How to manage panic attacks

Find out how to manage panic attacks

This was initially a guest post on Happiness between tails and I’m now sharing it with you. As someone who’s experienced and had to manage severe panic attacks, I understand just how frightening and debilitating they are.

I never want to experience another one and if this is you too, let’s look at how to prevent them.

First tho’, in order to overcome panic attacks, you’ll need to understand what they are. We’ve all had feelings of anxiety – it’s our body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come.

For example, you may feel anxious about a job interview. During times like this, feeling anxious can be perfectly normal, but some people find it harder to control their anxieties.The most severe form of anxiety can trigger panic attacks.

What is a panic attack or panic disorder?

We have panic attacks and panic disorder; one episode is a panic attack, which might occur following a stressful life event i.e death of someone close.

Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear. You experience regular and subsequent attacks. It’s a common yet very misunderstood illness and lots of people with this disorder won’t ever seek help due to fear and stigma.

The attacks can occur often and at any time, seemingly for no apparent reason. It feels like a sudden, unexpected rush of intense fear and anxiety along with a flood of frightening thoughts and physical sensations – so, panic attacks are not merely psychological.

What you should know about panic disorder

• Many of the symptoms of panic attack are similar to some physical illnesses i.e. heart attack or over-active thyroid. See your GP to rule these out.
• It’s a chronic condition and can lead to changes in behaviour, like avoiding situations or events.
• People dread the onset of another attack, and the fear of having one is just as debilitating as the attacks themselves.
• Panic disorder knows no boundaries as it affects people of all socio-economic groups and races. It’s more common in women than men. It can also affect children and the elderly.
• Although the exact causes are unclear, panic disorders can run in families.
• While many attacks are be triggered by stressful life events, they can also occur ‘out of the blue’.
• Be aware – anti- malaria medication, cold and flu medications, appetite suppressants and even too much caffeine can trigger panic attacks in some people.

If you experience panic attacks, you might then begin to avoid events or situations because you’re afraid of another attack. However, avoidance can create a cycle of living in “fear of the fear”, which only adds to your sense of panic. This can cause you to have more panic attacks, leading to diagnosis of panic disorder

What are the symptoms of panic attacks?

If we encounter a situation that threatens our safety, we’ll experience a series of reactions known as the ‘fight or flight’ response – triggered by the release of chemicals that prepare your body to either stay and deal with a threat or to flee to safety.

During a panic attack, we’ll experience similar symptoms, even when there’s no real threat involved. A panic attack might happen in response to situations that others find harmless. Symptoms include physical and physiological symptoms:

• Racing heartbeat, palpitations
• Dizziness, light-headedness, or nausea
• Difficulty breathing, like you can’t get enough air
• Dry mouth and unable to swallow – if you do need fluids, just take smalls sips to avoid choking
• Shaking, trembling
• Sweating and hot flushes or sudden chills
• Sudden need to go to the toilet, the body needs to lighten to fight or flee
• Numbness or tingling sensations, initially in your fingers and toes
• Your face, feet and hands might go white (as with the tingling, this is the blood leaving your extremities to rush to where it’s needed most i.e. heart and muscles)
• Chest pains – you might think you’re having a heart attack – one way to tell is – if your fingers and toes are tingling, you’re more likely to be having a panic attack. However, if you’re afraid call the emergency services to check

You might experience negative thoughts

• I’m so embarrassed, everyone can see me panicking
• I feel like I’m dying or I’m having a heart attack.
• I can’t cope with this!
• I’m so stupid, I’m never going to get rid of this feeling.

and feelings of:

• You’re going mad or crazy.
• Being out of physical or emotional control.
• Unreality/detachment from yourself or your surroundings.
• Heightened sound and visual awareness, and hypervigilance (for flight or flee you need to hear and see clearly and be vigilant).

A panic attack generally lasts between 4 – 20 minutes, although it often feels a lot longer. However, they have been known to last an hour. I had them one after another, and all night for around three months and it felt like torture. It’s no wonder I became psychotic!

How to manage panic attacks

• Breathe as slowly and deeply as possible, exhaling firstly through your mouth – slowly for a count of 8-10 seconds, then in through your nose slowly and so on.
• Some people use a paper bag to cover their nose and mouth, and breathe in an out. This is known to work but it’s not something I’d teach because you’re not always going to have access to a paper bag.
• Recognise that this is a panic attack and tell yourself that it will pass, because it will.
• Use muscle relaxation techniques – try slumping your shoulders, letting them drop down from your ears, give your jaw a little wiggle then let it relax, uncross your legs, unclench your fists and lay the palms of your hands lightly on your thighs (remind yourself that your body cannot be relaxed and tense at the same time).
• Try to get to a quiet space and sit down if necessary and continue with the breathing.
• If you’re at work or outside, ask for help, I know this might feel a little embarrassing, but do ask if you need to.
• Count backwards slowly from 100 or
• Look around for 5 things that you can see and name them out loud i.e. “I can see a red truck,” etc. You can go onto things you can hear, smell, taste, or touch in the same way – until the panic subsides. This technique will help you stay in the present and grounded by using your five senses.
• Put a few drops of lavender (known to ease anxiety) on a tissue, exhale then breathe it in slowly.
• Call emergency services if the symptoms continue or get worse, or if you’re afraid it might be something else i.e. heart attack.

How to manage someone else’s panic attacks

• Ask the person if they’ve had a panic attack before, and what they think might help or has helped them in the past.
• Encourage them (or tell them quite firmly if they’re confused and unable to follow directions) to breathe (as above). Do this with them if necessary, as often they think they can’t breathe and won’t be able to do this alone.
• Follow the above steps and call emergency services if necessary.

Self-help to combat panic attacks

• Listen (regularly) to free mental wellbeing audio guides online. These will help prepare you so that you can manage your panic attacks as you need to.
• Search and download relaxation and mindfulness apps or online community apps.
• Learn other skills like visualisation to help you relax and practice them often.
• Notice when your body is tense i.e. when your shoulders are up round your ears or your fists are clenched and let them relax. When your body is constantly tensed up, it’s effectively telling your brain you’re on alert, tensed and ready to fight or flee.
• Ask your close friends or family members to support you by gently pointing out when you’re all hunched up and tense. Even better, perhaps they’ll give you a light head massage, or lightly rub your arms and hands in a soothing way.
• Practice the breathing exercises often so that you’ll be able to use them easily when needed. Honestly, practice this all day, every day — it’s a great feeling and you’ll have it ready to use when you need it.
• Try mixing lavender oil with other aromatherapy oils like geranium or camomille to produce your own stress reliever.

I really can’t stress enough the need to practice the coping techniques. You know you wouldn’t be able to drive say on a motorway after having just one lesson. It takes practice!

Treatment for Panic attacks

Treatment aims to reduce the number of panic attacks you have and ease your symptoms:

• Psychological (talking) therapies and medicine are the main treatments for panic disorder
• Depending on your symptoms, you may need either of these treatments, or a combination of both

When to get help

• If you’re having suicidal thoughts, please seek professional help. Or talk to someone close.
• See a GP if you’ve been experiencing symptoms of panic disorder. Regardless of how long you’ve had the symptoms, if panic attacks are interfering with your life, work, or relationships you should seek professional help.
• Although panic disorder is a medical condition in its own right, there can sometimes be a physical reason for your symptoms – and treating it can bring the anxious feelings to an end. See your GP to rule out any other causes and don’t self-diagnose.

Over to you

Have you ever had panic attacks, or do you know someone who has? Do you have other coping techniques that might help readers? Do you think you’d be able to support someone having a panic attack now? I look forward to your comments as always and I’m happy to answer any questions.