panic attacks
by Sally Burningham
Panic attacks are periods of intense fear or discomfort that arise suddenly and unexpectedly and in the absence of any external danger or threat. They often take place when you are engaged in a perfectly normal activity such as travelling on a bus or doing the shopping.
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Panic attacks can happen to people who are already experiencing recognisable symptoms of anxiety as well as to those who, up till then, had not considered that they were particularly anxious. Whatever the situation, panic attacks can be very distressing and frightening, and many people worry that they may be due to a serious physical illness or that they are 'going out of their mind'.
In addition some people become even more concerned about the possibility of being taken by surprise and having a panic attack at an inconvenient or embarrassing time, than about the panic attack itself, and this can lead them to restrict their activities.
what are the symptoms?
If you have a panic attack you will experience a number of unpleasant symptoms, although you won't come to any harm. These symptoms will vary from person to person and even in the same person at different times.
The physical sensations you experience may include:
- difficulties in breathing (hyperventilation)
- dizziness, faintness, trembling or shaking
- sweating (particularly on the palms of the hands), nausea or abdominal upset
- palpitations or accelerated heart rate
- chest pain or discomfort or choking sensations
- numbness or tingling sensations in hands or feet, flushes or chills.
You may also experience overwhelming feelings such as:
- a sense of unreality – as though either you yourself are not real or your surroundings are not real
- a feeling of going mad or losing control
- a fear that you might die.
Panic attacks usually last for 5-20 minutes but can continue for up to an hour.
causes and effects
Panic attacks may arise for many different reasons. Sometimes they may occur when people are under considerable stress, due to work or a bereavement, for example. Some people may experience panic attacks following experiences such as surgery, a serious accident or childbirth. They can also be triggered by drinking an excessive amount of coffee or the use of stimulant drugs. But in many cases the causes are unclear.
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hyperventilation Abnormally deep or rapid breathing (hyperventilation), which sometimes occurs as a reaction to stress, can trigger or exacerbate a panic attack. This kind of breathing lowers the level of carbon dioxide in the body, which in turn causes a narrowing of blood vessels to the brain and reduces the blood flow. If this occurs, breathing into a paper bag or practising slow regular breathing with your hands cupped over your mouth and nose can help to rectify the situation. To get into the habit of breathing correctly, practice breathing slowly and calmly from your diaphragm each day. To make sure you are doing it correctly put one hand on your chest and one on your stomach. The hand on your chest should hardly move while the hand on your stomach should rise and fall as you breathe in and out. |
fear of fear and avoidance
Some people only experience one or two panic attacks and are able to put the experience behind them. However, for others, the attacks are frequent and distressing enough to lower their confidence and seriously disrupt their lives. For example:
- they may develop an intense fear of having a panic attack, which is present most of the time. This is sometimes referred to as 'fear of fear' or 'anticipatory anxiety' and it can be very disabling.
- they may develop fears about situations where panic attacks occurred and avoid those situations, or they may start to avoid situations in which it would be difficult to cope should a panic attack take place. This is often known as 'avoidance anxiety'. These habits can sometimes lead to phobias, particularly agoraphobia. For an explanation of phobias check out our feature on phobias.
- they may become depressed because their life feels out of control and they are very anxious. Anxiety and depression frequently occur together.
Once anxiety, avoidance and depression become entrenched they may be more difficult to deal with than the panic attacks themselves. That is why it is important to get help at an early stage. For more information, see our features on anxiety and depression.
treatment and self-help
It is a good idea to see your GP as soon as you experience the symptoms of a panic attack. The GP can give you a check up to make sure the symptoms are not due to any physical illness. The GP can also explain that panic attacks are in fact quite common and do not mean that you are 'going mad'. He or she can then suggest strategies to deal with panic attacks or refer you to someone who can help.
relaxation and breathing exercises
If you have only had one or two panic attacks and are not unduly concerned, your GP may suggest ways of coping with your anxiety or stress such as relaxation or breathing exercises.
cognitive behaviour therapy (CBT)
If, however, your panic attacks are more frequent and if they are beginning to affect your life, your GP may refer you for cognitive behaviour therapy. This is now considered to be the most effective treatment for panic attacks for the majority of people.
This approach can help you find strategies to cope with panic attacks themselves, as well as assisting you to overcome any anxiety, depression and avoidance behaviour associated with panic attacks. It is a brief, commonsense approach that focuses on what is going on in your life at present. You will be actively involved with the therapist in planning and monitoring your own treatment. For more information see our feature on cognitive behaviour therapy.
alternative therapies
You may, in addition, want to try an alternative or complementary therapy to improve your sense of wellbeing and help you to relax. Check with your GP first. Have a look at our feature that explains which complementary therapies can help with panic attacks and anxiety.
healthy lifestyle
A healthy lifestyle will make it easier for you to cope with panic attacks.
- Make sure you get regular exercise. Exercise is a good way of helping you to feel less anxious or depressed and giving you more energy to cope.
