Women and Panic Attacks

Colette Dowling, LCSW

Colette Dowling, LCSW, author of the following article on panic attacks,

is a psychotherapist in Manhattan,

For information, or for a free phone consultation

call Colette at 718-594-0201

Women and Panic Attacks

Back when I had my first panic attack, in college, there wasn't even a term for it. The consensus was that I was suffering from anxiety over leaving home and the impending separation from parents.

My second panic attack hit four years later, in the Brooklyn Museum, where a photographer and I were at work on a magazine assignment shortly after I graduated from college. The reason for Panic Attack No. 2? None that I or anyone else could ever come up with. Panic anxiety is scary and can be utterly mystifying. The physiological symptoms of panic disorder are so severe people may think they're having a heart attack or going crazy.

Some Symptoms of a Panic Attack

sudden onset of cardiorespiratory symptoms accompanied by catastrophic fears and the urge to flee,
tachycardia (rapid hearbeat),
nausea, sweating
fears of losing control or going crazy

There are two major explanations for the greater frequency and debilitation of panic disorder in women. One is hormonal and one is called the "suffocation alarm theory" and the two affect one another.

A triggered suffocation alarm can bring on acute and highly distressing breathlessness. Studies have shown that females with panic disorder have a hypersensitive suffocation alarm.

The Hormone Connection

Progesterone and estrogen stimulate chronic hyperventilation during the luteal phase of the reproductive cycle.
As estrogen levels fall after ovulation, higher carbon dioxide levels occur during expiratory respiration, and can cause hyperventilation.
Some females who have a low suffocation threshold may be particularly vulnerable to panic attacks, especially during the luteal phase of the menstrual cycle.

Treatment

Untreated panic disorder can lead to agoraphobia, or fear of leaving your home. Panic attacks should be treated as soon as possible. The longer they go untreated, the more entrenched the illness becomes. The brain needs to heal, and specific measures need to be taken to make that happen.

Once panic attacks become chronic they almost invariably require medical treatment. The most effective meds, hands down, are anti-depressants. Many rigorous medical studies have shown how quickly and thoroughly these medications do their work.

Sometimes psychiatrists will prescribe an anti-anxiety medication like Xanax, but only temporarily, until the antidepressant has time to build up in the system--usually a matter of a few weeks. (Ongoing Xanax treatment is rarely a good thing as it's highly addictive.)

Other Therapies

Therapists may offer cognitive treatments that can help patients temporarily avoid places and experiences that trigger their panic. Cognitive treatments like CBT (Cognitive Behavioral Therapy) are most effective when used in combination with medicine.
A regular meditation practice can be extremely helpful. Meditation--learning to focus the brain on the breath, let's say--helps those who practice it to stay in the moment. Highly anxious people tend to obsess about frightening things that have happened in the past, or which they fear will happen in the future.
Many life changes can help to calm and stabilize the central nervous system, lessening one's vulnerability to panic attacks. Getting your work load lightened to 40 hours a week would be a positive change. So, too, would repairing--or leaving--a stressful relationship. Entering psychotherapy is a change that can bring all kinds of positive benefits, leading to a calmer, less stressful life.

What Treatment Can Do For You

Those who do get treatment for panic attacks are often happily surprised. It's hard to believe that you can be feeling ready for the psych unit one day, and calm and stable a few weeks later. In educating my patients about this I sometimes compare it to having a really horrendous case of the flue and then being successfully treated by antibiotics. Crisis over.

Panic disorder is different from garden-variety anxiety. Its symptoms are more physical and frightening. Heart palpitations, vertigo, difficulty breathing normally, along with sensations of profound fear--including fear that one is dying--can absolutely de-rail any sense of stability. You feel as if you're going crazy, and usually the whole thing hits out of the blue, adding to the sensation of complete abnormality. There's no blueprint for this experience. One has never felt anything like it before. Friends and family often don't know what's going on, either. All in all, it's lonely and terrifying.

Search for therapists or doctors in your location who treat panic attacks. They will know exactly what you're going through, and you will be on the way to a swift recovery.

Author Bio:

Colette Dowling, LCSW, received her masters degree from The Smith College School for Social Work and has completed advanced training in psychotherapy and psychoanalysis at The Institute for Contemporary Psychotherapy, in New York.She is also trained in EMDR for the treatment of trauma

Colette has a private practice in the Flatiron district in Manhattan. For a free phone consultation, or for further information call 718-594-0201.

To hear Colette speaking about what it's like starting therapy with someone new, click the audio button.

For information on panic anxiety and other mood disorders see Colette's website on women's mental health.

Click here for description of Colette's approach to psychotherapy for women.