Our body gets overtaken by fear responses: heart pounding, trembling, feeling chilled or very hot. Sometimes we might feel like we are choking or going to be sick. And then our mind joins in and tells us that we are going crazy or that we are about to lose control, or even that we are going to die. All in all, a panic attack is very unpleasant and, even though they don’t usually last more than 10 to 20 minutes, we sometimes go to elaborate lengths to avoid having another one. In fact, that can end up being the worst part of panic attacks: we live in dread of having another one. We can start avoiding people, places and situations just in case we get triggered into another attack. (In fact, panic attacks can happen without a ‘logical’ trigger anyway). It can reinforce phobias because we get scared that if we encounter our ‘trigger’ we will have a panic attack.
Panic attacks and anxiety attacks may have some similar symptoms, but they are not the same – panic attacks are quicker, more extreme, and can come ‘out of the blue’, whereas anxiety attacks are physical symptoms after feeling a lot of stress and worry.
Chest pain can be a symptom of both anxiety and panic attacks… but of course it can also be the symptom of a heart attack! In fact, about a quarter of people coming into emergency departments with suspected heart attacks get diagnosed with anxiety or panic. The pain can be different – panic attack pain tends to be sharp, stay located in the chest, and fades after a few minutes, whereas a heart-attack tends to build more slowly, the pain often moves to the arm or jaw, and feels more like a crushing pressure rather than a stabbing pain. HOWEVER: don’t take risks! Even if we already have had a diagnosis of panic attacks in the past, if we suffer strong pain anywhere between our neck and belly-button, it is wise to get medical attention! You might feel embarrassed getting a ‘false alarm’ diagnosis, but embarrassment is considerably better than risking serious illness or death. And, if the pain is anxiety-related (which is still a real medical issue), the medical staff will be able to help you with that as well.
If we get a panic attack:
- It helps when we know what it is, and that we know that it will pass.
- We can reassure ourselves that our panic does not always tell us the truth about threats and dangers.
- Control your breathing. Slowly count your breath in: one, two, three, four, pause, out: one, two, three, four. Even if your breathing is okay, counting up to ten or twenty or whatever can steady your mind.
- Rate your panic attack, on a scale of 1 to 10. Strangely, observing yourself like this takes away some of the terror and gives you a feeling of control.
- If you have chest pain as well as other panic symptoms, note the time and make plans to get emergency medical help. If it doesn’t start fading within a few minutes, treat it as a potential heart attack and get assistance. (Better safe than sorry).
- Use your imagination to go somewhere happy: a pleasant memory, thinking about a favourite place, imagining a loved person or pet.
- Reciting in your mind the lyrics of a favourite song, poem or prayer can help you rein in racing thoughts.
- Tell someone what is happening, preferably a trusted friend but, honestly, the world is full of lovely strangers who will respond with reassurance and sympathy, and help you feel safe.
- We can do a ‘tour of our body’: in our mind, we visit each part of our body and command it to relax. (It’s our body! We can tell it to do what we want!). “Arms, hug me… and now go limp and relax. Feet, wriggle my toes, now stay still. Jaw, open wide in a yawn – not too wide! – now close gently without clenching. Neck, rock my head slowly, now just settle. Hands, tighten in a fist, now spread out the fingers, now just relax”.
Of course, the last tip is a form of progressive relaxation. If we learn how to do this at times when we are not actually having an attack, and make it a habit, it is a proven way of lowering stress and reduces the tendency of our nervous system to be triggered into the flight-or-fight response. It will probably reduce the chances of panic or anxiety attacks and, if we do have one, we will be able to readily use the exercise to help ourselves ride it through. If you Google ‘relaxation exercises’ you will find all sorts of recordings and videos that will lead you through. Some have far too many wind chimes and Tibetan bells for my liking, but I am sure you will find one that suits!
Panic attacks warrant the attention of your doctor, especially as they often accompany other mental health issues, and might also be linked to physical problems. Therapies, support and, sometimes, medication, can help de-throne panic attacks from being the master of your life!