- Eat regular, well-balanced meals. Missing meals or having an inadequate diet can increase anxiety and depression and reduce energy levels.
- Too much caffeine can contribute to panic attacks. Cut out or cut down your intake.
- Drinking too much alcohol or taking illicit drugs will make it harder for you to cope with panic attacks.
help and info
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organisations
Anxiety Care
Cardinal Heenan Centre
326 High Road
Ilford IG1 1QP
Helpline: 020 8478 3400 (Monday and Wednesday 10am-3pm)
Telephone: 020 8262 8891
E-mail: enquiries@anxietycare.org.uk
Website: www.anxietycare.org.uk
Anxiety Care is a registered charity based in East London that specialises in helping people to recover from anxiety disorder and to maintain that recovery.
First Steps to Freedom
24 Neville Road
Chichester
West Sussex PO19 3LX
Helpline and General Info: 0845 120 2916 (10am-2am the following day)
Info: 01926 864473
E-mail: first.steps@btconnect.com
Website: www.first-steps.org
A confidential helpline for people suffering from general anxiety, panic attacks, phobias, obsessive-compulsive disorder, anorexia and bulimia, and their carers. Offers counselling, listening advice, support and information.
Help Overcome Panic Effects Ltd (H.O.P.E)
Fellows Court Community Hall
Weymouth Terrace
London E2 8LR
Helpline: 020 7729 9418 (Mon, Wed, Fri 10am-2pm; Tues 5pm-9pm; Thurs 10am-4.30pm)
E-mail (office): hope_centre@hotmail.com
E-mail (Anxiety problems): healinghope2@hotmail.com
Website: www.hopextra.com
H.O.P.E is dedicated to helping people with panic attacks, anxiety and agoraphobia and runs a Centre in East London.
National Phobics Society
Zion Community Resource Centre
339 Stretford Road
Hulme
Manchester M15 4ZY
Helpline: 0870 122 2325 (Mon-Fri 9.15am-9pm)
E-mail: info@phobics-society.org.ukm
Website: www.phobics-society.org.uk
A membership-only organisation, run by sufferers and ex-sufferers of anxiety disorders, that provides support and advice to people affected by phobias and anxiety disorders. Offers one-to-one therapy (with home visits for those who are housebound through agoraphobia etc.) including Cognitive-Behavioural therapy, clinical hypnotherapy and counselling.
No Panic
93 Brands Farm Way
Telford
Shropshire TF3 2JQ
Helpline: 0808 808 0545 (every day 10am-10pm, answerphone 10pm-10am)
E-mail: ceo@nopanic.org.uk
Website: www.nopanic.org.uk
Provides a range of services for people who suffer from panic attacks, phobias and obsessive-compulsive disorder including literature, audio/ video cassettes, a membership scheme and "contact" service. Also offers telephone recovery groups for people who live in rural or isolated areas where access to local support is limited.
Triumph Over Phobia (TOP UK)
PO Box 3760
Bath BA2 3WY
Tel: 0845 600 9601
E-mail: info@triumphoverphobia.org.uk
Website: www.triumphoverphobia.com
A national network of self-help groups designed to help sufferers of phobia and obsessive-compulsive disorder (OCD) to overcome their problems using graded self-exposure (a lay form of behaviour therapy). If sufferers ring and there isn't a group nearby then they offer free info and advice on the phone.
websites
Anxiety Disorder Education Program
www.nimh.nih.gov/publicat/anxiety.cfm
Has information about panic attacks, phobias and other anxiety disorders and treatments, plus links and contacts. Part of US National Institutes of Health website.
No More Panic
www.nomorepanic.co.uk
Deals with all aspects of panic attacks and related problems. Also offers a chat room (busy from 8pm) and a message board.
Panic Anxiety Hub
www.panicattacks.com.au
Australian site offering advice and online courses focused on helping sufferers recover from panic attacks and related problems.
The Linden Method
www.thelindenmethod.co.uk
Site advertising a costly (£107+) but well-reviewed private treatment course devised by an ex-sufferer claiming a 96% rate of success.
reading
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Coping Successfully with Panic Attacks by Shirley Trickett (Sheldon Press, 1992) |
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Fast Facts: Anxiety, panic and phobias by Malcolm Lader and Thomas Uhde (Health Press, May 2006) |
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How to Cope with Panic Attacks by Sarah Teevan and Janet Gorman (Mind 1995, revised 2003) |
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Overcoming Anxiety by Windy Dryden (Sheldon Press, 2000) |
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Overcoming Panic by Derrick Silove (Constable and Robinson, 1997) |
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Panic Attacks: What they are, why they happen and what you can do about them by Christine Ingham (HarperCollins, 2000) |
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Panic Disorder: The facts by Stanley Rachman and Padmal de Silva (Oxford University Press, 2004) |
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(May 2002, resources updated November 2006)
