A Survivor's Guide to Panic Attacks
A panic attack is a brief and sudden episode of intense anxiety, which causes physical sensations of fear when the body’s fight-flight response is activated.
While fight-flight responses are the body’s natural response to danger, panic attacks are often experienced ‘out of the blue’; without an obvious trigger or actual physical threat being present. In some instances, such as with phobias, panic attacks can be ‘anticipated’ when confronted by certain triggers or stressors. For example someone with a fear of flying (aerophobia) may predictably anticipate a panic attack when boarding an aeroplane in readiness for air travel.
According to the Australian Bureau of Statistics, up to 40% of Australian’s will experience a panic attack at some time in their lives.
WHAT IS A PANIC ATTACK
A panic attack can be very frightening, especially if you don’t know what is happening to you. You may feel completely overwhelmed and are likely to experience at least four of the following symptoms:
Shortness of breath/difficulty breathing
Feelings of choking
Palpitations, pounding heart or racing heart-rate
Feeling dizzy, light-headed, unsteady or faint
Sweating
Trembling or shaking
Chest pain, discomfort or pressure
Nausea, stomach problems or sudden diarrhea
Hot flushes or chills
Fear of losing control or “going crazy”
Numbness or tingling sensations in parts of the body
Fear of dying
Feeling disconnected from reality (derealisation) or self (depersonalisation)
Panic attack symptoms can feel very intense and frightening and as such, it is not unusual for people to seek medical attention following a panic attack due to the severity of the physical symptoms experienced.
HOW LONG DO PANIC ATTACKS LAST?
Following the onset of a panic attack, symptoms usually peak within 10 minutes and then start to subside. Panic attacks rarely last more than an hour, with most ending within 20 to 30 minutes. Sometimes multiple attacks are experienced within a quick succession, making it difficult to identify when one attack ends and another begins.
After a panic attack, it is not unusual for people to experience a rapid heartrate, confusion, high anxiety and concentration difficulties for the remainder of day and feel as if another panic attack is imminent.
WHAT CAN CAUSE PANIC ATTACKS?
Panic attacks can occur at any time. You may be in a calm state or already anxious when it happens. The exact causes of a panic attack are not clear, but may include:
Ongoing stress – causing the body to produce higher than usual levels of stress chemicals.
A traumatic event causing acute stress – can flood the body with stress chemicals.
A physical illness or hormonal changes – can lead to physical responses that create stress.
Habitual hyperventilation – can reduce the amount of carbon dioxide in the blood.
Stimulants – such as caffeine, amphetamines and cocaine can lead to the development of panic attacks in some people.
Sudden environmental changes – such as walking into an overcrowded area.
Fearing panic attacks – can contribute to the physical sensations of fear.
HOW LONG DO PANIC ATTACKS LAST?
Following the onset of a panic attack, symptoms usually peak within 10 minutes and then start to subside. Panic attacks rarely last more than an hour, with most ending within 20 to 30 minutes. Sometimes multiple attacks are experienced within a quick succession, making it difficult to identify when one attack ends and another begins.
After a panic attack, it is not unusual for people to experience a rapid heartrate, confusion, high anxiety and concentration difficulties for the remainder of day and feel as if another panic attack is imminent.
HOW TO COPE DURING A PANIC ATTACK
Deep breathing
Hyperventilation is a symptom of panic attacks and can contribute to increased fear and panic. By consciously engaging in deep, slow, abdominal breathing you can reduce symptoms, the duration and the intensity of panic attack experienced.
Acknowledge that you are having a panic attack
Catastrophic thoughts such as ‘I’m having a heart-attack’ will increase fear and the severity of panic attack symptoms. Acknowledging that you are okay, that your symptoms are not life threatening and that they will pass, will help you to reduce panic and enable you to focus on other strategies to further decrease panic attack symptoms.
