Panic Attack Help: our complete guide

What is a panic attack?

The reactions that occur in the mind and body when we experience panic have their roots in the “fight or flight” reaction that has aided our survival as a species. We respond in a certain way when we encounter situations that we perceive to be dangerous, and that puts us in a state of readiness to react quickly to danger.

Imagine waking to find a pre-historic tiger prowling the cave you call home. You would experience an elevated heart rate for sure. This would create a ready supply of oxygenated blood to fuel your muscles as you run from, or wrestle with, the tiger. Your thoughts might quicken, preventing you from dwelling too long on what might have led the tiger to happen upon your cave. Your mouth may feel dry as your body tries to save water and so on.

A panic attack is when some or all of these reactions are triggered, but without there necessarily being a significant threat present. Those symptoms can include a racing heart, breathing difficulties, extreme anxiety – and a whole host more that we’ll run through below.

They tend to be triggered by stressful events or situations, but they can also simply come out of the blue. When these physical and emotional symptoms kick in, it can be very frightening for the person affected, prompting them to feel that they might be suffering heart attack or even that they’re about to die. Thankfully, that’s pretty much impossible. If this sounds familiar, and you’d like some panic attack help, you can check out our online course here.

Panic attack symptoms – Physical and Emotional

The symptoms of a panic attack can be said to fall into two categories: physical and emotional symptoms.

Physical symptoms

During a panic attack, just about any area or system of the body can be affected. Most commonly, a sufferer might experience:

• Trembling
• Dry mouth
• Perspiration
• Increased or irregular heart rate
• Hyperventilation or breathing difficulties
• Numbness or tingling in the limbs
• Aches and pains associated with tension occurring in the head, chest or elsewhere around the body
• Light-headedness or loss of balance
• Churning stomach

Emotional symptoms

The emotions experienced during a panic attack can be very upsetting indeed. They can include:

• Feelings of dread, that we are on the verge of catastrophe
• Feelings of helplessness and lack of control
• An inability to focus our attention on one thing at a time
• A narrowing of the field of vision, or “tunnel vision”
• A fear that we might have permanently lost our grip on our mental health
• A fear that we will do something out of our control, or behave embarrassingly

Feeling detached from what’s going on, like an out-of-body experience

What happens when you have a panic attack? – The feedback loop

Symptoms can spiral when the physical and emotional symptoms spark one another. When anxious emotions produce a physical reaction, that physical symptom can then make us more emotionally anxious. In turn the emotional anxiety prompts a worsening of the physical symptom and so on. This forms a feedback loop with each factor becoming the cause of its own cause. It can feel impossible for the sufferer to take a step outside of this cycle and to rationalise what’s really going on.

An example might be when an experience causes our heart to race. We might then worry that we are experiencing a heart attack, prompting further anxiety, prompting the racing heart to accelerate, prompting even further emotional anxiety. Being caught in this loop can feel inescapable and extremely distressing. It’s one of the main characteristics of a panic attack, but it’s important to remember that you’re in no real physical danger. For anyone experiencing these distressing symptoms, Therapy For You offers panic attack help in Essex, you can check out our online course here.

Panic attack causes

We don’t entirely understand what causes anxiety. There is a tendency for disorders to run in families, strongly suggesting a genetic link. They can follow on from post-traumatic stress disorder, and it’s widely believed that past trauma can be one of the causes for panic attacks in later life.

Panic attacks can be triggered during stressful situations in individuals with conditions such as depression, anxiety disorders and alcoholism, but they can just as easily be present in individuals that are unaffected by any additional condition. Some medications that have stimulant effects, that affect the hormonal systems or that are aimed at treating asthma or mood disorders have also been known to contribute to anxiety and panic attacks.

Can you die from a panic attack?

In short, no. For individuals with a pre-existing condition affecting blood pressure or the heart, stressful experiences can cause them difficulties, but for a healthy individual, a panic attack alone will not cause sudden death. That might not be much consolation to someone experiencing an attack, although trying to reconnect with this fact can be used as a technique to step away from feelings of panic and bring the attack to an end.

How long can a panic attack last?

A panic attack usually lasts 20 to 30 minutes, reaching a peak within the first 10 minutes, and then taking some time to ease off. For a sufferer in the midst of an attack whose symptoms are preventing them from understanding and rationalising the typical timespan, those 20 to 30 minutes may feel like they will never end.

For regular sufferers though, learning to keep a grip on the knowledge that the attack will not last forever can be an effective technique for alleviating symptoms and bringing the attack to a close.

Do I have Panic Disorder?

Some therapists identify Panic Disorder as a condition in itself, while others prefer to view panic as a symptom of other issues.

