PANIC ATTACKS SHATTER SECURITY; THEY GRIP MILLIONS OF AMERICANS.

Byline: Kathryn McKenzie Nichols Knight-Ridder Tribune News Wire

Its sufferers describe a crushing weight on their chests, dizziness and blurred vision, their hearts beating so hard it seems they will burst wide open. They are convinced they're going to die.

Some go to the emergency room, believing they're having a heart attack. Some just withdraw from the world. Still others turn to drugs or alcohol to cope.

``It's like a storm, or a tidal wave,'' said Karuna Licht, a marriage and family counselor in Monterey. ``It hits you from behind.''

Panic disorders may not have a physical cause, but they're very real to the estimated 24 million Americans who suffer from them. Also called panic attacks or anxiety attacks, they may cause individuals such anguish that they may change their lives dramatically.

``If you experience panic attacks with any frequency, this ... slowly erodes your self-confidence and self-esteem,'' writes psychologist R. Reid Wilson in his best-selling book, ``Don't Panic: Taking Control of Anxiety Attacks.'' ``After you experience several attacks, a certain doubt creeps into your mind: `What is wrong with me? Why is this happening? Am I crazy?' ''

People with the symptoms also fear they have some dreadful disease. It's common for sufferers to think they have heart problems, cancer, high blood pressure or even a brain tumor when those intense feelings strike.

Panic attacks don't discriminate; they strike men, women and even children, according to Flo Creighton, a licensed clinical social worker who is a partner in the Family Wellness Center, which provides services to Monterey County.

Creighton occasionally treats people for panic attacks, although she says she doesn't consider herself an expert on the subject.

``What I do is help the person figure out what is going on and how to change the cycle,'' she said.

Delayed reaction 

One of the interesting things about panic attacks is that they may not actually occur at times of great stress - they may happen while a person is driving, watching TV or even sleeping, according to Licht.

The feelings may creep in at a relaxed moment because the person has been ``on guard - hypervigilant'' during most hours of the day, Licht said. ``No way am I going to feel my fears and concerns,'' is how she explains this unconscious attitude.

Both counselors say that the key to overcoming panic attacks is to confront fears head on and to accept them.

The difference between people who suffer from panic attacks and those who don't, Creighton said, is that ``there's a certain threshold that's reached ... they can no longer calm themselves. It's beyond their control and not a conscious process.''

Sometimes there is a recent event that has triggered panic attacks, but an underlying cause also has to be dug up and examined.

Creighton said one client of hers had been attacked by dogs, resulting in panic attacks so severe that she was barely able to leave her home. It seemed like an obvious case of cause-and-effect.

But in counseling the woman, Creighton found there were also incidents of violence in her past that she had never dealt with and resolved.

Luckily, using a special technique called EMDR (eye movement, desensitization, reprocessing) developed by Dr. Francine Shapiro of Monterey, the woman's fears left her after one session and she was able to return to normal life.

Licht said that she often sees panic attacks in people who have grown up in dysfunctional families. They think they ``do not have a right to be heard and understood,'' she said. So the feelings are buried - until something triggers them, and they explode in a panic attack.

Getting to the root

These people also have unconscious beliefs that are hard to dispel, like ``I'm a bad person'' or ``I don't deserve to live.''

They may cut themselves off from their feelings, or use different means to distract themselves from their interior world - alcohol, drugs, work or relationships.

What can complicate matters is that panic attacks can lead to other problems, such as phobias - intense fears of everyday activities like driving, shopping or going to work.

Licht said medications prescribed by a medical doctor can often be useful in getting a person to relax so that they can finally confront their feelings. Creighton takes a behavioral approach, using the EMDR techniques or sometimes such things as deep breathing and stress management.

Often, both say, panic attacks can be resolved fairly quickly.

``Once you acknowledge their feelings and provide support, you bond through acceptance,'' said Licht. ``Accepting their feelings is not something they're doing themselves.''

Techniques to control your fear

In R. Reid Wilson's book, ``Don't Panic: Taking Control of Panic Attacks,'' he offers some techniques for sufferers to use when they experience attacks. One of these is to relax using ``Calming Counts'':

1. Sit comfortably.

2. Take a long, deep, breath and exhale it slowly while saying the word ``relax'' under your breath.

3. Close your eyes.

4. Let yourself take 10 natural, easy breaths. Count down with each exhale, starting with 10.

5. While you are breathing comfortably, notice any tensions, perhaps in your jaw or forehead or stomach. Imagine those tensions loosening.

6. When you reach ``one,'' open your eyes again.

Some of the other ways people can cope with panic attacks include using deep-muscle relaxation, imagery and meditation, all of which should be practiced for them to work properly.

Changing one's attitude about ``controlling'' panic is also important, Wilson says. He suggests saying to yourself, ``It's OK to be anxious here,'' and ``I want to face the symptoms to gain skills.''

CAPTION(S):

Drawing, Photo, Box

Drawing: (Cover--Color) HEART-POUNDING, MOUTH-DRYING, VISION-BLURRING PANIC

24 million Americans experience it, but panic attacks can be overcome

Photo: Panic disorders may not have a physical cause, but they're very real to the estimated 24 million Americans who suffer from them. Also called panic attacks or anxiety attacks, they may cause individuals such anguish that they may change their lives dramatically

Box: Techniques to control your fear (See Text)