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Panic attacks and panic disorder: an honest guide

Have you ever experienced intense fear and strengthening anxiety going through you? I have. My last panic attack happened to me about three years ago. I’ve been panic free since that 15 years panic disorder period has come to its end. Thank God. I have learned a lot from that. At next, as well as general panic information, I’m going to share my own experiences and success stories.

What is a panic attack?

Well, it is intense, but purely, it’s just a fear. In other words, it is an unflattened curve of highly peaked-fear. It’s like, “What? The previous minute it was a clear sky, but now it’s raining. It’s crazy!” A panic attack can appear like from nowhere. The first one, of course, comes from nowhere because you only know what is when you had it before.

Generally speaking, when there’s a moment when you’re like panic-free, and at the next moment you suddenly a panic-fear, a full of panic, then it comes with a list of symptoms. The symptoms are quite typical—heart palpitations as one of the first signs of the fearful state. At the same time, more physical or bodily symptoms appear. Shortness of breath joins to an already racing heart along with choking feeling, discomfort, or chest pain, sweating. And if you looked your hands likely, you would find them shaking.

When a panic attack strikes

When a panic attack strikes, your fear takes you, generally speaking, to another dimension, that is to say. Along with all of the above discussed bodily feelings, the fear changes your consciousness as well. Therefore along with the palpitations, etc., start feeling either fear fo dying or losing control and going crazy.

Do most people ask whether there are preconditions before the first panic attack? Yes, they do so. And the fact is most people have no previous health conditions before the first panic attack. So it’s perhaps appropriate to say it most of the time come as like much to one’s surprise.

But as I do believe, as I also experienced it already, it is not quite right. Why? Well, because you may go through a source of troubles in your life before the first panic attack occurs. Before I started to detail my story with panic, I’d like to mention that before my first panic attack, I already had social anxiety, depression, OCD, etc.

There’s always a price to pay when one’s let self-esteem to go at a very little value, which I made happen in my life. My point is here that you could still catch yourself where you are right now and, yes, do make the changes.

Gabor’s story

It will be hard ever to forget it.

Frequently I like to look back to my life before that when the first panic attack happened to me and to see it much more clearly from right here where I am sitting now and typing this line.

So let’s say about 20 years ago from now Gabor is a young boy. But he is an alcoholic and depressed, and OCD-ish thought patterns burden his life. And because of Gabor’s back problem, his self-esteem is already very low that gave him all sources of problems. 

That night: Gabor’s story

Perhaps all of these can outline a little bit of my current mental situation when that night, I experienced my first panic attack. I’ve got to say until that panicky night experience. I went through so many mental blocks that gave me a hard time. Still, that panic attack was incomparable to any of that happened to me before.

That first one so incredibly scary was that it’s hard to explain. It was quite a deadly feeling, to be honest. My legs after the panic attack can’t stop shaking. I was trembling so hard I couldn’t sleep back any time soon after that. If I only said it was horrible, well, it was right, of course, but it can never make it to carry enough of the real meaning of how it was.

Anyways, the following day I found myself being quite precautious. Precautious? Probably this is not the best word to describe my very next day of the first panic attack. I was awestruck. That’s better. I was not the same person as I was at yesterday. It was undoubtedly true. 

Panic thoughts

And after 15 years of panic disorder and over, I still think the same. But you know what? Even though I have already overcome panic disorder plus agoraphobia, but my mind, where I am to feel not the same as I was before the first panic attack. I do feel my mind post-panicky different right now, as I was pre-panic-attack, let’s say 20 years ago.

The thing is now I’m always ready for the next panic attack, and this just the way my mind works. And does that, even though I have already overcome the panic disorder and I have no more panic attack. But still, my brain functioning as I should be ready, and therefore, I should be cautious. All of that was not me before the first panic attack of mine.

Gabor’s second attack

The second panic attack? It came. I only needed to wait a little bit. And I do mean to ‘wait’ as it is fearful anticipation of a next occurrence. So it came after ten days or so? Something like that. And guess what! The second panic attack was way more devastating and deadly looking than the first one. Probably I should say if the first one was only ‘horrible,’ then the second one was ‘horrible-horrible.’

Then the rest of all of my panic attacks came too. Fifteen years of panic disorder equals beyond my worst dreams—a thousand in one. I mean, I had around a sort of thousand panic attacks. And it all happened in one panic disorder. Of course. 

Panic attack signs and symptoms

It’s no longer than 10 minutes between the first signs and symptoms until the panic attack peaks its worst. It comes fast. The first body sign that you’re experiencing until the top of the fear of death or going crazy is a matter of only a short time. 

