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A surprising amount of people have experienced an anxiety attack at least once in their life.

Anxiety attacks don't necessarily need a catalyst (something we'll discuss later in this paper) and could therefore happen to anyone - even those t hat don't fit into preconceived notions of who or what "fits" into the parameter s of one that has those experiences. In this paper, we will discuss the before, during, and after of anxiety attacks as well as several other related topics, mo st importantly stress, as many (although not all) anxiety attacks are stress rel ated and stress is lifestyle related, meaning that stress as well as other conse quences of stress (not just anxiety attacks) are preventable. WHAT ARE ANXIETY ATTACKS? Anxiety attacks are not the same as panic attack, although the two terms are oft en used synonymously, they names actually denote the intensity with panic attack s being the more intense of the two. According to one online source, the differen ces between panic and anxiety are best described in terms of the intensity of th e symptoms and length of time the predominant symptoms occur (1). The symptoms fo r panic attacks are more sudden, unprovoked, and intense but they do not last re latively long; although, there may be special occasions where the attack is prol onged and continuous. On the other hand, the symptoms for anxiety attacks happen over time, take longer to occur, or will intensify at a later stage. Anxiety at tacks may seem similar to panic attacks but the most significant differences bet ween the two is that anxiety attacks happen for a longer period of time and is m uch less severe. According to ABC News, another distinction is that most anxiety attacks can be attributed to excess worry and/or stress. Once the stressing fac tor disappears, so will the anxiety attacks (2). Panic attacks are usually sudde n and unprovoked, meaning that the attacks may stay constant even after certain stressing factors disappear. SYMPTOMS: Anxiety attacks are an exaggerated caricature of the fight or flight response, a mechanism in the body that enables humans and animals to mobilize a lot of energ y rapidly in order to cope with threats, according to the UT Counseling and Menta l Health Center website (i). With this mechanism comes a surge of stress hormone s, the Anxiety Centre reports (ii), common symptoms include: IN THE HEAD: + A feeling of impending doom > something horrible is about to happen > you are in grave danger > A strong feeling of fear, foreboding > An urge to escape, to get out, to run away from danger > fear of going crazy > fear of losing control, freaking out > incessant feaful thoughts + Confusion > Derealization (feeling surreal) > Depersonalization (detached from reality, separate from oneself) + Dizziness, lightheadedness, unsteadiness + Inability to calm self down, hysteria > Emotionally upset > Emotional distress > Panic + Plugged or stuffed ears WITH THE SKIN: + Blanching, turning white, looking pale + Blushing, skin blotches, turning red + Burning skin + Hot or cold chills > Trembling or Shaking

+ Numbness, tingling sensations in any part of the bod > Pins and needles feeling + Sweating WITH TIGHTENING: + Feels like there is a tight band around your head + Choking sensation, tightening of throat + Knot in the stomach, tight stomach + Tightness in the chest IN THE STOMACH: + Nausea > Upset stomach > Vomiting + Urgent desire to go to the bathroom (to urinate or defecate) CHEST: + Pounding heart + Racing heart + Shooting pains in the chest, neck, shoulder, head, or face + Shortness of breath, difficulty breathing (ii.) and more (ii*), especially as everybody has a mostly unique body chemical composition. TRIGGERS: Anxiety attacks can happen to almost anyone - but those exposed to stress repeat edly are at risk especially as well as people whose brain chemistry have been si gnificantly imbalanced (such as with pregnancy, drug abuse, or other medical fac tors) as well as genetics, with some families being more prone to others because of similar hormone changes. Environmental factors, however, may have more weigh t and are more attributed with anxiety attacks, e.g. trauma, abuse, neglect, str ess, and even through a change in your environment that you cannot adapt to (div orce, moving to a new home) (v). An estimated of 19% of North American Adults ha ve an anxiety disorder, and 3% or more who have experienced an anxiety attack(ii i). Of course, those with anxiety disorders also have their risk increased, such as people with anxiety, PTSD, or even those with severe phobias. With anxiety disorders, while varying from person to person, all will be acting very tense and fearful or, experience even the littlest of the "fight or flight" response daily in nonthreatening situations. This fight or flight respo nse was an evolutionary trait that is good in small doses when it's necessary i. e. in the case of a wild animal going loose, however this response can be activa ted during our internal struggles too, say because paying the bills on time. Thi s instinctual response to anything niggling us internally and externally can cha nge our body chemistry significantly. Our brain waves will alter themselves, our blood will change its circulation, and our hormones will be altered - most noti ceably (infamously) we get a boost of adrenaline. However, this reaction in our body is not and should not be sustainable - this response was created only for o ur short term survival, not long term. Our bodies have already evolved in a way that long term survival is already pre-installed (in most cases) and so the figh t or flight response is conflicting over prolonged exposure. (iv.) HOW TO REACT: Removing someone from their catalyst or their environment may be helpful, but do nt force the sufferer, coerce them gently. Try not to touch them without permissi on, and distracting them may be helpful - point out things to remind them of whe re they are. Shouting and belittling their problem will not help the situation, and telling them to calm down does not help, as that is exactly what they are tr ying to do.

