When confronted with a grave diagnosis or the loss of our companion animal, many of us experience an immediate and overwhelming sense of panic during our grief. When we’re feeling utterly vulnerable, our brain sends distress signals to our body, warning us that we are unsafe. Receiving these, we rapidly enter a fight-flight-or-freeze mode in response to our absolute worst fear – the passing of our best friend.
Although panic attacks are not life-threatening, they can be frightening and complicate our grieving process. They may also lead to our avoidance of the places that provoke panic, such as veterinary clinics and animal shelters. Furthermore, they may interfere with our ability to live our values, as we may hesitate to adopt a new love, convincing ourselves we cannot survive the heartbreak again.
What is a Panic Attack?
A panic attack is a sudden and unexpected episode of intense dread that triggers severe physical reactions and behavioral responses. These can happen anytime and anywhere — at home while driving, at work, or even after awakening from sleep. Cognitively, we may believe we are losing control or going crazy. Physically, we may feel we are having a heart attack, suffocating, or even dying. Behaviorally, we may try to flee our surroundings or completely shut down.
These acute sensations are precipitated by our amygdala, the core of our limbic system that processes fearful and threatening stimuli, sending alerts to our hypothalamus. This critical brain command center links our endocrine and nervous systems. The hypothalamus then fires warnings to the adrenal glands via the autonomic nervous system, prompting a surge of adrenaline and cortisol into the bloodstream. This rush of hormones provides us with the energy, blood flow, and oxygen our muscles need, allowing us to flee the perceived danger or challenge it head-on.
Symptoms of Panic Attacks
Panic attacks typically include a combination of physiological, behavioral, and psychological symptoms that peak and then subside within 5-20 minutes. Many individuals report feeling exhausted after a panic attack.
Physiological:
- Rapid, pounding heart rate
- Sweating
· Trembling or shaking
· Shortness of breath/tightness in your throat / choking sensations
· Chills / hot flashes
· Nausea
· Ringing in your ears/inability to focus your eyes / seeing colors differently
- Abdominal cramping
- Chest pain
- Headache
- Dizziness, lightheadedness, or faintness
- Numbness or tingling sensations
- Feeling paralyzed/unable to move
Behavioral: An urge to escape your surroundings, a desire to sit or lie down, becoming irritable (out of fear), avoidance of places where you think you might panic, anxiety regarding physically exerting yourself (through exercise / strenuous activities), fear of being on your own.
Psychological: Sense of doom or danger, feeling out-of-control or that you’re going crazy, fear of embarrassing yourself, a feeling of detachment from reality, a sense of an impending health incident (suffering a heart attack or stroke), catastrophizing that the absolute worst is about to happen (including your death), crippling worry that you’ll have another one.
Causes of Panic Attacks
It’s not yet known precisely what causes panic attacks to develop in an individual, but these factors certainly can play a substantial role:
- Consistent stressors;
- Inability to avoid situations that provoke dread/fear;
- Significant life transitions;
- Experiencing a traumatic event;
- Insomnia / not getting consistent, adequate sleep;
Effective Treatment
The first step in managing panic attacks is to understand how they happen and what beliefs and behaviors perpetuate this cycle:
Step 1: Recognizing the Signs of a Panic Attack
The first sign of a panic attack is usually a physiological symptom – an increased heart rate, sweating, difficulty breathing, etc. If we immediately attune to this sensation with the notion that something is wrong, it will trigger our sympathetic nervous system in preparation for a flight, fight, or freeze response.
| Symptom | Flight, Fight, or Freeze Explanation |
| Nausea / Butterflies in your Stomach | Blood is diverted away from the stomach to the major muscles to prepare them for action. |
| Racing Heart | The heart beats faster to serve muscles with oxygen and remove metabolites and waste products for anticipated physical exertion. |
| Bowel Movement | Stomach contents are emptied, leaving you lighter to run. |
| Sweating | The body is attempting to cool itself down from anticipated physical exertion. |
| Shallow Breathing | Attempt to acquire more oxygen rapidly. |
| Shaking | The body surges blood into the arms and legs, preparing them for fight or flight. |
Step 2: Understanding the Panic Attack Cycle
During a panic attack, the symptoms stated above are recognized as harmful to our physical health; this thought pattern creates more anxiety and hence more symptoms, and the cycle becomes self-fulfilling.
Of particular note, when we experience a panic attack, our breathing speeds up and becomes shallow. As this happens, more carbon dioxide is exhaled, and our blood becomes more alkaline. A series of physiological changes then occur in our muscles and nerves: as the smooth muscle of our blood vessels constricts, we can experience heart palpitations. This results in our blood pressure rising, potentially leading to tingling sensations and numbness throughout our body. It is thus not uncommon for people to feel like they are having a heart attack or stroke, perpetuating more anxiety.
Step 3: Breaking the Panic Attack Cycle
If you are experiencing a panic attack, knowing that slow, paced breathing elicits our parasympathetic nervous system can be beneficial. When you notice the first panic symptom, try to become aware of your breath. Begin to slow your breathing down, taking a deep breath through your nose and exhaling gently through your mouth. Take a few more deep breaths and start to sense the freshness and coolness of the air in the nostrils and the expansion of the chest. It may help to focus on a single object in the room as you do this, or if you are feeling overstimulated, go to a place where you feel safe – outside, a bathroom stall, or your car. Try breathing in for a count of 7 and exhaling for a count of 11; your heart slows down as you breathe out.
In the long term, the most effective treatments focus on preventing panic attacks by reducing your fears and anxiety. Regular exercises such as walking, swimming, and yoga deepen your breathing capacity and also help relieve muscle tension and built-up stress. Relaxation and Grounding Techniques have also been effective, as have Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) provided by a licensed mental health professional.
If you are experiencing panic attacks during grief, please know this is a common occurrence, and you are not alone. Once you understand how these happen and the cycle perpetuating them, engaging in self-care and evidence-based treatment can support your healing journey.
Sources:
Baines, D. (2018). “Panic Attacks – Breaking the Cycle”
Panic attacks – breaking the cycle – Daniel Baines Hypnotherapy
Barbash, E (2018). “All About Panic Disorder.
American Psychiatric Association, & American Psychiatric Association. (2013). DSM 5. American Psychiatric Association, 70.
Harvard Health Publishing (2020). “Understanding the stress response: Chronic activation of this survival mechanism impairs health.”
Understanding the stress response – Harvard Health
Mayo Clinic (2018). “Panic Attacks and Panic Disorder.”
https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021