Grounding Strategies
Panic attacks can cause a feeling of detachment from reality and self. By using grounding strategies to focus on your immediate surroundings, you might be able to combat your panic attacks before they take hold or reduce the intensity and duration of symptoms.
Muscle relaxation techniques
As with abdominal breathing, muscle relaxation techniques can be helpful in preventing or reducing the duration of panic attacks. When engaging in regular progressive muscle relaxation practice you gain awareness of when your muscles are tense, which is often a warning sign that a panic attack may occur. When you are attuned to muscular tension, you can then consciously relax one muscle at a time, starting with something simple, such as the fingers on your hand, and progressively move through your body. As with any new skill, it is important to practice this in advance so that you can call on it in times of high distress.
WHAT TO DO FOLLOWING A PANIC ATTACK
See your Doctor
Often the first step towards managing panic attacks is to see a medical practitioner in order to rule out potential medical causes underlying your panic attacks. Sometimes the re-assurance from a Doctor that your symptoms are in fact panic attacks and not due to medical reasons, can assist to reduce your fear of future attacks.
Positive self-talk
Without a doubt panic attacks can leave you feeling highly anxious, exhausted and afraid that they might re-occur. The fear of panic attacks alone can elicit a fear response in the body that can contribute to further panic attacks occurring. This said, it is important to be aware of, and challenge negative self-talk that might exacerbate this fear. Positive statements such as ‘I have survived panic attacks before and can survive them in the future’, or ‘I can manage my anxiety’ can assist to reduce fear and enable you to implement coping strategies.
Re-focus on something else
It is not unusual to be overly focused on anxiety and symptoms following a panic attack. Rather than feeding your fear by focusing on worrying thoughts and anxiety sensations, it can be helpful to re-focus your attention on something that brings you happiness or a sense of calm. Activities such as chatting to a friend, going for a beach walk or getting some fresh air can be helpful for distracting from anxious thoughts and clearing the mind.
Don’t avoid activities/situations - don’t let your panic prevent you from activities or situations you enjoy. Ease yourself into these activities if you start fearing or avoiding them. While avoidance of anxiety provoking situations is a natural response and can provide short-term relief, it can further exacerbate anxiety and panic in the longer-term.
Avoid caffeine, alcohol, smoking and recreational drugs – as all of these can trigger or worsen panic attacks.
Practice stress management and relaxation techniques – such as yoga, abdominal breathing and progressive muscle relaxation to reduce overall tension and stress levels that can contribute to panic attacks.
Get help - talk to a friend, family member or a helpline such as Lifeline (13 11 14). Make an appointment with your GP who can help identify the best treatment for you. If the panic attacks recur and cause you distress, professional help is warranted. Seek a GP mental health care plan referral to a accredited mental health professional for information, support and treatment.
TREATMENT OPTIONS
If left untreated, panic attacks can lead to panic disorder and other issues. They can cause you to withdraw from your normal activities and reduce your daily functioning. Whether you are dealing with panic attacks, panic disorder or persistent anxiety, effective treatments are available. Some common treatment options include psychotherapy, prescription medications, and self-help strategies. You might decide to try one or a combination of these methods.
Psychotherapy – can be helpful for developing ways to manage your symptoms, and identifying and changing worrisome thoughts and behaviours that lead to feelings of panic. Engaging with a mental health accredited therapist can assist you to overcome your fears and regain confidence and control of your life.
Medications – are not always needed but in some situations, can assist to reduce the severity of symptoms. They may only be needed for a short period of time to control symptoms while you work on other strategies. Medications should be managed by a medical practitioner.
Self-Management strategies – such as breathing exercises and desensitisation can be helpful for managing symptoms at your own pace.
Panic attacks can disrupt your everyday life and cause intense fear and distress. Whether you experience them or you want to understand what a friend or loved one is going through, know that help is available. With the right treatment and self-help, it is possible to reduce or eliminate the symptoms of panic, regain confidence, and take back control of your life.
