"Oh, just not now, just not now!", he rumbled through his head buried in his palms while, sitting on the couch, he tried to compose himself as quickly as possible.
In less than ten minutes, the online job interview was supposed to start, but a new, powerful panic attack threatened to spoil everything.
During these sudden bouts of chills, which happen to him once or twice a month and last ten minutes, fear and a terribly unpleasant restlessness paralyze the entire organism of Dusan Mijanović, a 36-year-old IT engineer from Belgrade.
They appeared for the first time five years ago, not long after a family tragedy, the story for the BBC in Serbian.
At first he was shocked and scared, because he didn't know what hit him, thinking he was having a heart attack.
This storm, as he describes it, would always subside after a few minutes and he would realize that nothing fatal had happened after all.
"Since then, every time is the same - I start by suddenly breaking out in a cold sweat, my heart is pounding and it seems as if I can observe myself completely apart from my body.
"When it finally roars, I feel exhausted, as if I've been doing the hardest jobs for hours," he says.
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Panic attack is a sudden and intense feeling of fear or apprehension, without the presence of actual danger.
"It is a condition in which a person has a strong fear that he will not be able to breathe, and that is why he starts breathing rapidly, sweats, and shivers.
"Usually an attack lasts up to 40 minutes and has its amplitude when it is the strongest, and later it weakens," says Biljana Ćulafić, a therapist, for the BBC in Serbian.
In addition to situational, when anxiety is caused by specific moments and circumstances, panic attacks can also be spontaneous.
They then happen in seemingly ordinary situations, for example during rest, during morning coffee or some other usual activity.
Don't be afraid, you won't die
They most often occur between the ages of 15 and 45 (in people over 65, this phenomenon is even 12 times less common).
They are much more common in women: it is estimated that about 75 percent of all attacks happen to women.
They mostly arise as a result of fatigue, trauma and stressful events, such as job loss, serious illness or the death of a loved one.
The main symptoms are sudden, intense fear, loss of control, palpitations, tightness in the chest, nausea, dizziness, sweating, weakness in the hands.
"It can be scary, because people then feel like they have no conscious control over the situation, and some even think they are going to die," explains Mike Ward, a psychotherapist from the London Anxiety Clinic.
The body then, says Biljana Ćulafić, refuses to obey the brain.
"It's as if he's saying to him, 'You rushed, you were in a hurry, you didn't take care of yourself, and now I'm coming as a body to stop this man who needs to stop, see what happened to him and move on.'"
She adds that she herself went through two such attacks in the past, precisely for the reasons that normally appear as frequent "triggers".
"The first happened to me during a difficult relocation, due to overtime and stress, and the second when my brother died and I couldn't quickly process what happened to me," recalls Ćulafić.
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How to help yourself during an attack?
Dušan says that "each new attack is a story in itself", but that in those moments similar thoughts pass through his head.
"I get scared and a bit angry with myself for not getting rid of it yet.
"Then I usually think about my daughter, because that calms me down and, it seems to me, helps me get through the attack more easily," explains Mijanović.
Although there is no universal "cure" for panic attacks, experts recommend several methods to immediately curb and alleviate them when they occur.
Clinical psychologist Nick Gray from the National Health Service Great Britain advises to combat panic attacks in several ways.
- It is important to remember that there is no real danger.
- Facing your fear will give you a chance to realize that nothing bad will happen.
- Sometimes, it's also good to have someone next to you to confirm it for you.
- If you feel like you can't breathe, try breathing exercises.
- Inhale the air as slowly and deeply as possible through the nose, and then exhale slowly through the mouth.
- Some people also find it helpful to count to five with each inhalation and exhalation.
- Closing your eyes can help.
Risk factors
- Family history of anxiety disorders or mental illnesses (anxiety, bipolar disorder, depression);
- Smoking;
- Asthma and other respiratory disorders;
- Emphasized sensitivity in stressful situations;
- Long-term exposure to stress;
- Traumatic experiences and events from the past.
Source: British National Health Service
Adolescents are more vulnerable than children
Panic attacks are rarely encountered in children, while they are much more common in adolescents.
"The adolescent period, known as the period of 'storms and storms', due to various changes, challenges and demands, contributes to the appearance of panic attacks," psychologist Anja Aleksić told the BBC in Serbian.
Noting that she is not a child therapist, her colleague Ana Ivanov says that her youngest clients who faced this problem were high school students.
"Compared to those in adults, panic attacks in children and adolescents are often more dramatic in their manifestations. For example, they are accompanied by screaming, crying and hyperventilating."
Hyperventilation is accelerated and deepened breathing.
It leads to dizziness, shortness of breath, rapid heartbeat, numbness and muscle stiffness.
Aleksić reminds that with further growing up, the probability of people experiencing losses of a different nature also increases.
"The environment also imposes more demanding tasks on people, which can also be a factor in the development of panic attacks," Aleksić points out.
Anxiety 'older', attacks more intense
As we often associate panic attacks with anxiety, Aleksić warns of the danger of identifying them, even though they are not the same.
"Panic attacks are often sudden and intense, with the presence of various physical symptoms and the experience of loss of control.
"Anxiety lasts longer, while the physical complaints are not so intense, most often the experience of loss of control is not present, but only constant discomfort," she says.
Biljana Ćulafić specifies that anxiety is fear, apprehension of the unknown.
"In some situations, it escalates and it can lead to panic attacks."
As he points out, with adequate psychotherapy, they are transitory and that is still comforting.
In order to get rid of them permanently, it is necessary to start without hesitation in seeking professional help, says Ana Ivanov.
"Waiting for them to spontaneously disappear is a slow process that will lead to dissatisfaction over time, will become the cause of new problems, and in all likelihood the problem will actually get worse."
She considers it paradoxical that people often do not accept panic attacks as psychological problems or learn to live with them, even at the cost of impaired quality of life and general satisfaction.
"Panic attacks are very successfully solved with psychotherapy.
"When the disorder lasts a long time without treatment, and the symptoms become serious, drug therapy is also included".
The drugs, as he explains, are there to help enter the psychotherapy process, which means that the drug therapy is discontinued when the symptoms decrease or disappear.
Dušan Mijanović does not use drugs, but admits that he is getting closer to the decision to start psychotherapy.
"It's been a long time since the first attack, and the various tips I've come across on the Internet are obviously not helping," he adds.
Psychotherapists have various ideas and techniques to combat panic attacks.
"If you see me running with clients down and up the stairs, we're probably working on solving panic attacks," concludes Ivanov with a smile.
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