Before I forgot, let me mention here that I used to create sound-patches on synthesizers. Any sound has an envelope; that’s how they call it when a sound-patch starts sounding from its start to fading away completely. ADSR is an envelope that describes how the sound changes over time, says Wikipedia. Now I think it’s a good enough analogy to explain how a panic fear changes over time too.

Panic attack signs & ADSR envelope sound design therms

 A is ‘Attack’ of ADSR in sound design therms. At panic, it’s an attack too. Let’s describe the time taken from “I’m fine.” to the peak of the panic-fear. Generally, it’s around 10 minutes.

 D is ‘Decay.’ the time of run down to a sustainable level, in sound design. 

 S is ‘Sustain’ the duration. They are combining with a general panic attack that consists of a mixture of ‘Decay’ and ‘Sustain’ phases. That means after the first peak of panic, there may be a second and a third peak that can follow. The time of these can take up to another 30 minutes.

So these were the ADS phases, and now let’s see the last step of an ADSR envelope. 

 R phase ‘Release.’ that is the PANIC relief phase. Usually, the R phase of a panic attack is a mental trigger. A thought that indicates that there’s no more life-threatening danger. And this can be the only one that could end up the sustaining phase and trigger up the Release phase to let the panic fade away. I assume this shouldn’t take up more time than a few minutes. Let’s say 3 minutes.

So by summing up the ADSR panic envelope if you will take up averagely 43 minutes. Of course, this does vary in every case, and every person a little bit.

Symptoms of a panic attack with most people and as it has happened with me too

In this chapter, I’d like to write a comparison table. I plan that the table columns show you the panic attack symptoms generally and widely adapted to panicky cases. On the other hand, the right side of the panic symptoms table will parallel show you the panic symptoms as I experienced while I had a panic attack.

Symptoms when having a panic attackSymptoms when I used to have a panic attack
Fear of death, burning desire to escape or seek helpFear of death was my number one cause of panic attack all the time
Accelerated or intensified heartbeat or palpitationsBecause of the intense fear, I always had heart palpitations.
Feeling faintFeeling faint was not my thing too much. I sometimes had, but not many times.
Difficulty breathing, a kind of subjective feeling of the impossibility of inhalingYes. I did this one also. I hyperventilated during a panic attack.
A significant, sometimes dangerous rise in blood pressure and heart rate during the panic attackMy heart rate. Oh yes. Racing heart during a panic attack was almost unbeatable.
Difficult to articulate, rather a discomfort, but a non-painful chest feelingI had this. Always. My inner fear was all about my heart. I felt the discomfort all the time.
PerspirationI can’t remember. Perhaps perspiration wasn’t any significant accompany of panic attacks.
Pins and needles sensationMany times at my wrists.
Dizziness, nausea or light-headed feeling and rarely faintI sometimes had nausea and a light-headed feeling.
Tingling or itching sensation in the face, mouth, hands or feet (paraesthesia)I felt tingling mostly and sometimes itching sensations around my mouth.
Feeling of weakness starting in the stomachProbably I didn’t feel much difference in my stomach, but sometimes I felt like my legs got real weak.
Sudden abdominal pain, diarrhea, stomach crampsAbout the shaking? Oh yes. Always.
Occasional hives-like redness, especially in the chest areaI had some funny feelings in my chest area all the time during a panic attack
Dreamy feeling or sensory disturbances (derealization)I had a dreamy feel, and I believe my sensory perceptions went crazy too.
Dissociation, the impression that the individual is not in connection to one’s own body, or even time and space (depersonalization)Oh yes. Tell me about it! It was beyond belief.
A kind of sense, as if a glass wall had descended between the person and the outside world.Somewhat I had this one also. Perhaps this wasn’t a significant symptom of my panic attacks.
Sometimes a fall for a few moments.The fall. I will never forget my first panic attack. It was all about the fall that scarred me forever.
Fear of losing control that the one’s doing something stupid, going crazy, attempting suicide, etc.I know there’s another kind of panic attack, and it is all about the fear of going crazy. However, this wasn’t my thing.
Trembling or shakingYes. Always.
Numbness of the tongue and also of the face; it can occur in any part of the body.I had the numbness of my tongue with that funny feeling of my face.
Compulsive thoughtsCompulsive thoughts? Yes, I had and am having still many.

Palpitations: heart attack or panic attack?

Many times, the symptoms of a panic attack are very similar to the symptoms of a heart attack. Because of this, many people often consider the symptoms of a panic attack to be life-threatening, which when they experience and then seek immediate medical attention. They do well, of course, as it is only a doctor who can determine that symptoms like heart palpitation, chest pain, shortness of breath, what is.

