How can I hide panic attacks

Panic attacks: It doesn't always have to be medication

In the event of a panic attack, the body switches to flight even though there is no acute threat. This type of anxiety can affect life. Those affected feel stress. It is important not to hide yourself.

Sweaty hands, a lump in the throat, a feeling of pressure in the chest: Andrea Müller (name changed) has panic attacks. "Then I can no longer think clearly either. In that situation, there is only fear, fear, fear in my head," she says.

"The tongue becomes so hot as if you had eaten something sour." And the whole body tenses. This can happen in the elevator, in the subway or when there are big changes in your life. Müller is not alone in this: According to the Robert Koch Institute, two percent of Germans have panic disorder.

Helplessness and fear of losing control

Behind this is often the fear of giving up control, explains Christa Roth-Sackenheim, chairwoman of the Professional Association of German Psychiatrists (BVDP). "Those affected have the feeling that they are helplessly locked in the situation and that they cannot easily get out again."

Panic attacks are triggered, for example, when people close to you suddenly die or you were helpless in an accident. But positive changes such as the birth of a child or marriage can also cause the condition. The anxiety attacks rarely have physical causes, such as an overactive thyroid.

The causes of panic disorder

Panic disorder usually affects two areas of the brain. The first area of ​​the brain is the left inferior frontal gyrus in the frontal lobe. This area is responsible for functions such as attention, sanity, and intellect. The second affected brain area is the so-called fear network, where emotional events are processed and evaluated.

A panic attack lasts about 20 minutes

During a panic attack, the mechanisms of the sympathetic nervous system, which cannot be controlled voluntarily and which, among other things, make the body ready to flee, run independently of external circumstances. The consequences can be a racing heart, sweating, urination or shortness of breath.

A panic attack usually lasts about 20 minutes. The body behaves as if it were facing a lion. In principle, everyone can experience a panic attack. Most initially mistake the symptoms for a heart attack or a stroke. "Many people experience this as if the fear were the result of the physical symptoms they perceive," explains Roth-Sackenheim.

You develop fear of death

Andrea Müller didn't even know what was going on when she had her first panic attack. She also didn't know there were panic attacks. "I thought I was dying." The now 32-year-old was 17 at the time and had just smoked a joint on her graduation trip from school. After this experience there was silence for a while, but the next attack came a few weeks later, again on vacation. And the next attacks came too.

"There were phases in which I no longer took to the streets," says Müller. She is now in therapy, regularly attends the Munich fear self-help service (Mash) and has been to a clinic. There are now times without the anxiety attacks. Shortly before completing her studies two years ago, for example, things got worse again - because that was a big change.

Behavior therapy often helps

Roth-Sackenheim advises anyone who has a panic attack about twice a month or notices that the triggering situations are expanding should consult a doctor. Cognitive behavioral therapy helps many sufferers. First of all, it is important to explain to the patient what is actually happening to them. Because people with panic disorder are often so afraid of the next panic attack that they develop a fear of expectation, a fear of fear.

"Panic attacks are a functional disorder. This means that it is not the function itself that is pathological, but its control," explains Roth-Sackenheim. The most important aspect, however, is to make it clear to the patient that what he experiences during a panic attack will pass by itself and quickly.

Walks and sports have a positive effect

Müller also learned to deal with panic attacks. When the first hint of fear is felt, she tries not to pay any attention to the feeling. If she has a panic attack, she goes to exercise or goes for a walk outside. And she's on the phone quite a bit. "The cell phone is my lifeline. It helps me when someone is there - live or on the phone. It grounds me when I can't think clearly." If she is woken up by a panic attack at night, series that she knows almost by heart often help. The often recommended calm breathing does not help her. "Then I get the feeling that I'm hyperventilating."

Hedgehog balls and the cold can help

Cold stimuli or a massage with the hedgehog ball also help some, says Roth-Sackenheim. "Such things help to anchor oneself in reality." A component of cognitive behavioral therapy is also confrontation: This means that those affected get through fear-inducing situations together with their therapist. Anyone who is afraid of taking the subway should sit down with their companion in a subway.

The fear of fear

The confrontation must take place without aids: "Many drink water or listen to music as a distraction. That artificially suppresses fear," explains Jens Plag from the special clinic for anxiety disorders at the Berlin Charité. Because in the long term this means that panic may break out if, for example, you don't have water with you. "When confronted, those affected experience that the physiological fear falls off by itself," he explains.

Drug treatment mostly with antidepressants

The supportive agent D-cycloserine is only given to those affected in the particular situation. If panic disorder is treated with medication in addition to cognitive behavioral therapy, this is currently mostly done with antidepressants, which must be taken daily. "They compensate for the low serotonin level in those affected and do not make them dependent," explains Plag. This is different with benzodiazepines. Therefore, in his opinion, they have no place in treatment in the medium and long term.

Endurance exercise can relieve symptoms

Sport, on the other hand, is beneficial. Plag and his colleagues have also researched this. In the study, one group of 40 people ran for 30 minutes three times a week in addition to cognitive behavioral therapy; the other group did stretching exercises alongside therapy. "Six months after the end of the study, the running group showed fewer symptoms of anxiety," says Plag. It is "absolutely" recommended for those affected to do endurance sports such as running, cycling or swimming.

Andrea Müller also helped the self-help group a lot. "You don't have to explain anything. And you just notice that you are not alone." She used to hide at home and feel ashamed because of her panic attacks. Today she says: "Don't be."

Find support

If you have recurring panic attacks, the first thing you can do is contact your GP. He can usually help you and, if necessary, also help you to find a suitable therapist. If you prefer or if you are suffering from an acute panic attack, you can also contact a therapist of your choice directly - a referral required can usually be submitted later.

Important NOTE: The information is in no way a substitute for professional advice or treatment by trained and recognized doctors. The contents of t-online cannot and must not be used to independently make diagnoses or start treatments.