What Is A Panic Attack?
Panic attacks are an extreme stress response. They are an exaggerated version of your body’s normal reaction to fear or danger. Realistically though, they are rarely caused by real danger and far more like to be driven by perceived danger often as a result of anxiety or heightened stress.
What Does A Panic Attack Feel Like?
Panic attacks can really vary from person to person. You could get two people to describe their experience of a panic attack and they could be completely different. So there’s no ‘right’ or ‘wrong’ way to experience or describe it. That said, there are a number of common symptoms and experiences of panic attacks.
The most common physiological symptoms are linked to the effect of hormones that are designed to help you survive stressful situations (adrenaline, cortisol, norepinephrine). So think about what happens to your body when you feel scared or excited, exaggerate it and there you have an idea of what’s happening physically during such and experience.
Common physical symptoms include:
- Heart rate increase. (Pounding or racing heart)
- Rapid, shallow breathing
- Struggling to breathe and/or feeling like you’re choking
- Trembling or shaking
- Feeling Dizzy or light-headed
- Nausea (feeling sick)
- Pain in your chest (or elsewhere)
- Weak legs (trembling or ‘feeling like jelly’)
- Dissociation – feeling disconnected from your mind, body or surroundings.
During a panic attack it is not uncommon to think/feel/worry that you:
- Might feint
- Are having a heart attack
- Will never get better
- Are dying
- Have ‘lost control’
One of the most common things that makes a panic attack worse – especially if you’re not used to the experience, is panicking about the panic itself. When you feel any of the above symptoms it can be very frightening. This often results in further panic and worsening symptoms. The good news is – you WILL get better and there are things you can do to ease the situation.
Most panic attacks will last less than 10 minutes and it’s rare for them to last any longer than 20 minutes.
How To Recognise A Panic Attack
If you have already experienced something which fits the description above and there is no underlying medical cause then it’s most likely a panic attack. That said, It’s worth seeking medical support from your GP if you are unsure, especially if you are unaware of any stress-related causes.
If you feel anxious generally or in specific situations or there is a stressful event of some kind preceding the experience then it’s quite likely to be a panic attack.
If you are looking to recognise a panic attack in someone else then be aware that everyone experiences it differently, reacts differently and therefore displays different behaviour. Some people will be very good at covering it up where others will a lot more visually obvious.
Look for signs of the symptoms listed above or have a conversation with the person after the event if you wish to understand it better. Read on for more on how to support others with panic attacks but for now just know that everyone is different and do your best to understand their individual needs. If in doubt – give them space and time to deal with it in their own way.
Are Panic Attacks Normal?
YES – completely normal and very common.
In the UK it’s reported that as many as one in three people experience panic attacks in their life. So if this includes you then you really are not alone. It’s incredibly common. Some consider it a symptom of our busy, modern lifestyles. I’m inclined to believe that a lack of education and understanding around anxiety and mental health has a key role in that statistic too.
What Causes Panic Attacks?
Panic attacks can be caused by a number of things, most commonly anxiety in some form but other related common causes include:
- Anxiety (especially generalised anxiety and social anxiety),
- Some medications and their side effects
- Past trauma – Trauma can be a scary word but this can relate to a range of difficult past experiences.
- Stress and your current life situation
- Physical and mental health conditions
I find that often panic attacks come about after someone attempts to ignore or deny how they are feeling. Someone may begin to feel uncomfortable long before the panic attack but the act of denying and trying to ignore that discomfort just makes things worse until it gets “too much” and the person feels they can no longer ‘control’ it – that’s when the panic attack often occurs.
The other common experience that people describe are panic attack that seem to “come from nowhere”. This is generally the case where there is an underlying issue – such as unresolved trauma or chronic stress – which is being ignored. It’s almost as if by ‘pushing something down’ and refusing to face it (or not knowing how to) it finds a way to ‘come back up’ in the form of a panic attack, this can even happen in the middle of the night waking you from your sleep.
How can I Avoid Panic Attacks?
“Prevention is better than cure” is a very relevant phrase here. By the time you experience a panic attack you will likely be feeling out of control. It’s much more effective to deal with the underlying factors to stop them from occurring.
The Underlying Problem
If someone is experiencing regular panic attacks there is something causing them. This can often be a trauma that hasn’t been addressed or anxiety in some form that could be better managed and ultimately resolved. When this is dealt with and better understood then the exaggerated fear response is reduced (and ultimately eliminated) and the panic attacks stop.
Addressing trauma and other underlying causes can be a scary idea. People often worry that it will be even worse facing it and dealing with it. In reality – if you’re having panic attacks then it is already having a huge negative impact, the sooner you get the support you need, the sooner you can start feeling better. Get in touch today if you’d like to find out how I can help.
A Different Approach
Often, the cause of the panic attack is the panic itself. You may be amazed at how easy it can be to change that. If this common experience is familiar to you then you’re in the right place…
Looking back on it, you may not even remember what caused the panic to begin. It may feel like it just came from nowhere. In reality – you were feeling uncomfortable before the panic really set in. Maybe it was the situation you found yourself in. Maybe it was the expectation that you would feel anxious or uncomfortable that was the start of it all. Or maybe it was something seemingly unrelated. Either way, the panic attack probably started as an underlying sense of discomfort before it built into what it became.
You noticed it. You knew what was coming. But you didn’t want it. So you did what anyone would probably do if they didn’t know better. You ignored it. You tried to distract yourself with other thoughts and you kept busy. It probably worked to begin with, right? You carried on and ignored it. But no matter how much you ignored it – it was still there. It didn’t go away. You knew ‘in the back of your mind’ that something still wasn’t right.
