Beth Rutkowski, PsyD, Clinical Psychologist, Shanghai

Panic attacks can be very frightening for both the person experiencing the panic attack and anyone who witnesses it. Simply put, panic attacks are periods of intense fear where someone’s body reacts with physical symptoms and intense thoughts. These episodes usually begin very quickly and resolve themselves within ten minutes. Panic attacks are not dangerous, despite the physical symptoms, and do not cause any lasting harm. However they can be very disruptive and confusing.

Symptoms of panic attacks consist of different combinations of symptoms for everyone, and include at least four of the following:

• Pounding or racing heart
• Shortness of breath
• Feelings of choking or smothering
• Dizziness, light-headedness, or feeling faint
• Feelings of unreality or being detached from oneself
• Fear of losing control, dying or going crazy
• Sweating
• Numbness or tingling
• Chills or hot flashes
• Trembling and shaking
• Chest pain
• Abdominal pain or nausea

Panic attacks occur because your body is reacting as if it were in danger. Many of the symptoms would actually be very helpful if you were in a hazardous situation. If threatened, the body has evolved to go into “fight, flight, or freeze” modes. Blood is pulled away from your stomach and head to prepare your limbs to run or attack. Your breath gets heavier as you bring in more oxygen. Your extremities become sweaty and tingly as they are pumping with adrenaline. The problem is, there is no danger to be found. What has happened is that at some point, your body came to associate a certain situation with danger- even if none exists. Then it reacts with panic, even when there is no need.

If you witness your child, or any individual, experiencing the symptoms above, speak to them calmly. Let them know you can tell they are having a difficult time and that you are there to help. First, be sure it is not a medical emergency. If this is your child, you likely already know if they have a history with panic attacks or any medical conditions. If not, ask if the individual knows what is going on and look for any medical bracelets. If you are confident it is not a medical emergency, explain this to them.

In general, remain calm and speak in a reassuring but firm manner. Be patient and avoid any negative reactions to the panic- even though it is likely distressing for you to witness. Acknowledge that the terror feels very real. Remind your child that while a panic attack is frightening, it is not life threatening. Reassure them that they are safe and that the symptoms will pass. Try to maintain clear, slow speech and use short sentences.

Move the individual to a place where it is quiet and private. Stay with them throughout the duration of the attack and take cues from them as to whether they want you nearby, to keep your distance, or if physical contact is desired. If this is a situation that has happened before, behaving in a predictable manner will help your child remember that they have conquered these circumstances and will make it through once again. Help the person focus on the present by asking him or her to repeat a simple task such as raising his or her arms over the head. Help slow their breathing by breathing with them or by counting slowly to 10.

After the panic symptom subsides, comfort and reassurance are both important. Let your child know they are safe and that you are proud of them for getting through it. Help them understand what a panic attack is and why it occurs. Reassure them that effective treatments are available for panic attacks and that you will work together to find the right care.

Therapy for panic attacks is often rather brief is available through the Psychology team at LIH Olivia’s Place. For more information, contact Olivia’s Place at contactoliviasplace.lih.pub or (010) 6461-6283 (Beijing) (8621) 5404-0058 (Shanghai). .