Panic attack v panic disorder

There’s one thing in mind when it comes to differentiating between a panic attack and panic disorder, and that is the number of panic attacks. According to the psychological literature, it is, of course, not that simple. There’s much more to characterize a panic disorder versus a panic attack.

DSM-5 defines panic disorder is a recurrent, unexpected panic attack. There’s at least one panic attack that must follow at least one month of persistent concern about having more panic attacks. There’s also worry about the consequences of the attacks. DSM-5 defines maladaptive behavior, like, for example, avoidance of work or school activities, and these are all because of the panic attacks.

Panic disorder signs and symptoms in general

I want to share with you here some of the general signs and symptoms of panic disorder. As a comparison table, you will find it easy to compare the signs and symptoms in general and also the way I used to experience them.

Symptoms during panic disorderSymptoms when I used to have a panic disorder
DSM-5 has added panic attacks as a potential specifier for all mental disorders. Therefore one of the signs of panic disorder is, of course, the recurring panic attacks.My existence wouldn’t be able to represent the truth regarding the panic attacks the course of my 15 years of panic disorder as I experienced them, then the statement on the left.
Panic attacks strike most of the time unexpectedlyI’d argue with this one. Let me explain. As I’m out now of the panic disorder and I can view it from above, then I can tell one thing. The fact is that I worried too much about having more panic attacks was telling me that a next panic attack will come for sure. So I’m not quite sure about what DSM-5 has to say about the unexpected panic attacks.
There’s a persistent worry about having more panic attacksYes. Indeed. In other words: 15 years of worry of a next panic attack generated over a thousand panic attacks. Am I serious about this? Oh, yes.
Avoidance strategies of work or school because of an anticipated panic attack.Sure. Avoidances was part of my life. Moreover, what I right now consist of all of those things that I have never avoided. Much or small? You decide, but I’m sure you get my point.

Panic disorder characteristics

Even though a panic disorder has a few signs and symptoms and characteristics, it has a different manifestation in every individual life. Let’s see what the general appearances of a panic disorder are. And to compare, I write next to each item in the table below my experiences. So you can easily compare the way panic disorder manifested in my life, particularly, align or not to general.

Characteristics in the course of panic disorderSigns and symptoms of the panic disorder of mine which I will never forget
Anticipations are full of fear about the next panic disorder.Throughout my panic disorder, there was one thing that characterized my life: the fear of fear. Where, of course, the fear was all about the anticipation of a next dreadful panic attack that freaked me out.
There’s a maniac avoidance to stay safe throughout the panic disorder. Why? Well, it’s a guessed way to avoid the next panic attack and stay safe.Yeah. Me too; I avoided a lot. And when I couldn’t avoid, it generated a rising worry in me. That made the next panic attack to be, almost to say like, it was inevitable.
One of the most visible characteristics of one’s panic disorder is to call family members or friends to give the company to stay safe.Well, asking to give a company was not my thing. I’d instead been myself as I often felt ashamed because of the panic attacks and the whole panic disorder thing.

Panic disorder and agoraphobia

The book DSM-5 brings five primary changes on how to diagnose panic disorder and agoraphobia.

  1. While agoraphobia used to be part of panic disorder, it is now separated.
  2. Appears new criteria and guidelines for distinguishing agoraphobia from the category called Specific Phobias.
  3. One of the requirements for agoraphobia is now a 6-months duration.
  4. Previously it was relatively easy to say that a lot of panic attack means and characterizes that perhaps there’s panic disorder. Not anymore. A panic attack is now, according to DSM-5, is a specifier of many mental disorders.

I wanted to mention here one more fact about the panic attacks according to the new way how DSM-5 characterizes panic attacks. It says there are “unexpected” and “expected” panic attacks.

It’s interesting. But pulling out my memories of that 15 years of panic hell, I’d say I’ve started with having unexpected panic attacks. Then it turned into expected panic attacks. It well can be because, in the second half of my panic disorder, it was agoraphobia.

What causes of panic disorder?

The exact causes of panic disorder are unknown. But stressful life events are likely to play an essential role in its development. It is also possible that panic disorder inherited based on studies. Familial accumulations are suggesting that some genetic variation may also play a role in the onset of symptoms. In many people, on the other hand, the panic disorder appears without any precedent within the family.

Self-help tips: panic disorder

panic disorder self help tips

If I could go back in time, I would probably tell it myself too. But in the absence of a proper time machine, I’ll let you know this right now. No matter how much the hell of recent panic attacks plus the torments of current panic disorder takes off your feet right now, there are still things that you can do. 

Please see the comparison table below to compare general panic disorder self-help tips with all of those that I found helpful in my case.

