“I can’t stand it anymore,” “I think I’m going to have a heart attack,” “These symptoms are horrible,” “When I’m short of breath, I think I’m going to die from anxiety.” These complaints are common in patients suffering from panic disorder or anxiety attacks. People with panic disorder have sudden, repeated attacks of fear that last for several minutes. Sometimes the symptoms can last longer. These attacks of fear are called panic attacks.
Attacks can occur at any time, and many people worry about having another attack. For example, a person experiencing panic attacks may feel discouraged and embarrassed about not being able to do everyday activities, such as going to the store or driving a car.
“The more attacks I had, the more afraid I became. I was always living in fear. I didn’t know when I might have another attack. I was so scared that I didn’t want to leave my house.”
-Lucia-
Panic attacks are characterized by the fear of losing control or dying from anxiety. These people have strong physiological reactions, which can feel like heart attacks, for example. Therefore, one of the most common symptoms of panic disorder is the fear of dying.
I would like to send a reassuring message to these people. No one has ever died from a panic attack. The symptoms are indeed very unpleasant and alarming, but no one dies “just” from a panic attack. It is quite another thing if this panic attack generates uncontrolled behavior (such as running out and crossing a street without looking) that can endanger our physical integrity.
The panic attack
Panic attacks can occur in the context of any anxiety disorder, as well as other mental disorders. These disorders can include depressive disorders, post-traumatic stress disorder, substance abuse disorders, etc. In addition, they can also occur in some medical conditions (e.g., cardiac, respiratory, vestibular, gastrointestinal). As we can see, a panic attack is not a disorder in itself. It is rather a symptom.
What is a panic attack?
A panic attack is a sudden onset of intense fear or discomfort that peaks within minutes. During this time, four or more of the following symptoms occur:
- Palpitations, pounding of the heart, or rapid heart rate.
- Sweating.
- Shaking or trembling.
- The feeling of difficulty breathing or suffocation.
- The feeling of suffocation.
- Pain or discomfort in the chest.
- Nausea or abdominal discomfort.
- Feeling dizzy, unsteady, lightheaded, or faint.
- Chills or feeling hot.
- Paresthesia (numbness or tingling sensation).
- Derealization (feeling of unreality) or depersonalization (separation from oneself).
- Fear of losing control or going crazy.
- Fear of dying.
As we said, these symptoms can occur in the context of several disorders. If you suffer from anxiety, these symptoms may sound familiar to you.
So could I die from anxiety?
Anxiety is an emotion common to all human beings. It is present throughout life. Like other emotions, it serves a purpose. It prepares us for what could be dangerous and is therefore activated when we perceive a threat or danger.
Evolutionarily, it has served human beings to survive, preparing them for fight or flight. Its purpose is adaptive, generating protection against possible dangers. We could imagine it as an alarm system that protects us. But, if it protects us, how can it harm us, to the point of ending our life?
“One day, out of nowhere, I felt terrified. I was so scared that I thought I was going to die. My heart was racing and my head was spinning. I had these symptoms every two weeks. I thought I was going crazy.”
Anxiety is neither good nor bad, it is just another emotion, like anger or joy. However, it becomes negative or pathological when it is excessive or uncontrollable.
Pathological anxiety is defined as anxiety that is excessive or disproportionate to the stimulus that causes it. It appears very frequently or for a long time and limits the life of the person who suffers from it, restricting their adaptation to the environment. It cannot kill us on its own, because it is “overprotecting” us from the dangers we imagine.
If we think about anxiety and its adaptive function, we see that it is necessary. For example, when faced with a loud noise, it is normal for us to startle and become tense. This would help us to flee the place in case something might fall on us.
If anxiety isn’t bad, why do I feel like I’m going to die?
If your brain perceives a risky situation, whether real or imagined, it will activate an alarm system that will lead to physiological changes to protect your life. These changes in a panic attack are experienced as a threat since the danger is not real. If you were facing a risky situation, you would not feel these symptoms as dangerous. You would see them as something normal in this particular situation of real danger.
For example, if you were in a place that was on fire right now, you would sense the danger and your alarm system would go off. This would trigger physiological activation, allowing you to run away from the place and save your life. To do this, you would need your heart to beat faster to send more blood to your extremities. However, your heart is not beating faster because of heart failure, so you are not going to die of anxiety.
Something similar happens with a lack of air. No one has died from suffocation or drowning during a panic attack. On the contrary, oxygen in the blood increases as a result of increasing the number of breaths we take. This is what is known as hyperventilation.
So, you don’t have to worry. You’re not going to die from anxiety. The symptoms are annoying, but they’re not dangerous. Most likely, if you go to the doctor for these symptoms, he or she will tell you that it’s anxiety and that you shouldn’t be alarmed. In cases where this anxiety is very intense or recurrent, you will be referred to a specialist.