So it came back… Only now, it’s worse than before. The sense of panic has built up stronger and it’s harder to ignore. Maybe you can push it down again this time but the pattern repeats. Each time it gets stronger and each time you have less energy to fight it. Eventually, you can fight it no longer and the panic attack sets in.
But it doesn’t have to be that way. One of the most impactful things you can do is to notice it early on, accept that it’s okay to feel that way and respond to it while you have the strength. It’s often worrying about the worry that makes it worse so acceptance place a key role.
How Do I Manage Panic Attacks?
As mentioned above, everyone is different. It would be wrong for me to sit here and tell you what one thing everyone should do during a panic attack to calm themselves down. It’s important to find what works for YOU. But here are some options that many people have found to be incredibly helpful to manage panic attacks when they do come up. Remember, these ‘tools’ and ‘techniques’ aren’t a permanent solution – they are way to manage panic attacks but not having to deal with them to begin with would surely be better. When you’re ready to change that, get in touch to find out how we could work together.
Bringing your attention to your breathing can help you to focus on something other than the panic itself. It can also help ease a lot of the symptoms that would otherwise worsen due to the panicked, fast breathing. There are many different breathing techniques you can use. You may like to try a few different ones and see what suits you best in advance so you have practiced and know what to do.
Breathe in to a slow count of 5. Hold it for a count of 2 and breathe out for a count of 7, then repeat. You may even like to count along to a ticking clock or a second hand on a watch.
All The Way
Start by breathing out normally then breathe in as far as you can, take your time over it and see how far you can breathe in, pause for a moment and then see how long you can breathe out for. Really empty your lungs. Take a couple of normal breaths and then repeat if you wish to.
Often when panic sets in people feel they are struggling to breathe so they try to take in as much air as they can. This can often lead to shorter, shallower breaths and a fight to breathe IN when the lungs are already full. Start, instead, by breathing out as far as you can. You may even choose to scream (loud if appropriate or silently if you prefer) to expel as much air as you can – you will naturally breathe in automatically when you brethe out that much and your breathing will likely feel calmer. Another similar option is to imaging out have a candle to blow out but it just won’t go out. Keep this up and your breathing will be able to become more steady and under control.
If you’re at home you can create a physical ‘safe place’ to retreat to in those moments where you need to. What that looks like is up to you but for many it would be full of soft, cozy items. For others it may be a clear, clean, open space.
But you don’t need a physical place to go to, you can take yourself to a safe place in your own mind. When you are calm and happy, take the time to imagine a ‘safe place’ in your own mind. Really imagine what it would be like to be there. It could be a real place you’ve been to, completely imaginary or inspired by something you’ve seen in a photo or on TV. Really think about what you see, hear, feel, smell in this safe place ready to recreate it when you choose to.
For some this sounds like a terrible option but to others it can be really beneficial. This DOESN’T mean talking to someone else about how you’re feeling. That is an option and it can help but there are other options too.
Bringing your focus to your words activates a different area of the brain and can distract you from focusing on the panic. Some people like to repeat a poem they enjoy or list important people in their lives. Others just list things around them or make up a conversation to shift focus.
Focus On Your Senses
Focusing on your different senses can help to bring you back to the present moment. It’s also a good way of keeping your mind focused on reality rather than the panic and worry in your mind. A common technique that works well for many is…
Think or 5 things you can see in your surrounding environment. List 4 things you can hear around you. Then list 3 things you can touch or feel around you – or things you can imagine the texture of. Think of 2 things you can smell and finally one thing you can taste. You don’t need to complete all of these steps, you may prefer to focus on listing the things you can see instead. And it doesn’t need to be in that order.
Stimulate your senses and focus on that stimulation. This could be eating a strong mint or chewing gum. It could be smelling some vapour rub, perfume or other strong smell. Maybe for you gently stroking your the back of one hand with the other is something to take your focus.
Another popular technique that you can use involves tapping in different areas. The repetitive tapping in itself both distracts and desensitises. EFT is an approach that teaches specific tapping techniques in specific locations but to keep it simple use the points in the image below. Tap on each point (from the top down) counting ten taps before moving to the next point. Focus your attention on how the tapping feels and on breathing while you do it.
There are a number of ‘grounding’ techniques that bring you back to the here and now and promote awareness of you present reality. These can be especially useful for those who feel dissociated during a panic attack. Here are some examples:
Covering yourself with a blanket (one with some weight can be helpful) and just allow yourself to focus on how that blanket feels all around you.
Walking barefoot and allowing yourself to ‘connect’ to the earth around you and feel the sensations on your feet can help you feel more grounded and present.
How Do I Help Someone Who Is Having A Panic Attack?
If you don’t really know the person well then I would advise acting on the side of caution. People will often already have their own coping mechanisms and interference from someone they don’t know well could make things worse so don’t get too involved unless welcomed to do so.
Make sure they have space and as much as possibly leave THEM in control of the situation. If they try to move away from people then give them space, if they reach out to you then by all means allow physical contact (where appropriate) to help them feel connected.
STAY CALM yourself. This situation will pass and they will be okay. Staying calm and centred yourself will make it easier for them to do so. Getting worked up and panic will likely just make the situation worse.
Encouraging calm breathing is generally a good idea and focus but again, don’t try and force anything upon the other person if they don’t feel comfortable with it and make sure they don’t feel crowded.
If you know the person well then you will likely have a better idea of what to offer. Discuss with them afterwards what they would like you to do differently if the situation happens again and let them know that you are there for them without forcing them to talk about it if they don’t want to.