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Published on April 12, 2022

Do you and Ted Lasso have something in common?

Panic Attacks

Ted Lasso, the ever-optimistic soccer coach of the Apple TV series of the same name, is known for his upbeat attitude and pithy quotes like, “I do love a locker room. It smells like potential."

But as his story unfolds, it turns out the seemingly happy Ted has a secret: panic attacks that send him fleeing from a team party and even a game. Ted, of course, is a fictional character, but panic disorder - a disruption of our fight or flight instincts - is a real problem that affects up to 5% of the population, according to a report by the Harvard School of Public Health and the World Health Organization. And, as Ted exemplifies, it can be disabling.

“A panic attack is a sudden, intense feeling of being acutely anxious - feeling like you’re going to die - accompanied by several physical sensations,” said Psychiatrist Cathy Perkins, MD, who is the medical director of Emergency Psychiatry Services at Cape Cod Hospital. Those physical sensations, according to Dr. Perkins, might include:

  • Shortness of breath
  • Dizziness
  • Areas of numbness
  • Heart palpitations
  • Sweating
  • Chills
  • A sense of doom.

“It definitely gets kicked off by a circuitry in your brain that’s very real. Your adrenaline and cortisol kick in because anthropologically, we needed to be able to move our bodies away from something that was attacking us. Sometimes it just activates when it doesn't need to.”

Most panic attacks last only 15 or 20 minutes, although they can take up to an hour to subside, Dr. Perkins said.

Anyone can have one, although some people seem to be more susceptible, including those with post-traumatic stress disorder, depression or substance use disorders, she said.

“Certain people are just, in general, anxious, worried, afraid of change,” she said. “Also, people who don’t handle stress as well as the next person might be more prone to it, [as are] people who are under a huge amount of stress or acute amounts of stress.”

Panic attacks tend to be a little more common in women than men, she said, and often first happen when a person is in their 20s. “I think the older you get without having them, the less likely you would be to probably have one,” Dr. Perkins said.

Some people have them spontaneously, without any obvious trigger. Some experience them on and off throughout life; others have one and never have another, she said.

Attacks can become self-fulfilling prophecies. “It’s such an intense experience that people often get a fear of having another one,” Dr. Perkins said. “They’re like, ‘oh my god, am I going to have one? It happened while I was in the elevator; it happened while I was driving the car.’ And they start to sometimes avoid things that they think are associated with it.”

Some people learn to calm a panic attack with deep breathing, music, or talking to a friend - whatever takes their mind off what’s happening in their bodies or soothes them from panicking about the panic attack itself.

But there are times when panic attacks call for professional help, especially when someone isn’t sure if it’s a panic attack or another physical issue such as asthma or a heart attack. “A lot of people present to the emergency room or their primary care doctor before they even think they are having a psychiatric or psychological issue,” Dr. Perkins said. In that case, clinicians do a work-up to rule out heart attack, arrhythmia, or other irregularities, she said.

If it is ruled a panic attack, Dr. Perkins said treatment might include:

  • Psychotherapy
  • Cognitive behavioral therapy
  • Relaxation techniques
  • Meditation
  • Learning how to anticipate an incident.

For patients with persistent attacks, doctors can prescribe a low dose of an SSRI-type antidepressant, many of which are FDA-approved to treat panic disorder and other anxiety disorders, Dr. Perkins said.

The important thing is to treat panic attacks as a serious health threat, Dr. Perkins said.

“It seems really important to emphasize [panic attacks] are real,” she said. “Sometimes people just dismiss it as being in their head, but this is a real physical event.”