I had a fight with my girlfriend in college. It was a big one. I do not remember what it was about or who was to blame--if anyone. All I know is that after a year and a half of going out we were disappointed enough after the argument that we decided to split. This was my first breakup.
We were inexperienced when it came to fighting. Small disagreements usually ended quickly and we had no clue how to weather a significant battle. Once this disagreement blew up we had no idea how to restore ourselves. It felt final. In a matter of minutes the whole relationship was lost. After we exchanged our frustrations we turned and wandered away from each other.
After a moment my walking pace picked up and as I scurried away I became like a scare mouse looking around for shelter. My mind became unfocused and racing. Agitated, I could feel my heart pound and my breathing accelerate. I was walking fast-- darting my way across campus to get something to eat. Then it happened. I got light headed and my heart rate soared. It was as though I had no control over my own body. I'd been marching along--then suddenly it seemed hard to lift my legs and couldn't take a full breath. I was trembling. A terrible feeling of dread--like I was about to die--came over me. It gripped me. Although I was an athlete and only 20 years old the first thought was that I was having a heart attack. My mind scrambled for a solution. I alternately tried to calm myself down--then freaked out because I couldn't. But it was my heart that was causing all this. I was having a panic attack.
Going to the college infirmary the nurse practitioner calmed my fears. She told me it was unlikely I was having a heart attack. When I explained what just happened with my girlfriend she said it sounded more like an anxiety reaction. That was the first time she used the phrase 'panic attack.' The term 'panic' didn't resonate with me. I was certainly having a reaction--but panic? Panic over what?
A panic attack isn't the normal fear or stress reaction you might have to a situation. If you have a near accident in your car, or a barking dog with sharp teeth comes toward you--these are fear-based reactions--reality based--that have many of the same symptoms. The difference is that panic attacks seem to come out of nowhere. They have been found related to such things as family history, substance abuse, and major stressors. But, I had none of these indications. The only thing that seemed related had to do with the timing of the fight. Could that be enough to trigger a panic attack? The answer was a resounding 'yes.' But the reason why surprised me.
It wasn't the novelty of the fight, or the fact that it raised my heart and breathing rates. It also had nothing to do with the intensity of the argument itself. The panic attack was about us separating--and to be more specific, separation anxiety. The fact that we were going to break up triggered the panic. Like a baby parted from its mother panic attacks are often related to issues around separation and loss. It was the fear of separating from my girlfriend that triggered the reaction.
After graduate school I went on to become a licensed psychologist. After many years in practice, I've learned a great deal about what these disorders are all about and how to treat them. Nearly two-and-a-half million Americans are affected by panic disorders, and experiences like mine are typical as it usually begins in late adolescence and early adulthood. More than twice as many women experience panic attack than men.
The treatment usually involves cognitive behavioral therapy, a particular form of psychotherapy designed to identify and change negative thought patterns beneath anxious and difficult feelings. This and other forms of therapy have the objective of uncovering what the triggers are causing the anxiety. Medications can also be helpful, such as antidepressants like Paxil and Zoloft, and antianxiety prescriptions like Xanax and Ativan. Learning to meditate or use relaxation and breathing techniques can also be useful.
But as a psychologist helping someone understand the trigger, particularly the potential loss of something or someone, is key. Helping people trace back their panic attack to the fear of separating from someone, or a recent loss (such as a death, or a divorce, or the ending of a relationship) is typically very insightful. Most people seeking treatment don't realize how profound a loss--or a potential loss--can be in triggering their panic.
Of course fear of separation isn't always the cause. Yet, there is ongoing research that suggests it may often be a significant part of the problem. There are other conditions, such as agoraphobia, where people avoid places or situations that could cause panic, which have other activators. In the case of agoraphobia people usually dodge places that make them feel trapped, helpless or embarrassed.
Panic attacks typically last only a few minutes. Learning the coping skills to get through it will help lessen the anxiety--and learning what the separation triggers are that may be at the root of it can help even more.