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Panic Disorder: The Three Types of Panic Attacks

by Dr. Blumberg on October 17, 2010

The following is part of a training session, I administered last Thursday to one of my panic attack sufferers. 

 The Three Types of Panic Experiences:

 Type One: The Major Emergency Room (ER) Panic Attacks

Major panic attacks hit you suddenly, without apparent reason, “Out of the Blue.”  Here, there is a sudden surge of multiple bodily sensations that seem to escalate rapidly including; heart racing, shortness of breath, numbness and tingling in the hands, feet and face, head pressure, chest pressure, weakness and drained feelings, lightheadedness and disorientation, rubbery legs and a lump in the throat. 

 You Are 100% convinced “This is the End!”

The intense rush of physical symptoms can be so frightening that you are convinced that something awful is about to happen.  You think “This is the end”, heart attack, stroke, brain tumor, lose my mind, go crazy, lose control, have a nervous breakdown, collapse. The alarming thoughts set off discharges of adrenaline that surge through your body and the bodily symptoms can quickly intensify. The key feature of a major attack is that your intense bodily sensations completely trick you into being 100% convinced you are dying or losing your mind at that very moment.  At that very moment, you do not realize you are having a panic attack and you race off to the Emergency Room.

 Type Two: Minor Panic Attacks

Minor attacks, most often occur after, you have, at least, partially accepted the diagnosis of panic disorder to explain the array of physical symptoms of a panic attack. In contrast to major attacks, minor attacks are characterized by only a few physical sensations like dizzy feeling, disorientation and heart pounding.  The minor attacks can be more frequent than major attacks and less intense but they can last longer that the powerful panic that drove you to the ER.

 With Minor Attacks You Begin to Consider the Possibility That You Are Not Dying or Going Crazy

For example, you might think, “The chances that my heart pounding is a symptom of a heart attack is about 50%.” I have a 50% belief that I am having a heart attack right now and that the doctor might have missed something serious during my last examination.  I also have a 50% belief that my rapid heart beating is probably due to a panic attack, since I have had this same symptom on numerous other occasions and I have been reassured in each instance by my doctor that I am in good physical health.

 Type Three: Chronic Panic Attack Symptoms

Chronic panic attack symptoms are usually limited to one or two symptoms of mild to moderate intensity.  Common chronic, isolated symptoms include shallow breathing, lightheaded feelings and chest tightness. The physical symptom seems to be with you all the time.  You can wake up with the symptom. You struggle with the symptom all day. Then you go to bed with the same annoying symptom. You can become preoccupied with the symptom and fixated on it.  Common embedded thoughts that feed chronic panic attack symptoms include:

“When will these symptoms go away? This is not a panic attack! There is no trigger.  There is no stress. Why am I feeling this way? What if the doctor missed something and I have an underlying progressive, life threatening illness? I will never get better.”

 Which of the three types of panic attacks apply to your situation?  I welcome your comments in the comment section below.

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