Panic Attacks

A panic attack is a rush of intense psychological and physical symptoms. These symptoms of panic can be frightening and happen suddenly, often for no clear reason.

Panic attacks usually last between five and 20 minutes, and although it may feel as though you are in serious trouble, they aren't dangerous and shouldn't cause any physical harm. It is unlikely you will be admitted to hospital if you have a panic attack.

You may feel an overwhelming sense of fear and a sense of unreality, as if you’re detached from the world around you.

As well as psychological symptoms, you may also experience physical symptoms of panic, such as:

  • a sensation that your heart is beating irregularly (palpitations)
  • sweating 
  • trembling
  • shortness of breath
  • a choking sensation
  • chest pain 
  • feeling sick 

The physical symptoms of a panic attack are caused by your body going into "fight or flight" mode in response to something you think is a threat. As your body tries to take in more oxygen your breathing quickens. Your body also releases hormones, such as adrenaline, causing your heart to beat faster and your muscles to tense up.  For example - if you were a caveman being chased by a deadly animal the adrenaline created inside would help you physically run.  The deadly animal is the threat so your body goes into flight mode and in order for you to physically run faster your body creates adrenaline.  Therefore, imagine how you would feel inside if you were running from a deadly animal - the only difference is you are not physically running during an attack.

In a situation when you your body is 'running' at top speed then it can be really difficult to counter that.  If you’re breathing quickly during a panic attack, slowing this down can ease your other symptoms.  We are not saying that is easy but here are some things you can try:

  • Breathe in deeply through your nose
  • Breathe out slowly through your mouth
  • Focus your thinking on the word "calm"

Keep calm and concentrate on your breathing. You should start to feel better as the level of carbon dioxide in your blood returns to normal, although you may feel tired afterwards.  Ask a friend or family member to help and remember to practise breathing at times when you are calmer.  The more you practice the more you will be able to bring that slower breathing in to help during an attack.

It's worth remembering that you may have to seek medical advice if:

  • Your panic attack continues after following these breathing techniques for 20 minutes
  • You still feel unwell after your breathing returns to normal
  • You still have a rapid or irregular heartbeat or chest pains after your panic attack
  • You regularly have panic attacks, as this could be a sign that you have panic disorder.

By going to your GP it can understand the facts of what is exactly happening and that can be reassuring (and you can positively reinforce that thought when relaxing) when you are working hard at relaxation if experiencing the symptoms.

The following practical suggestions may help prevent panic attacks:

  • Learn relaxation techniques, such as deep breathing and muscle stretches – see Steps to deal with stress.  Remember to practice your relaxation techniques so that they are easier to bring in when experiencing an attack
  • Eat regular meals to stabilise your blood sugar levels
  • Avoid caffeine, alcohol and smoking – these can make panic attacks worse
  • Keep a record of when attacks happen to help you understand if there are any triggers or thigns that specifically increase stress.  Sometimes we may not realise these things until we look over a period of time to see trends or common thoughts or events which trigger attacks

Panic attacks can and are very real.  They can be really frightening to experience and it is important to be open with friends and family to ensure they can help.  It is also worth reading over this booklet created by the NHS and ask your friends and family to look over that too.  Having someone there to help you cope, especially during an attack, can make a real difference.

What do I do if I am with someone having a panic attack?

If someone you know has a panic attack, he or she may become very anxious and not think clearly. You can help the person by staying with them and helping them to keep calm.  Move into a quiet place and help the person's breathing by breathing with them and encourage them to try and match your slower bigger breaths in and out.  Counting can also help.  If the person is finding it really difficult to control their breathing then try encouraging them to breath into a paper bag for a couple of minutes.  Encourage them to concentrate on filling the bag with air and pulling all the air out again.

It is helpful when the person is experiencing a panic attack to say things such as:

  • "You can get through this"
  • "Concentrate on your breathing.  Stay in the present"
  • "I am proud of you. Good job"
  • "Tell me what you need now"

Remember to be patient and praise efforts.  Their fear may appear unreal to you personally but to them it is real.  Once they have come out of the attack gently discuss what their fear was and challenge a thought that was not real.  For example, during an attack the person may say they are scared of dying because they cannot breathe properly.  That is a real fear - but ask if that happened.  It helps to challenge that thought as it reinforces that it was symptoms of the panic attack and not their fear.

Try not to panic and stay calm and relaxed - your voice being calm will help them too.

We have detailed support sources below where you can find out more information and access self-help resources online.

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Personality disorders

Information and advice on personality disorders and mental health in Shetland.

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