Panic attacks are sudden extreme episodes of anxiety that can happen out of the blue with no clear trigger. They are common with around 1 in 10 people experiencing them during their life. During a panic attack, your body has gone into "fight or flight" mode where adrenaline is released into your bloodstream. This causes physical changes where your heart starts racing and you’re breathing fast (hyperventilating).
The adrenaline released during the "fight or flight" mode of a panic attack can cascade into you feeling dizzy, sick, short of breath, and even some sensations like pins and needles. You might be sweaty and shaky, you may get a heaviness or tightness in your chest. Most frightening of all, you may feel you’re going to die. But these are physical symptoms to say that your mind is in distress – panic attacks are not life-threatening even when they feel like it, and it’s important to try to break the cascade before it gets to this awful crescendo of feelings.
On the whole, panic attacks last for up to 20 minutes. Certain techniques help to prevent or ease an attack. First and foremost, try to slow your breathing down – this gives you a focus, or distraction, which helps the mind to settle. It also gets vital oxygen into the lungs and to your brain and tissues, then you breathe out carbon dioxide and avoid it building up and becoming toxic – by keeping oxygen and carbon dioxide in balance, other symptoms don’t spiral as quickly.
Breathing techniques sound so simple, but it’s easier said than done, especially in the grip of an attack. Practice does make perfect – try this when you’re calm, and gradually build up to when you first feel a panic attack coming on – it does improve with time.
There are many breathing techniques out there. Let’s talk through one: focus on your breathing, counting slowly up to 3 while you breathe in, then slowly count to 3 while you breathe out. You can test out if you’re breathing deeply by putting your hand on your tummy and trying to make your hand rise as you steadily breathe in, filling the lungs up, instead of shallow breathing with just the ribs moving.
Otherwise, there are natural or herbal remedies available from your pharmacy that can help to calm you during an attack.
Your doctor is a good first port of call and will be there to listen, support you, listen and provide advise on the best course of action, including any of these therapies.
Panic attacks can occur alongside other mental health conditions, such as severe anxiety or depression. Speak to your doctor if this is having an impact on your life. If you feel in a crisis, with suicidal thoughts or thoughts of self-harm, either contact your doctor for an urgent appointment, or outside of working hours, call 111 or attend the Emergency Department.
Doctors may also worry about other causes for your symptoms. If chest pain is the biggest symptom, along with difficulty in breathing and sweating, and if you are in a high-risk group, it’s best to get checked out as an emergency. You sit in the higher risk category for a serious heart problem if you have diabetes, high blood pressure, high cholesterol, or previous heart problems, if you are older than 65, a smoker or you are obese. In this case, call 999 if you are experiencing chest pain or attend the Emergency Department immediately.
There are treatments for people experiencing a panic disorder. Learning about panic attacks to help reduce the fear surrounding them can help, or cognitive behavioural therapy (CBT), where you aim to break the negative loop that escalates into a panic attack. Some medications may be helpful, such as tablets that aim to calm the heart rate and stop escalation, or certain anti-depressants can be helpful.
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