Understanding and Coping with Silent Panic Attacks

Understanding Silent Panic Attacks

Panic attacks can be an extremely distressing experience. The combination of physical symptoms and anxious thoughts can make a panic attack feel like a life-threatening medical emergency even when a person is otherwise healthy.

Most people associate panic attacks with hyperventilation, a racing heart, sweating, and other visible signs of anxiety. However, some panic attacks can occur with few outward symptoms, known as silent panic attacks.

What Are Silent Panic Attacks?

Silent panic attacks, or interior panic attacks, occur when a person experiences the fearful thoughts and internal body sensations of an anxiety attack but does not display many of the outward, visible signs. A silent panic attack is still a very real and scary event for the person experiencing it.

During a silent panic attack, a person may experience some or all of the following internally:

• Racing, pounding heart
• Chest tightness or pain
• Tingling sensations in the hands and feet
• Feeling dizzy, lightheaded, or faint
• Nausea or abdominal distress
• Shortness of breath or air hunger
• Feelings of losing control or going crazy
• Fear of dying or impending doom

Differences from Traditional Panic Attacks

The difference between silent and traditional panic attacks lies in the outward symptoms people show. In a typical panic attack, the person may also:

• Breathe rapidly or hyperventilate
• Sweat excessively
• Tremble or shake noticeably
• Get hot flashes or chills

They are likely to vocalize their internal experience through cries for help or expressions of catastrophic thinking. Their panic and anxiety are evident to outside observers.

Causes of Silent Panic Attacks

Silent panic attacks share the same underlying trigger as other anxiety attacks - the fight-or-flight response kicking in even when no real danger is present. Possible causes include:

• Stress build up
• Fear-provoking thoughts or situations
• Periods of hyperarousal
• Trauma or PTSD
• Genetics or brain chemistry

Those predisposed to anxiety in general are more likely to experience occasional panic attacks, including the silent subtype. An estimated 2-3% of Americans deal with panic disorder, classified by recurrent unexpected panic attacks.

Recognizing and Diagnosing Silent Panic Attacks

One of the difficulties of silent panic attacks lies in identifying them properly. Without obvious physical signs, a person may not know what is happening in the moment. And since the fears and sensations pass without outside notice, others may minimize or doubt the experience when described to them after the fact.

Common Thoughts and Self-Talk

Paying attention to one's inner experience and self-talk during an anxiety episode can help indicate a silent panic attack. Some examples include:

• "I think I'm dying."
• "I can't breathe!"
• "My chest hurts, I must be having a heart attack."
• "I'm going to pass out."
• "I have to get out of here."
• "This will never end."
• "I've gone mad."

These panicked thoughts are often accompanied by urgency to flee the situation or social setting. The intense discomfort drives a desire to escape even without exhibiting the fight-or-flight actions of someone in an obvious panic.

Aftermath and Reflection

Taking time to reflect following an unexplained anxious episode can unveil whether a silent panic attack occurred. Asking oneself the following questions may help determine what happened:

• Did I feel an intense rush of fear or sense I was in danger?
• Did I experience physical symptoms like a racing heart, dizziness, or nausea?
• Did I fear losing control or going crazy?
• Did I feel urgency to get away even though nothing threatened me?

Affirming one or more the above, in the absence of external triggers like trauma, may indicate an interior panic attack took place.

Consulting a Professional

To confirm a diagnosis of silent panic attacks, it is best to schedule an appointment with a mental health professional. Ideally, this would be a psychiatrist, psychologist, or licensed therapist with expertise in anxiety disorders. Describe your experience to them in detail and ask if it fits the criteria.

In some cases, a doctor may order medical tests to rule out other conditions like thyroid disorders, hormonal imbalances, or heart problems that could play a role. Once other conditions are excluded, anxiety is likely the source.

Coping with Silent Panic Attacks

Living with recurring silent panic attacks can be challenging and frightening. The first step is the diagnosis itself - merely having a name and understanding of the condition can provide relief.

Treatment Options

From there, the mental health professional can outline treatment options. Many of the same modalities used for traditional panic disorder apply:

• Medication - Anti-anxiety meds like SSRIs or benzodiazepines may ease symptoms. Antidepressants may also help.
• Psychotherapy - Usually cognitive behavioral therapy (CBT) to address panic-inducing thoughts.
• Holistic therapies - Meditation, yoga, massage, and acupuncture promote relaxation.
• Support groups - Sharing experiences with panic disorder peers reduces feelings of isolation.
• Lifestyle changes - More exercise, sufficient sleep, healthy diet, and stress management assist overall wellbeing.

Self-Care Coping Strategies

Implementing self-care strategies between appointments can help individuals managing interior panic attacks. Useful approaches include:

• Carrying a list of coping statements to read during an episode.
• Learning abdominal breathing exercises to restore a sense of control.
• Practicing progressive muscle relaxation when tension builds.
• Maintaining a consistent daily routine to limit unpredictability.
• Avoiding triggering situations when possible to prevent attacks.
• Expressing your feelings to supportive loved ones.
• Staying grounded in the present moment, noticing current surroundings.

While immensely uncomfortable, silent panic attacks are not dangerous or harmful in and of themselves. Implementing appropriate treatments and positive coping strategies can help restore a sense of stability.

When to Seek Emergency Help

In most cases, interior panic attacks will pass on their own within a half hour or so, even without intervention. However, extremely prolonged, repetitive attacks may require emergency support.

Go to an Emergency Room or call emergency services if:

• A panic attack lasts over an hour despite self-care efforts.
• You experience multiple episodes in a single day that overwhelm your ability to function.
• You have collapse, loss of consciousness, or signs of a heart attack or stroke.
• You have suicidal thoughts or attempts during or after repeated panic attacks.

The emergency medical team can evaluate whether a complex health condition underlies your silent panic attacks and ensure your safety going forward. Most panic episodes do remit on their own without drastic intervention, but take precautions if they become prolonged or dangerous.

Trust Your Instincts

Silent panic attacks can be challenging to identify, validate, and treat appropriately due to the lack of visible symptoms. Trust yourself and seek professional support if needed to determine effective treatment options.

Learning to address the anxiety and fear response underlying interior panic attacks makes them more manageable over time. It takes perseverance and patience with the process, but you can overcome attacks to regain a sense of calm and stability.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.