MANAGEMENT: As long as individuals are motivated enough to improve his or her condition, tre atment for anxiety attacks is possible. With the right mindset, professional cou nseling, help, and support, there can be an end to ones suffering. Treatment/ man agement of anxiety attacks does not necessarily have to take a lifetime but they will never go away if left ignored. The worst thing you can do is nothing! (3). T he longer a person waits to improve his or her anxiety attacks, the more dramati c, intense, and prolonged these attacks will become. Untreated anxiety attacks m ay also worsen ones mental and physical conditions. Some complications of anxiety attacks include: depression, insomnia, headaches, substance abuse, disruptive d igestive systems, teeth-grinding, and more (4). So the longer you do nothing, th e more difficult it would be to recover. The earlier you intervene and take acti on, the better. So for the folks who are suffering from anxiety attacks, please remember that it does get better and do not let anyone else tell you otherwise! What is the treatment/ prevention for Anxiety Attacks? Do not fear! Anxiety atta cks are treatable, manageable, and preventable! If you have severe and recurring anxiety attacks, it is recommended for you to go see a therapist or counselor. Seeking professional help, getting the right information, having a good support group, and being determined are key factors to help treat anxiety attacks. It is important to relax. Do not overwhelm yourself with stress! Take a chill pill at times, chillax, and indulge in yourself. Invest in activities that you like or go on a vacation. The main priority is to eradicate stress factors and uplift yo ur mood. RELAX: Try to keep calm by listening to nature sounds such as water, bird, or breeze no ises. Water noises such as ocean waves and rain sounds are especially soothing b ecause we ourselves are composed of approximately 70% water. Look at calm colors such as green and blue or other pastel/ light colors. Green is a tranquil color because it is often associated with nature and vegetation (5). Blue is a serene c olor that is often associated with the sky and water. Too much blue may be bad b ecause the color is also associated with a sense of sadness. Try to refrain from hot colors such as red or orange. People often sleep or engage in leisure activ ities to relax but that is still making your brain work. To truly relax, make su re youre awake and do some quiet sitting. Dim the lights (optional), close your e yes, and think of calm ocean waves. It is really important to also do some deep breathing exercises. Try counting backwards from 10-100. Drink plenty of water t o replenish your system. Shifting toward a healthier diet and incorporating some exercise would be super beneficial (6). Remember to avoid unhealthy substances such as tobacco and alcohol as much as possible. Try keeping a journal to keep t rack of your mood during certain situations and take note of major stress factor s. Definitely try yoga and meditation! Make sure you get enough sleep every nigh t (at least seven hours per night) because stress and irritability may arise fro m lack of sleep. Try taking your stress out on stress balls by squeezing them. I f it helps, try popping bubble wrap! In most movies, there is a scene where some one hyperventilates and breathes through a paper bag. This does not actually hel p stop the anxiety attack because breathing through the paper bag only helps wit h increasing your carbon dioxide level.Too much CO2 is bad for the body so breat hing too much through the paper bag will not help with much (7). Instead, try si tting down with head between your knees so the blood will pump to your head. FOOD: Food is so important and sustains our life! Diet changes can help plenty such as complex carbs (breads, pastas, oatmeal) which are digested slowly and release t he happy feel good hormone serotonin; magnesium, which can be found in spinach, help aid migraines, fatigue, and even the compounding effects of stress. Omega-3 fatty acids, which are in fish, can temper the surge of stress hormones. (xii.)

