During a virtual appearance on “The Tonight Show Starring Jimmy Fallon,” actress Dakota Johnson revealed that she had suffered a panic attack while shooting her upcoming film “Our Friend.”
The 31-year-old, best known for her role as Anastasia in the “Fifty Shades of Grey” franchise, told Fallon that the attack occurred just before filming her first singing scene: “Singing in front of people is actually so terrifying for me,” she said. “We had to shoot this scene where you don’t even really see me — the camera is in the back; you can’t even really tell what is going on. I was meant to be performing in community theater, and they hit playback of my vocal recording and called, ‘Action,’ and it was like I had a panic attack that manifested in all the ways that it does, that it can.”
That manifestation apparently included “running around, laughing, and then [I] just stopped moving and started crying,” Asked by Fallon what caused her attack, Johnson replied: “I don’t know, it took over. I got so scared. It was extreme flight mode.”
However, this wasn’t her first experience with panic attacks. In a September 2015 article in AnOther magazine, Johnson admitted that despite her recent success, she still found auditions frightening: “Sometimes I panic to the point where I don’t know what I’m thinking or doing. I have a full anxiety attack. I have them all the time anyway, but with auditioning it’s bad.”
What is Panic Disorder?
People with panic disorder have sudden and repeated attacks of fear that last for several minutes or longer called panic attacks. These are characterized by a fear of disaster or of losing control even when there is no real danger.
A person may also have a strong physical reaction during a panic attack. In extreme cases, patients may feel like they are having a heart attack.
Panic attacks can occur at any time of the day. An attack usually peaks within 10 minutes, but some symptoms may last much longer.
Panic disorder affects about six million American adults and is twice as common in women as in men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. The tendency to develop panic attacks appears to be inherited.
What Causes Panic Disorder?
Panic disorder sometimes runs in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain, as well as biological processes, play a key role in fear and anxiety. Some researchers think that people with panic disorder misinterpret harmless bodily sensations as threats.
By learning more about how the brain and body functions in people with panic disorder, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.
What are the Signs and Symptoms?
People with panic disorder may have:
- Sudden and repeated panic attacks of overwhelming anxiety and fear
- A feeling of being out of control, or a fear of death or impending doom during a panic attack
- Physical symptoms during a panic attack, such as a pounding or racing heart, sweating, chills, trembling, breathing problems, weakness or dizziness, tingly or numb hands, chest pain, stomach pain, or nausea
- Intense worry about when the next panic attack will happen
- Fear or avoidance of places where panic attacks have occurred in the past
Since many of these symptoms mimic physical disorders, patients often have repeated physician or emergency room visits before being diagnosed.
People who have full-blown, repeated panic attacks can become very disabled by their condition and should seek treatment before they start to avoid places or situations where panic attacks have occurred. For example, if a panic attack happened in an elevator, someone with panic disorder may develop a fear of elevators that could affect the choice of a job or an apartment and restrict where that person can seek medical attention or enjoy entertainment.
Some people’s lives become so restricted that they avoid normal activities, such as grocery shopping or driving. About one-third become housebound or are able to confront a feared situation only when accompanied by a spouse or other trusted person. When the condition progresses this far, it is called agoraphobia, or fear of open spaces (originally taken from the Greek expression for “fear of the marketplace”).
Those with panic disorder may become discouraged and feel ashamed because they cannot carry out normal routines like going to school or work.
How is Panic Disorder Treated?
Before a diagnosis of panic disorder is made, a person should be seen by a health professional and have a medical history taken and physical exam performed to make sure that an unrelated physical problem is not causing the symptoms. A referral may then be made to a mental health specialist, such as a psychiatrist or psychologist.
Panic disorder is generally treated with psychotherapy, medication, or both.
A type of psychotherapy called cognitive-behavioral therapy (CBT) is especially useful as a first-line treatment for panic disorder. CBT teaches a patient different ways of thinking, behaving, and reacting to the feelings that come on with a panic attack. Over time, the attacks can lessen and even disappear.
Doctors may also prescribe different types of medications to help treat panic disorder, including:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
SSRIs and SNRIs are commonly used to treat depression, but they are also helpful for the symptoms of panic disorder. They may take several weeks to start working. These medications may also cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts low and is increased slowly over time.
Beta-blockers can help control some of the physical symptoms of panic disorder, such as rapid heart rate. Although doctors do not commonly prescribe beta-blockers for panic disorder, they may be helpful in certain situations that precede a panic attack.
Benzodiazepines, which are sedative medications, are powerfully effective in rapidly decreasing panic attack symptoms, but they can also cause tolerance and dependence if used continuously. Therefore, benzodiazepines should be prescribed only for brief periods of time as needed.
Both psychotherapy and medication can take some time to work. Adopting a healthy lifestyle, including getting enough sleep and exercise, eating a healthy diet, and having trusted friends and family to turn to for support can also help combat panic disorder.
Michele R. Berman, MD, and Mark S. Boguski, MD, PhD, are a wife and husband team of physicians who have trained and taught at some of the top medical schools in the country, including Harvard, Johns Hopkins, and Washington University in St. Louis. Their mission is both a journalistic and educational one: to report on common diseases affecting uncommon people and summarize the evidence-based medicine behind the headlines.