Panic attacks and panic disorder

‘Fear of panic attacks is stopping me from living my life’

My vision blurred and warped, I couldn’t catch my breath, and everyone around me looked as though they were melting. I ran from the shop in tears. After that, I felt ill when I tried to get on a bus, go into a shop, or enter any other enclosed public space. I tried to get a train to see friends but was flooded with a tremendous wave of nausea that only dissipated when I stumbled out on to a platform, miles from my destination, and walked home”Robyn Wilde, journalist, Elle UK

What is a panic attack?

A panic attack is a period of intense anxiety, in which you experience highly unpleasant physiological symptoms associated with the ‘fight or flight’ response. These symptoms include things like hyperventilating (breathing too quickly), tightness or pains in the chest, nausea, dry mouth, headaches, dizziness, a sense of unreality and shakiness. During a panic attack, feelings of anxiety intensify and spiral out of control because the symptoms of anxiety themselves become frightening.


How does a panic attack become panic disorder?

The experience of having had a panic attack is pretty common. Research indicates that about 20 percent of people have at least one panic attack in their lives. For most people the panic attack is a once-off event, triggered by intense stress or a very difficult or traumatic situation. The panic attack is unpleasant but once the situation is over, panic attacks don’t recur.

However, for some people the panic attacks don’t stop. ‘Panic Disorder’ is a way of describing what happens when panic attacks start to take over your life. You have recurrent panic attacks and they can happen to you at any time, unexpectedly. You are thinking about and worrying about having more panic attacks, and these worries are starting to dominate your thoughts. Maybe you are starting to worry that there might be something wrong with you, that you are going to have a heart attack, lose control or go crazy. Due to your fears of panicking you have started to change your life, by avoiding things that you fear may cause you to panic.

As the problem intensifies, you may find yourself withdrawing from many situations. Examples include the avoidance of large open spaces, bridges, driving a car, crowds, queues, buses or trains. If you avoid places where you have previously had panic attacks because you fear those places might trigger further attacks, the number of places you avoid increases over time, restricting your life more and more. For some people, avoidance reaches a point where it is impossible to leave your own home (this is sometimes referred to as agoraphobia).


Things you can do

  • Educate yourself about anxiety and its physical symptoms. Learn about the ‘fight or flight’ response. Are the symptoms and sensations that you find distressing actually symptoms of anxiety? More about the fight or flight response here.
  • Breathe. When you become anxious, you tend to take rapid shallow breaths. Many of the unpleasant feelings that occur during a panic attack are due to this kind of breathing. Instead, try to breathe slowly and more deeply. Rather than focusing on the feelings of panic, try to notice your surroundings. What are three things you can see, touch, hear? Stay anchored to the ‘here and now’ while you let the feelings of panic wash over you, knowing that these feelings will pass.
  • Talk to a psychologist. We have a range of strategies and techniques that can help.

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