Green tea has also shown to not only relieve stress, but is also an anti-inflam matory and can reduce the risk of stroke. (xiii.) HOLISTIC PREVENTION: Holistic remedies for relaxation include things such as aromatherapy, music, and maybe even an alternative diet. Although for some, treating anxiety attacks and panic disorder, may be second to treating the main anxiety disorder as panic at tacks could be the offspring of them. Like in music: binaural beat are a genre using frequencies that move the music a nd although most scientific studies are inconclusive (and speculative at best), some say that binaural beats help calm and relaxation. These are all hypothetica l. (viii.) Placebo effects are what you use to trick your mind to curing the body. With tri cks and tips that have little studies, the very least it could do is create a pl acebo effect, which is defined the measurable, observable, or felt improvement in health or behavior not attributable to a medication or invasive treatment that has been administered. (ix.) One thing people have claimed to help is aromatherap y: for example, many people have claimed that lavender can reduce stress. Music can help bring out a placebo effect as well: binaural beats are a genre of music that utilizes frequencies that can affect the brain. Although research and studies have been inconclusive, the soothing power of music is well-established. It has a unique link to our emotions, so can be an extremely effective stress ma nagement tool. (x.) DRUGS AND PILLS: There are drugs out there to help tame these anxiety attacks and other anxiety d isorders but please keep in mind that you must not rely solely on drugs to impro ve your condition. The following drugs differ in how they affect the brain. Busp irone, sold under the brand names Buspar and Vanspar, is a medication that treat s generalized anxiety disorder by binding and activation of a certain type of ser otonin receptor in the brain -- specifically the 5HT1A receptor -- and it's thro ugh this activity that buspirone is thought to have its anti-anxiety effects (8). Serotonin is a hormone that is known to help in the regulation of sleep, mood, learning, and constriction of blood vessels, anxiety, migraine, and appetite (9) . Changes in the level of serotonin in the body can drastically affect our mood. Antidepressants can also be used to treat anxiety symptoms. Also known as selec tive serotonin reuptake inhibitors (SSRIs), these drugs work by interacting with serotonin (10). Some commonly used antidepressants include Prozac, Effexor, Pax il, etc. Benzodiazepines are also a treatment for anxiety attacks but they shoul d be for short-term usage only. These drugs have sedative qualities, meaning tha t they promote calmness and induce sleep. Some of the sedative drugs are Xanax, Librium, Valium, etc. However, despite western medicine persistent idolization, drugs are not always the way to go without attempts with holistic medicine first , such as exercise, therapy, rehabilitation. With many drugs, there is always th e risk of addiction which could cause damage to the liver. Some may find this at tempt unfavorable as well, feeling unconnected to reality, foggy, dizzy, and out of sorts and suicidal thoughts. (vi.) DISCIPLINES INVOLVED: Professions that get involved when after one goes through an anxiety attack are normally those in the mental health profession. Although some may find your symp

toms [when experiencing an anxiety attack] confused with a heart attack and call for an ambulance (more on that below). Afterwards, you may consult a psychiatri st who can diagnose, treat, and possibly prevent whatever has triggered that sud den case. A regular doctor or general practitioner can try to see what is going on but may lack depth in the field you need and so those in the mental health fi eld who have had experience are your best bet. Another profession that some see is in the CBT, or cognitive-behavioral therapy. This is a type of therapy that i nvolves talking and discussing the problems in order to how your thoughts and ac tions correlate and then go to teach how to control yours reaction in that situa tion differently. The goal is to change your thought process - instead of reacti ng to bills like you would react to a wild animal, you change your reflex so you treat it as a bill, not life-threatening bad but something of importance. Clini cal social workers may also get involved, as their goal is to help and support t hose whose situations are in need of it as well as improving their quality of li ving. They also look at their client's progress overall and may get involved wit h their treatment. ONGOING RESEARCH: Although there does not seem to be much on the study of anxiety attacks specific ally, there is a lot of ongoing research into the study of anxiety as well as st ress. Research from a little less than a year ago has shown that these attacks a ren't just "out of the blue" as the endocrine system sends out signals and chemi cals as well before the actual suffering begins. Elsewhere, the National Academy of Sciences is currently attempting to see how brain acidity can be correlated with certain functions of the brain. (vii.)

APPENDIX A: i. http://cmhc.utexas.edu/stressrecess/Level_One/fof.html ii. http://www.anxietycentre.com/anxiety-attack-symptoms.shtml ii*. http://www.anxietycentre.com/anxiety-attack-symptoms.shtml for a mo re comprehensive list on the symptoms of an anxiety attack iii. http://www.anxietycentre.com/anxiety-attacks.shtml iv. Dr. Staggers Lecture @ Samuel Merritt; February 27th, 2013 v. http://www.calmclinic.com/anxiety/causes vi. http://www.helpguide.org/mental/anxiety_medication_drugs_treatment.htm vii.http://www.adaa.org/understanding-anxiety/panic-disorder-agoraphobia/news-an d-research viii. Wahbeh H, Calabrese C, Zwickey H (2007). "Binaural beat technology in huma ns: a pilot study to assess psychologic and physiologic effects" ix. http://skepdic.com/placebo.html x. http://psychcentral.com/lib/2007/the-power-of-music-to-reduce-stress/all/1/ xi. http://www.wikihow.com/Help-Someone-Having-a-Panic-Attack xii. http://www.webmd.com/diet/ss/slideshow-diet-for-stress-management xiii. http://www.npr.org/blogs/thesalt/2013/03/15/174334493/

APPENDIX B: 1. http://panicdisorder.about.com/od/understandingpanic/a/anxvspanic.htm 2. http://abcnews.go.com/Health/AnxietyOverview/story?id=4659738 3. http://www.anxietycentre.com/anxiety-attacks.shtml 4.http://www.mayoclinic.com/health/generalized-anxiety-disorder/DS00502/DSECTION =complications 5. http://voices.yahoo.com/the-psychology-color-calming-colors-will-soothe-53334 51.html 6. http://health.yahoo.net/health/anxiety-prevention 7. http://jama.ama-assn.org/content/305/12/1256.full.pdf 8. http://abcnews.go.com/Health/AnxietyTreating/story?id=4660154 9. http://www.medicalnewstoday.com/articles/232248.php 10. http://health.yahoo.net/health/anxiety-drugs

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