How to Deal With Panic Attacks
Panic attacks are surprisingly common, with at least one in 10 people having them occasionally (i). They can also be very frightening, especially if it’s the first time you’ve had an attack and you don't realise what's happening to you.
Many of us know what it’s like to feel a sudden pang of panic in certain situations. If you’re flying, for instance, you may feel that pang when you hit some turbulence. But that unpleasant feeling isn’t a panic attack.
In fact, panic attacks are what can happen when you have a fear of flying and you start worrying about the journey as your travel date approaches. You worry about it more and more, and eventually it’s on your mind almost constantly. And the more you think about it, the worse it gets. Then suddenly – sometimes without any warning whatsoever – you’re having a full-blown panic attack.
Another example is feeling nervous about being in a crowded, stuffy environment. Simply thinking about it can set you up for panic. And when you’re confronted with the actual situation you may have an overwhelming urge to escape. You start feeling more and more panicky, and eventually you end up having an attack.
Phobias are obvious triggers of panic attacks. But anything else that makes you stressed out or anxious can trigger an attack too, such as divorce, moving house, public speaking and work deadlines. Reading alarming stories in the media – during the coronavirus pandemic, for instance – may also make you feel so much anxiety that it builds into a panic attack.
What are the symptoms?
Panic attacks can start very suddenly, often without much warning. Thankfully they tend to pass fairly quickly, often within 10 minutes, but you may feel drained and unsettled for some time afterwards. There are many symptoms, including:
Pounding or racing heartbeat
Shortness of breath or hyperventilation
Feeling you’re being suffocated
Feeling faint or dizzy, shakiness
Chest pain or discomfort
Fear of dying
Feeling very hot or very cold
Numbness or tingling
Feeling you’re not connected to your body
Feeling you’re losing control
Feeling something terrible is going to happen
As a result of some of these symptoms, many people having their first panic attack think they're having a heart attack. However, a heart attack doesn’t make you breathe so fast that you start hyperventilating. Chest pain during a heart attack tends to feel more like crushing than being sharp. And while a panic attack can cause tingling, it’s usually just in the fingers, whereas a heart attack usually causes tingling in the left arm.
Thankfully, however, panic attacks – while scary and quite unpleasant – aren’t usually dangerous (unlike heart attacks).
Meanwhile if you have panic attacks regularly rather than occasionally, you may have a condition called panic disorder. This can have a significant impact on your daily life, as you may avoid everyday situations that could trigger an attack (being in enclosed crowded spaces, for instance).
The mental health charity Mind also suggests there’s evidence that people who have panic disorder might be very sensitive to sensory experiences such as smells, changes in the weather and even sunlight (though it’s not clear whether these things are involved in causing panic disorder or a side-effect of having it) (ii).
What happens in a panic attack?
So what exactly causes panic attacks?
According to Mind, a panic attack is an exaggeration of the body's normal response to fear, stress or excitement (ii). Here’s what happens.
When faced with a situation seen as potentially threatening, your body automatically gears itself up for danger by producing a hormone called adrenalin. Our cave-dwelling ancestors needed this extra adrenalin to fuel something called the fight or flight response. In other words, it gave them the energy to fight or run away from danger (approaching wild animals, for example).
These days encounters with man-eating beasts are, thankfully, not a problem for most of us. But our bodies still produce that extra adrenalin when we’re faced with other things that causes extreme stress. And when we don’t use up that adrenalin to fight or take flight, the result can be many of the symptoms of a panic attack.
However, while stress and anxiety are known to cause panic attacks in some people, they can also happen for no reason and have no clear trigger. Some experts believe that abnormalities in certain brain chemicals called neurotransmitters may have something to do with why some people have them (iii). Your genes may also play a part, as panic attacks can run in some families.
Treatments for panic disorder
If you are having panic attacks regularly, your GP may want to rule out any other conditions that may be causing the symptoms before diagnosing you with panic disorder. If you are diagnosed with panic disorder, there are treatments available designed to relieve the symptoms as well as reduce the number of attacks you get. But if you only have panic attacks once in a while, it’s unlikely you’ll need any treatment.
The main treatments offered for panic disorder are talking therapies such as cognitive behavioural therapy (CBT) and medicines – you may need one or the other, or both, depending on your symptoms.
CBT is thought to be the most effective treatment (iii). This aims to help you manage your panic disorder by changing the way you feel, think and act, and to find ways to deal with your symptoms in a positive way. It’s available on the NHS – you can ask your GP for a referral to a CBT therapist, or you can refer yourself to an NHS psychological therapies service that offers CBT (if you live in England you can find your nearest psychological therapies service here).
Meanwhile medicines prescribed for panic disorder include:
SSRI or tricyclic antidepressants
How to stop panic attacks
If you've been having panic attacks, the good news is there are things you can do that may help prevent them or reduce the number of attacks you get.
