbness in the hands or feet, or even loss of memory for a short period of time.

What is happening in the body that causes this response?

The body responds to any stressful situation regardless of whether it is “real” or “anticipated”.  If you were being chased by a bear, your heart would start pounding and you would feel like you couldn’t breathe. That is an automatic “fight or flight” response of the body produced by a surge of adrenalin. Your mind controls your adrenalin release, and so naturally your mind can do this regardless of the situation.  We all have a different level of “stress or anxiety” that will trigger this response.

What can someone do to calm the symptoms of a panic/anxiety attack?

The best thing to do is take a few minutes and, if possible, remove yourself from the environment that is causing the stress. Taking a walk outside would be the best. If that’s not possible, then go to another room and try to focus on something entirely different. The mind needs to be refocused on an activity that is not stressful and soothing to the person, like baking, meditating or exercising. 

What are lifestyle changes someone can make to reduce anxiety/panic attack occurrence?

Certainly trying to avoid those situations would be best, but frequently, significant anxiety or stress needs to be discussed. Speak to a friend or trusted family member, and then think hard about going to visit a counselor. Counselors and therapists are specifically trained to work with you on what causes your panic attacks, and how you can decrease them.

When should someone come into the Emergency Department?
Many times, it’s difficult to tell if an Emergency Department visit is necessary. If someone tries for 10-15 minutes to relieve their stress or anxiety and they are still having significant chest pain, they should seek care immediately. Especially if this is something entirely new to them. If they feel like they may pass out, they should lay down and call someone for help, just to have them there to watch them for a few minutes. Again, if the symptoms last more than 10-15 minutes, they should seek further medical care. If they have had the same symptoms multiple times, they need to make sure they contact their primary care physician and discuss them with their doctor.

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