Generally helpfulRemembering they were great for me too
Learn as much as you can about panic attacks! Just by knowing a little bit more every day about panic disorder, you can find out more about its mental components. Should you have a panic attack or panic disorder, it will help a lot.I used cognitive behavioral therapy every day for a year and a half. I learned an indescribably much about myself. Without it, I wouldn’t have been able to come out of the panic disorder, that’s for sure.
To use cigarettes, alcohol, drugs, coffee. From smoking to the habit of drinking a few coffees a day, all of those produce bodily sensations. In other words, they have psychological effects and after-effects too. One with panic disorder inevitably feels the physical feelings and its mental effects to be the direct cause of a recently happened panic attack.Smoking and drinking. Oh yes. I could tell you about these. While I smoked, but I quit about 15 years ago, I also was an alcoholic. Luckily I quit drinking about 14 years ago. Drug? Well, I have never taken drugs. But I love drinking coffee, and my soul hasn’t yet led me to quit drinking coffee.
Meditation. Regular meditation like yoga, mindfulness, or any relaxation technique, will help you to experience to bring more joy and more serenity into your life. It becomes a vital island, that is to say, in your life where you can always return to, and to take back control over the panic.I also meditate regularly, especially towards the end of the 15-year panic disorder period. I’d say I loved the fact I was doing meditation a lot. It was so helpful to me.
Exercise regularly! It helps a lot in relieving stress. Swimming or gymnastics, radio exercises are good ones. It is worth maintaining often.I swam. But the truth to be told, in swimming and other workouts, I was much better after the panic disorder then I was in the meantime.

Panic attack and panic disorder with agoraphobia treatment

woman sitting with a therapist at a panic disorder with agoraphobia therapy

In the next, I’m going to discuss treatments.

Panic disorder treatmentMy success story on how to overcome 15 years of panic disorder
Cognitive Behavioural Therapy (CBT) is one of the most effective to relieve the symptoms of panic disorder. For many people, only one session is successful enough.
I did cognitive therapy too. More accurately, I did a sub-technique of CBT called Thought Record writing that I did every day within one and a half years. I want to thank Dr. Steven M. Melemis Ph.D. MD and his brilliantly helpful book, ‘I Want To Change My Life.’ Every day, I wrote Thought Record linked to a panic attack. I chased back my childhood-self to find out where it started. I had never dreamed of what presented me with my past. That’s for sure: that I wouldn’t be able to step out by myself from 15-years of panic disorder without writing the Thought Record every day.
Panic disorder treatment with confrontation is also a useful technique. The point is here to create a situation to cause bodily sensations are very similar as if you had a panic attack. The dizziness, the tingling feeling in the body, sometimes hyperventilation are very effective treatments that targeting to the brain to confront what seemed dangerous they are not dangerous at all.Hyperventilation? Well, I wouldn’t say that the hyperventilation was the lone causer to help me out from one and a half-decade of panic disorder. However, the hyperventilation program was the last one I had had before I came out from the panic disorder.
Exposure therapy is a technique to treat a variety of mental disorders. Let’s say, for example, having a fear in the lift. The exposure therapy will help you to expose your anxiety to the lift situations without the intention to cause any danger. Doing so little by little or step by step is thought to help you to overcome your fear of being in the lift.I applied it to myself as well. And also, I helped with it to others as well. There’s indeed a tiny small footstep that is still doable and gives you courage. And little by little, it is possible to get to the end of panic disorder or other mental health problems where confrontation techniques are working.

Medication for panic

There are medications available to targeting people getting a diagnosis with mental illnesses, indeed. There are people out there with mental illnesses and medication treatment for years, and there are also people with medication only for a short time. When it comes to short time medication, it can give perhaps a bit better chance to reduce suffering to prepare for a nonmedicated psycho-therapy. 

Psychiatric medicationMedications I took over the course of panic disorder
Antidepressants are medications to treat a major depressive disorder, some anxiety disorders, and some chronic pain related to some degree of mental illness.I never took antidepressants at all. If you don’t mind me disclosing or admitting it right here to you, I was an alcoholic. I quit drinking, and it was not easy for me. More accurately, to end up being an alcoholic was very hard. And while I was in panic disorder, the last thing I wanted to become addicted to any psychiatric drug. Or at least that was my thought at that time.
Benzodiazepines are also a treatment for anxiety. It is in a longer-acting therm while in short-acting benzodiazepines are treating better for insomnia.Not at all. But I am aware of what happened with Dr. Jordan Peterson.


I couldn’t be more grateful for the fact that I have found the way out by myself from 15 years of panic disorder with thousands of panic attacks with fear of death, alive. If you’d like to follow me, please join me by clicking here and go for whatever coaching options work best for you.

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