A panic attack (also known as an anxiety attack) is a relatively brief episode of intense fear that comes on suddenly, where the person is both terrified of the physical symptoms that are afflicting them as well as by the associated fears that either triggered or accompanied the attack.
A panic attack typically lasts for at least ten minutes but can stretch on for much longer, even hours or days if cyclic in nature. Cyclic panic attacks are where a person is subject to a continuous cycle of attack after attack, with a new attack triggering even as the previous one is fading away.
The fears associated with a panic attack are strongest when the attack begins. These fears demand our attention, yet the more attention we give them – the more we fear them - the greater they become. Fighting, arguing with, fearing or trying to flee the panic attack and its disturbing symptoms causes negative adrenalin to flood our being. This in turn causes even greater anxiety and even more disturbing sensations to afflict us during the attack.
In my case, a typical panic attack included an increased heart rate, flushed face, increased temperature, shortness of breath, chest feeling constricted, a complete lack of peace, and an intense churning/discomfort in the stomach. These physical symptoms were accompanied by a terrifying fear that was so vivid and threatening that I would often ‘scream’ in my mind. Many sufferers wail or scream quite loudly during an attack.
What triggers panic attacks?
A panic attack can be triggered by an extremely stressful or fearful situation, or even by an exceptionally terrifying fearful thought. Subsequent exposure to the same situation or fearful thought may trigger further attacks. Being afraid that another attack may come increases the likelihood of them striking again.
The stress of trying to making an important life decision can also trigger a panic attack. (See below for how this can affect Christians in particular.)
Panic attacks can even trigger without a cause, however, in these cases, the mind typically searches for a reason for the attack, and may latch onto a fear which then becomes the associated fear for that attack. It is typical for the mind to latch onto a fear that has terrified the person in the past.
A mind prone to anxiety is the perfect seedbed in which a panic attack can take root and flourish. Some people by nature have a sensitive nervous system, which can be due to past or recent traumas or even due to genetic inheritance. However, those suffering from depression are especially susceptible to panic attacks as their minds are locked in a state of constant anxiety.
1 Peter 5:8 is a perfect description of how panic attacks operate. 'Be self-controlled and alert. Your enemy the devil prowls around like a roaring lion looking for someone to devour.’ Although Satan has been defeated by Christ’s victory on the cross, he masquerades as a roaring lion and tricks people into believing that panic attacks have real power and can devour them, when in fact they have no power at all.
Dealing with Panic Attacks
In late July, 1990, I read ‘Self Help for Your Nerves,’ by Dr Claire Weekes, which taught me all about the ‘fear-adrenalin-fear cycle,’ (1) and how the more we fear, flee or fight panic attacks, the worse we become as the additional adrenalin produced prolongs symptoms and produces more disturbing physical, mental, emotional and spiritual sensations. It is a very vicious cycle.
To recover from panic attacks we need to break this cycle.
Break the Panic Attack Cycle using the AWARE Technique:
A- Accept the panic attack. Do not fear it or fight it. Fearing or fighting it just makes it worse. Just let it be there for now, like background music. Do not be afraid that you may have more panic attacks in the future. Let them come.
W- Watch the panic attack, by rating it right now on a scale of 1 to 100, 100 being the worse it has ever been in the past, and 1 meaning it has gone. Remember all anxiety attacks follow a pattern in that they increase to a peak and then decrease and stop. So do not be alarmed at its intensity during its worse phase. It will pass.
A- Act normal Carry on as normal. If you are currently engaged in an activity, concentrate on that activity. Otherwise, find something constructive to do, such as going for a walk, weeding the garden, washing the car. If you stop being active and focus on the panic attack and the fearful topic associated with it, it will suck you in and it will get temporarily worse. However, if you carry on as normal, choosing to focus on something else, the panic attack will start to fade.
R- Repeat Let time pass and keeping repeating the above three steps until the panic attack has faded away.
E- Expect Expect the best and remember that this panic attack will end soon just like all the previous ones did. Furthermore, expect each future attack to reduce in severity and duration, the more times you react to them with the AWARE technique. Eventually, you will no longer fear them and will be able to nip them in the bud before they start.
To help with future attacks, write this on a card or print it out and keep it in your wallet/purse:
A- Accept the panic attack. Do not fear it or fight it.
W- Watch the panic attack, by rating it right now on a scale of 1 to 100.
A- Act normal Carry on as normal. Do not stop being active and therefore focus on the panic attack.
R- Repeat Keeping repeating the above three steps until the panic attack has faded away.
E- Expect Expect the best and remember that this panic attack will end.
(These steps are a practical application of Bible verses Philippians 4:12-13, John 14:1, James 1:2-3. If you would like to read further Bible verses to deal with panic attacks, ie, that illustrate the above technique, please read this post, Breaking Depression's Fear Cycle.)
After I read ‘Self Help for Your Nerves,’ whenever a panic attack hit me, I said to myself: “Peter, you're having a panic attack. Don't fight it or fear it, just accept it, and learn to live with it, don't debate it and argue with it, and let time pass, and it will fade.”
To my amazement, the above technique worked, as it broke the fear-adrenalin-fear cycle. First the intensity of the attacks reduced, then their frequency grew less, and finally I found that in most cases, I was able to nip the attack in the bud before it could take off.
Another thing that can help when afflicted by an annoying re-occurring panic attack is to share the panic attack topic or fear with a wise Christian friend, so that we can get a fresh, healthier perspective on the issue. Although a fearful thought may seem larger than life to us, our friend will see right through it. In this case, trust their perspective, not our own fearful one. (A word of caution, it is not wise to continually run these fears past our friends, as this will not only drive them crazy, but in time we need to learn how to find a fresh perspective ourselves from prayer and Bible study.)
