Panic attacks

Panic attacks can occur at any time, repeatedly and without warning, often leaving the individual feeling like they are dying. The symptoms of a panic attack include elevated anxiety, heart palpitations, hyperventilation, muscle pain, dizziness and sweating, often accompanied by a fear of totally losing control. These symptoms can develop into a panic disorder, where the attacks are intense and frequent. If untreated, a panic disorder can be a debilitating condition, which severely restricts the quality of life.

The physical symptoms of a panic attack are extreme versions of our body’s normal responses to danger. Adrenaline causes the heart to beat faster, and the breathing rate to increase to supply major muscles with more oxygen.

Blood is diverted away from non-essential areas, including the stomach, brain and hands, often causing digestive problems, dizziness and tingling or numbness in the hands. Pupils dilate for more acute vision and this can cause difficulty with bright lights or distortion of vision.

Sometimes it may appear that the walls are closing in, or inanimate objects may even appear to move. It is common to think the symptoms are due to a major health problem, such as a heart attack, brain tumour or mental illness. This fear causes more adrenaline to be released and can lead to a worsening cycle.

Panic attacks are an anxiety disorder that can be accompanied by other conditions such as depression, or they can give rise to the development of phobias or panic disorders. For example, experiencing a panic attack in the supermarket may cause someone to associate the supermarket with anxiety, leading them to avoid going in the future. Some people’s lives become very restricted in this way. Panic attacks can develop into an anxiety disorder such as obsessive-compulsive disorder (OCD) where repetitive activities are used to prevent anxiety from occurring.

There are various treatments for panic attacks, with research showing cognitive behavioural therapy (CBT) to be the most effective. It is common to combine several treatment options:

Cognitive behavioural Therapy (CBT)

While not always effective for those with a cognitive deficit, CBT shows a person how to identify their anxiety and change anxiety-generating thoughts. The premise is that it is not the events that cause anxiety, but how we think about those events.

Medication

Anti-anxiety drugs and similar medications can be very helpful, although they can have unwanted side effects for some people. They are best used with other strategies, including counselling and learning more about the condition.

Diet and exercise

Good diet and exercise are essential for emotional well-being. Exercise often stops the ‘keyed up’ feelings associated with anxiety. Caffeine in coffee, tea and chocolate can increase anxiety for some people.

1. Slow breathing
   When you’re anxious, your breathing becomes faster and shallower. Try deliberately slowing down your breathing. Count to three as you breathe in slowly – then count to three as you breathe out slowly.
2. Progressive muscle relaxation
   Find a quiet location. Close your eyes and slowly tense and then relax each of your muscle groups from your toes to your head. Hold the tension for three seconds and then release quickly. This can help reduce the feelings of muscle tension that often comes with anxiety.
3. Stay in the present moment
   Anxiety can make your thoughts live in a terrible future that hasn’t happened yet. Try to bring yourself back to where you are. Practising meditation can help.
4. Healthy lifestyle
   Keeping active, eating well, going out into nature, spending time with family and friends, reducing stress and doing the activities you enjoy are all effective in reducing anxiety and improving your wellbeing.
5. Take small acts of bravery
   Avoiding what makes you anxious provides some relief in the short term, but can make you more anxious in the long term. Try approaching something that makes you anxious – even in a small way. The way through anxiety is by learning that what you fear isn’t likely to happen – and if it does, you’ll be able to cope with it.
6. Challenge your self-talk
   How you think affects how you feel. Anxiety can make you overestimate the danger in a situation and underestimate your ability to handle it. Try to think of different interpretations to a situation that’s making you anxious, rather than jumping to the worst-case scenario. Look at the facts for and against your thought being true.
7. Plan worry time
   It’s hard to stop worrying entirely, so set aside some time to indulge your worries. Even 10 minutes each evening to write them down or go over them in your head can help stop your worries from taking over at other times.
8. Get to know your anxiety
   Keep a diary of when it’s at it’s best – and worst. Find the patterns and plan your week – or day – to proactively manage your anxiety.
9. Learn from others
   Talking with others who also experience anxiety – or are going through something similar – can help you feel less alone. Visit our Online Forums to connect with others.
10. Be kind to yourself
    Remember that you are not your anxiety. You are not weak. You are not inferior. You have a mental health condition. It’s called anxiety.