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Answered Ask: Writing About Panic Attacks


I am writing about a person who experiences panic/anxiety attacks , how do I go about writing a realistic one ? And I am writing about someone who is self harming and then another person finds out about it , I need help writing a realistic reaction.

Part 1:

Panic/anxiety attacks:

For starters: What is a panic or anxiety attack?
A panic attack is an episode of intense fear and discomfort, which begin abruptly, and are frequently short (10-20 minutes), but can be longer (hours). To be considered a panic attack by the DSM-5, the episode must have at least four out of a list of thirteen possible symptoms (such as trembling, chest pain, dizziness, nausea, or chills/hot flashes). Essentially, a panic attack is when someone’s body prepares a fight or flight response to fears that can’t be dealt with physically. Because the fight or flight response is inappropriate for the situation, and the symptoms themselves can be very frightening (many people think that they are having a heart attack, nervous breakdown, etc., especially first-time sufferers), the attack itself frequently increases the individual’s fear and anxiety, creating a self-feeding loop. The attack typically ends on its when it has run its course. 

Panic attacks- general  
Panic disorder severity scale
The DSM-5

Your character and panic attacks:
Okay, now that you know a bit more about what panic attacks are like, you need to decide what sort of panic attack your character has. Remember, everyone’s experiences with mental health are different. People are rarely textbook examples of symptoms and experiences, and have their own ways of dealing with things, and their own relationships with themselves. So, you’ll need to decide: What are your character’s panic attacks typically like? How severe are they? How do they feel about them? What is causing their panic attacks? What triggers their panic attacks? What helps them cope? 
You know your character the best, so use that knowledge to figure out what their experiences are going to be like. Consider the rest of your cast, as well- who would be the most helpful to this character when they are having a panic attack? Who would deal with it very badly? 

On writing about panic attacks: 
When it comes to writing, I think that there are two different kinds of ‘realistic’. The first is factual realism- by which I mean, the stated facts check out. This can be very pleasing to people who are aware of the correct facts, and the sense of the topic having been researched adds an air of reality to the work. However, writing that is only based in factual realism can feel very bland and mechanical if the writer allows themselves to be caught up in writing a list of symptoms or facts, rather than a scene- which brings us to the second kind of realism that I’m thinking of- what I’m going to call experiential realism. What I mean by ‘experiential realism’ is that the author is either relating a first-hand account, or that their experiences are informing what they write. The writing will naturally be realistic, and will have a sense of practical knowledge that people with similar experiences can relate to. 
Ideally, your story will have both kinds of realism in regards to your character’s panic attacks. However, since you wrote in asking for advise, I’m going to assume that you don’t have panic attacks, yourself. So, that cuts out first person knowledge for you. I recommend that you do lots and lots of research to get the facts neat and correct, and then read personal accounts, or speak to people who do experience panic attacks, as first-hand sources. 

Good luck!

(A few more links for further reading):

HelpGuide: Panic Attacks and Panic Disorder
WebMD: Panic Attack Guide
MayoClinic: Panic Attacks and Panic Disorder

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