Another small note: if you suffer from panic attacks and you simply cannot put into practice the steps I have outlined above, I recommend seeing a doctor. If the doctor recommends anti-depressants and professional counselling, consider the advice carefully. Anti-depressants dull the effects of depression and panic attacks and this is a huge help in overcoming them. (See my entry, Depression, Christians, and Anti-Depressant Medication.)
2 Timothy 1:7 ‘For God did not give us a spirit of timidity (of cowardice, of craven and cringing and fawning fear), but [He has given us a spirit] of power and of love and of calm and well-balanced mind and discipline and self-control.’ (Amplified Bible)
Panic Attacks and Christians
Unfortunately, for some Christians, a panic attack caused by the fear of making the wrong life choice has another insidious dimension to it. Since they cannot control it or make it stop, and because it is accompanied by a distinct lack of peace, they erroneously misinterpret the panic attack as God guiding them. A common expression not found in the Bible is, “Let the peace of God guide you.” It embarrasses me to admit that for many years I thought panic attacks were God guiding me.
Mistaking panic attacks as being God’s guidance actually makes the panic attacks worse, as such Christians in their eagerness to obey God are (unnecessarily) terrified of disobeying Him. A verse which used to torment me when I resisted and fought against a panic attack was 1 Samuel 15:22 “Does the LORD delight in burnt offerings and sacrifices as much as in obeying the voice of the LORD. To obey is better than sacrifice.” As I drew closer to depression as 1989 wore on, I had an attack and lost my peace every time I was faced with a major decision. Every time I tried to take a step forward, an attack (which I misinterpreted as God’s guidance) would send me reeling two steps backwards. In the end, I was too scared to make decisions any more. 18/2/1990 – I’m scared to commit to anything, such as joining a new church, getting a girlfriend, buying a computer, etc, in case He says no. It’s got to the point that I won’t do anything in case God says 'no.'
Can you imagine the relief I felt when I discovered that panic attacks were not God’s guidance, and that ignoring them was not disobeying Him?
The most bewildering aspect of mistaking panic attacks as God guiding us is trying to work out exactly what God is trying to say (since He is not actually saying anything). When severely depressed I was frequently afflicted by cyclic panic attacks over a period of months. These were associated with a large range of fears, most telling me that I was supposed to be doing this or that. Here is a diary entry showing the exasperation I felt at that time.
15/3/1990 – I feel like saying, “What sort of God are You to do this to someone, and why don’t You speak clearly? All You have to do is speak to me or give me a vision, etc, and I’ll obey, but what is this ‘Guess what I’m saying with the hit and miss affair [when I take away your peace to guide you.]’ ”
Before I became depressed, one thing that reinforced my belief that losing my peace due to a panic attack was God’s voice, was that every time I gave into the panic attack fear, the attack ended and my peace returned immediately. For example, once I was about to leave my job, enter part time ministry and look for a part time job. The massive panic attack which followed ceased as soon as I decided to turn down the offer for part time ministry and remain at my job.
However, when I became clinically depressed, giving into a panic attack and doing what it appeared to be 'saying' no longer stopped the attack. The attack just kept coming back, normally by switching immediately to another fearful thought, or topic. This was because while suffering from depression, we are in a state of constant anxiety. This was when I got my first real clue that the attacks and the lack of peace were not God’s attempt to guide me, but something else. Being convinced of this was another matter entirely.
“Then you will know the truth, and the truth will set you free." John 8:32
Finally in April 1990 I saw a Christian counsellor. She told me that I was suffering from depression, and assured me that the panic attacks and lack of peace were NOT God attempting to guide me. She said that I had been placing my trust in following a lack of peace as guidance – “It’s always worked before” – instead of in Him. Through her counselling, prayer and Bible study, the Lord taught me the following truths, which set me free from the erroneous belief that panic attacks were God guiding me.
Isaiah 9:6 ‘For to us a child is born, to us a son is given, and the government will be on his shoulders. And he will be called Wonderful Counselor, Mighty God, Everlasting Father, Prince of Peace.’ Jesus is the Prince of Peace, not the Prince of a lack of peace.
John 14:27 “Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid.” It does not say “My lack of peace I give to guide you.”
John 14:1 “Do not let your hearts be troubled. Trust in God; trust also in me.”
So if the Bible does not say, “Let the peace of God guide you,” what then does it say should guide us?
Psalm 119:105 ‘Your word is a lamp to my feet and a light for my path.’
Proverbs 3:6 ‘in all your ways acknowledge him, and he will make your paths straight.’
James 1:5 ‘If any of you lacks wisdom, he should ask God, who gives generously to all without finding fault, and it will be given to him.’
In conclusion, we need to make our life decisions prayerfully, with wisdom based on God’s Word, and we need to do so while dwelling in His peace with an untroubled heart.
A small footnote here. Our heart can of course be troubled without suffering a panic attack – our heart can be troubled by a great number of things. For example we may have agreed to take on one too many jobs, causing such stress that we cannot relax or sleep properly. To reduce our workload here would be the wise choice. This is a case of noting the warning signs of our mind and body and taking appropriate action.
If we are feeling pressured, rushed, or stressed out by any circumstances, we need to step back, meditate upon God's Word, pray and seek His guidance. In such times, we need to wait upon Jesus to receive His rest for our soul. Matthew 11:28. “Come to me, all you who are weary and burdened, and I will give you rest.”
Now although I was relieved to know that the panic attacks were not God guiding me, the attacks continued relentlessly and with almost as much power. My nervous system was still exhausted, and I was still reacting to the attacks in the wrong way - by fighting and fearing them. Freedom from the panic attacks came when I read “Self Help for Your Nerves,” as I mentioned above.
(1) ‘Self Help for Your Nerves,’ Doctor Claire Weekes, Angus & Robertston Publishers, 1989, p10.