Panic Attacks
What is a panic attack?
A sudden rush of physical and emotional symptoms that can occur apparently without warning
Physical symptoms include:
- Heart palpitations
- Shortness of breath
- Tightness in the chest
- Increased sweating
- Clammy hands
- Light-headedness, dizziness, faintness
- Shaking or trembling
- Nausea
Psychological symptoms include:
- An impulse to run away
- Fear of dying, going crazy, going out of control
- Feeling of unreality
What causes it?
Physiologically the body is reacting to a perceived threat – a similar reaction to the need to escape from a physical danger eg a fire or an accident. The body produces large quantities of a hormone – adrenalin which causes increased heart rate, breathing, muscle tension. With panic attacks normally there is no apparent or immediate danger and they frequently happen in the most ordinary settings, on a train, in a shop, lecture etc. The lack of obvious explanation can make them more frightening. Sometimes they occur in settings that are more obviously stressful eg in an exam, in a crowd but soon the attack may become more frightening than the situation itself
What can I do?
Stage 1: ‘first aid’
- Retreat - if appropriate quietly leave the situation until you feel calmer eg walk out of the shop, library, stop the car, leave the underground at the next stop.
- Slow your breathing down – focusing on your out breath rather than your in breath, as if you are sighing and continue for 2-3 minutes
- Ground yourself – feel your feet firmly on the ground and if sitting, lean back against the seat back. Bring your attention into your feet and legs, letting them feel heavier and heavier
- Stay focused in the present by looking around and noticing small details of external objects – become more interested in your surroundings than in what’s happening internally
- Do a repetitive activity eg count backwards from 100, clench and unclench your fists 100 times
- Accept and be prepare to ride out the sensations – they will only last a few minutes and are not dangerous
Stage 2: immediately afterwards
- Talk to someone about everyday things to normalise the situation as much as possible
- Do something enjoyable – treat yourself to a snack or a meal (but avoid high sugar/caffeine/alcohol based foods at this moment, go for a walk in a park, buy a magazine
- Consciously relax any tensed muscles
- Remind yourself of things you are good at
- Decide how and when you can repeat the activity – don’t make it daunting
Stage 3: prevention strategies
- Identify any early warning signals (familiar physical symptoms or thoughts) and take remedial action
- In potentially trigger situations identify a withdrawal route which will allow you to exit temporarily eg sit/stand near an exit
- In potential trigger situations have someone you trust with you
- Have a distracting activity with you eg a good book, a walkman with your favourite music, a crossword
- Learn and practice body relaxation and breathing techniques so they come easily when you need them
- Practice positive self statements eg I can calm myself, I have ways of coping with this, this will pass soon
- Limit your intake of food/drink containing refined sugar, caffeine, colour additives, alcohol
- Consider consulting a counsellor to explore any context in which the panic attacks have occurred. Sometimes they are associated with more general stress, loss or unexpressed feelings
Remember
- A panic attack will not cause you to stop breathing or to suffocate
- A panic attack cannot cause you to faint
- You will not ‘go crazy’ during a panic attack
- A panic attack cannot cause you to lose control of yourself
- A panic attack is not dangerous and will normally stop after 3-4 minutes