The most obvious step is, if possible, to reduce your exposure to any stress that may be causing your attacks. Taking regular exercise can help too, so try staying active by going to the gym, doing some yoga, going swimming, walking the dog or indeed anything else that you enjoy and feel you can stick to in the long term.
Doing something that helps you relax is also a good idea. If, for instance, you like the idea of meditation, why not find a local class that can teach you how to do it? If meditation isn’t your thing, just try to do whatever helps you feel calm – if you can get into the habit of doing something relaxing every day, it could be helpful.
Also try not to skip meals, as eating regularly can help prevent your blood sugar levels dropping (this too can bring on some of the symptoms of a panic attack).
Other things you can try include doing breathing exercises every day (they may also help relieve an attack when you’re having one – see below for an example). Avoiding stimulants such as caffeine, alcohol and smoking is also a good idea, since they’re thought to make panic attacks worse.
Keeping a panic diary may also be useful if you have attacks more than occasionally, as it could help you understand why attacks happen:
Every time you have a panic attack, write down where you were, what you were doing and who you were with, as well as all the symptoms you experienced.
Also make a note of how you felt, and what you thought was going to happen (such as you thought you were going to collapse or faint) and what actually happened.
After a while you can look back over your panic diary and notice any patterns that may help prevent attacks happening again. In time you may also see that what you thought was going to happen never did happen, which could help reduce any fears you experience when you’re having an attack.
Stopping an attack
If, however, you feel a panic attack coming on, there are ways to stop it – or at least reduce its impact:
If you are breathing rapidly you may be hyperventilating, which means your body is getting too much oxygen. Try using the 7:11 breathing pattern to reduce the amount of oxygen in your bloodstream. Sit down comfortably and close your eyes, then breathe in for a count of seven and out for a count of 11. Continue until you feel calmer.
Alternatively, hold your breath as long as you comfortably can (around 10-15 seconds should be enough). Repeat this a few times to stop the effects of hyperventilation.
Another technique is to stamp your foot on the spot – according to Mind, some people find this helps control their breathing (ii).
Distract your mind from what's happening – count objects in the room, for instance, recite your favourite poem or song lyrics in your head, or try to picture a pleasant scene in your mind.
Reassure yourself by telling yourself: ‘I'm having a panic attack. I feel terrible, but I realise nothing bad can happen. I can control this. It will pass.
If you feel like running away, try to stand your ground. If you can do that, you'll prove to yourself that nothing bad will happen if you have another panic attack in the same situation.
For more information on dealing with panic attacks, try the following organisations:
03444 775 774
0300 123 3393
0844 967 4848
Coping with coronavirus anxiety
If you are susceptible to panic attacks and have found your anxiety levels rising as a result of the coronavirus pandemic, the charity No Panic suggests keeping in mind the following (iv):
The vast majority of people who catch the virus recover and many only experience mild symptoms.
Remember that worrying rarely leads to a solution.
Focusing on the worst-case scenario only stops you enjoying the present moment.
Fake news is widespread and headlines can be misleading.
Natural support for anxiety
If stress and anxiety tend to trigger your panic attacks, taking a multivitamin and mineral supplement could be useful since there’s evidence they may help reduce stress and anxiety symptoms (v). Another study also suggests taking a multivitamin may help you cope with stressful situations more effectively (vi).
Other nutritional supplements that could help you cope better with stress and anxiety include the following:
With a history of traditional use for the temporary relief of sleep problems and mild anxiety, valerian is a herbal remedy that may help you to feel calm in stressful situations (vii). The US-based National Institutes of Health also states that valerian has sedative properties (viii).
This amino acid is often used as a natural remedy for depression and low mood. It has also been studied to find out if it could help people with anxiety disorders, with results suggesting it may well be effective (though not as effective as an antidepressant called clomipramine) (ix).
Rhodiola is a herb used traditionally throughout Europe for stress relief. Its roots contain many active ingredients, including rosavin and salidroside. There’s some evidence it may help reduce anxiety and stress more effectively than a placebo (x).
A traditional Ayurvedic herb, ashwagandha is often used to help with tiredness, fatigue and stress. One small-scale study suggests it may reduce levels of the stress hormone cortisol (xi), while another found the majority of trial participants felt less anxious after taking it (xii).
Found almost exclusively in green, black, oolong and pekoe tea, theanine is a non-protein amino acid that’s thought to help your brain produce calming alpha waves. Studies suggest taking a theanine supplement may help you feel more relaxed without making you drowsy (xiii).
Tea made from the herb lemon balm is often used to help aid relaxation. A couple of small-scale studies have also found it may help to reduce anxiety levels (xiv), and there’s evidence that combining lemon balm with valerian (see above) could help if your anxiety is contributing to increased stress levels (xv).
Having a panic attack can be very frightening, but this guide shows some of the ways you could cope with any you may have in the future. Meanwhile for more information on stress, anxiety and mental wellbeing issues, visit our health library.
Available online: https://nopanic.org.uk/coronavirus/
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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.