How do I deal with persistent fear

In four steps against panic attacks

"In Germany, one in five people experiences a panic attack once in their life, and almost four percent develop a panic disorder," says Professor Andreas Ströhle. The psychiatrist heads the anxiety disorders working group at the Charité in Berlin. With panic disorder, fear keeps coming back. Either just like that, apparently out of nowhere, or in certain situations. Places with many people or full department stores are typical triggers. The more pronounced the disease, the more it determines the everyday life of those affected.

Panic is extreme: every heartbeat can be felt, sometimes painful. You sweat, shiver and have the feeling that you can no longer breathe. Fear of having a heart attack or stroke wells up. The fear of going crazy is added because everything around you becomes unreal. You want to run away - which is not possible because the fear runs along with you. And everything culminates in the fear of dying. But what doesn't happen.

The panic attack subsides after half an hour

"A panic attack is basically harmless," says Professor Manfred Beutel, director of the Clinic for Psychosomatic Medicine and Psychotherapy at the Mainz University Hospital. And it goes by again. The attack usually reaches its peak in the first ten minutes and subsided after about half an hour. Our body could not maintain this extreme state any longer.

From an evolutionary point of view, the alarm reaction is actually healthy. It should make us aware of danger and - depending on how we assess the situation - help us to flee or fight. Our attention is increased. The body releases the stress hormone adrenaline, constricts the blood vessels, pumps more blood through the veins and prepares the muscles for the fact that they will soon have to work.

4 steps to manage panic attacks

Classify feelings: Try to make it clear to yourself that you are having an anxiety attack that will go away. Your life is not in danger.


Live healthier:
Living a conscious lifestyle will help reduce the chances of having panic attacks recurring. Avoid substances that can aggravate panic - for example, nicotine, caffeine, and alcohol. Eat and sleep regularly.


Trust your own body:
Do not spare yourself despite panic symptoms such as palpitations. During exercise, for example, you will notice that a fast pulse is also produced by physical activity and is a normal reaction. This is how you learn to trust your body again.


Take the lead:
Try not to let fear dominate you in everyday life. Do not withdraw or avoid situations that are troubling to you.

Symptoms of an anxiety disorder

If we panic nowadays even though we are not facing a tiger in the wild, then it is "due to a bundle of risk factors and possible causes," says bag expert. For example, the predisposition to generalized anxiety disorder can be inherited. It is now also known that excessive alcohol consumption and psychoactive substances such as cannabis or stimulants such as cocaine promote attacks. And finally, illness events such as heart attacks also play a role.

Above all, however, it is also a question of personality structure how susceptible a person is to panic attacks. Does he generally have confidence in life and in himself? How well can someone deal with fears, classify and process them? Does he have a strategy for coping with stress? Does he even recognize himself that he is in a stressful, emotionally difficult situation? Much of this is already brought up and learned in childhood. It is more difficult for those who have been overprotected. Sentences like "Child, go to bed and cure yourself so that you don't get even sicker" when your nose is running a little do not help to strengthen confidence in the resistance of your own body.

Stress overwhelms the brain

"But even those who have been emotionally neglected and did not get enough support and security have an increased risk of anxiety disorders," said Beutel. We need the security that we can turn to our attachment figures in case of danger. That someone will help us and take care of us. This kind of trust makes you calm.

Panic often breaks through in difficult life situations in which the stress level is high. "When I am extremely busy with a lot of things, the brain is overwhelmed at some point and has fewer resources to properly control the fear network," explains psychiatrist Andreas Ströhle.

Everyone reacts differently to panic

Which of these possible factors must come together in order for someone to panic differs from person to person - just like the way in which those affected deal with the experience.

The attack hits some in the evening on the sofa in front of the television. Seemingly out of nowhere. Nevertheless, he approaches the whole thing rationally, arranging an appointment with the family doctor the next day. He wants to clarify whether everything is okay with his organs. All findings are normal. That is enough for him to tick the incident off as meaningless for the rest of his life.

Fear does not let go of others, even if the panic attack was a long time ago. The fear is seared deep in her mind. You brood over and over again. Imagine all sorts of diseases they could have.

Affected people often get caught in a spiral in which they develop fear of fear. For example, if you have a panic attack in the subway, you may avoid using public transport in the future. If fear overtakes him in the elevator, he takes stairs immediately. This is a normal reaction, but it helps the problem solidify. The person concerned may allow himself to be guided by his fear.

Early help is worth it

Because the symptoms of a panic attack are relatively unspecific and because the patients themselves often cannot allow stress, repressed conflicts or feelings to torment them, it often takes several years before the diagnosis of panic disorder is made. Then the disease can be treated relatively well.

Therapy in which patients face their fear and find out what exactly is stressing them can achieve success. "It works in about 80 percent of the cases," says Ströhle. The earlier you start, the better the chances of recovery. If the anxiety disorder is very pronounced or if problems such as depression arise, doctors also use psychotropic drugs. These drugs can regulate the increasingly activated fear network in the brain.