It’s generally accepted that, while most people can experience a small number of panic attacks over the course of their lives and suffer no lasting ill-effects, people who continue to suffer from attacks on a regular basis and find that it impacts their life and work are said to be suffering from Panic Disorder.

When panic attacks become a regular feature in life, it’s not just the attacks themselves that cause difficulty. A patient’s wellbeing in the periods between attacks can also be affected in two ways; “anticipatory anxiety” and “phobic avoidance.”

Anticipatory anxiety is the fear of having a panic attack at any time. Having an ever-present fear of the onset of an attack affects the patient’s wellbeing, preventing them from feeling at ease and enjoying everything life has to offer.

Phobic avoidance is where the patient actively avoids places and circumstances that may have coincided with attacks in the past or that they suspect may trigger a future attack. In more severe cases, the mere suspicion that an attack may occur, or that a specific set of assurances are not in place, can cause great anxiety. In the most extreme cases, phobic avoidance can take the form of agoraphobia, where the patient isn’t able to leave their home.

If you feel you may be affected by Panic Disorder, or if you just need some panic attack help, you can get in touch to book a telephone assessment with one of our qualified therapists.

How to deal with panic attacks – tips & techniques

Not every technique will help everyone that experiences panic attacks, and we certainly don’t want to overwhelm you with a dozen things to remember while your head is spinning. However, if just one or two of these tips sound like they might connect with you, then maybe you can keep them in your toolkit in the event of an attack:

Have something helpful handy

By its very nature, a panic attack is overwhelming and it can feel impossible to take a moment to remember and implement tips and techniques. That’s why it can be useful to have something handy to use or refer to when panic takes hold. A phone can allow you to contact a trusted friend or access a familiar podcast or app that you know to be helpful. Even a hand written note or list can be a godsend when panic is preventing you from recalling helpful tips.

Realising what is happening to you

The first step to tackling a panic attack is to realise that you are having a panic attack. Once the conscious mind is aware of what’s happening, it opens us up to understanding and rationalising the situation and coming to realise that the experience is not likely to be long lasting – which bring us on to…

This will pass

This is important to remember, although it’s tough to appreciate at the time. A panic attack won’t last forever – simply remembering this fact can be enough to pull you out of the turbulent confusion you might be experiencing. It can help you to begin to regain perspective and recover from the attack. If “this will pass” is not a phrase that resonates strongly with you, you may find other powerful words that express this in a way that connects with you. Try repeating them as a mantra as a way to help you appreciate that the panic attack is only temporary – it may help it to subside.

It’s not your fault

This is another fact that’s useful to remember. You didn’t ask to feel this way. Self-blame is not only inaccurate, it’s unhelpful. Feeling bad about feeling bad is another one of those feedback loops that we do well to avoid.

Breathing techniques

Panic attacks are characterised by feelings of a lack of control, so efforts to regain control are a good way to bring the attack to a close. Regaining control of our breathing rate is particularly helpful, as it will help with other physical symptoms like tension and a pounding heart. Again, this is easier said than done when you are in the throes of an attack, but if you learn a specific technique, even one as simple as taking slow, deep breaths, counting to 4 or 5 as you inhale and exhale, you may find it easier to regain control.

Relaxation techniques

In addition to calming the breathing, we can also use techniques that help reduce tension by relaxing the muscles. There are various techniques that involve picturing yourself in relaxing surroundings or relaxing muscles one by one. These “visualisation” and “progressive relaxation” methods can help you to take control of your body’s responses. Regular practice will help you to get better at using these techniques. For this and other panic attack help techniques, you can check out our online course here.

Mindfulness

The regular practice of mindful meditation can help reduce frequency and intensity of attacks, but in the event of an attack, mindfulness techniques can be employed too. If you have a mindfulness routine, try to bring it into practice during an attack as this can help to focus the attention and reconnect you with the here and now. To learn more about this useful technique, check out Therapy For You’s online treatment course about mindfulness.

Select something to focus on

During an attack we can feel overwhelmed by everything that’s going on around us, and our thoughts can fly off in every direction. Picking an object in plain sight and focusing our attention on it can help us to cut out excessive stimulation from our surroundings and settle or thoughts in one place.

The 5-4-3-2-1 technique

Another great focussing exercise is the 5-4-3-2-1 technique. Look around you. Find 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Going through these lists systematically can help to ground you and regain control of your thoughts and feelings.

For further advice on techniques that offer panic attack help, you can check out our online course here.

What are the signs of a panic attack coming on?

Signs of an impending attack will be different for different people, but typically they will be the onset of one or more of either the physical or emotional symptoms.

That might include the mouth becoming dry, an elevated heart rate, an inability to focus our attention or a sense of impending dread. For some, familiarity with these warning signs can present an opportunity to stop a panic attack in its tracks.

How to stop a panic attack when you feel it coming on

Sufferers that have developed ways to recognise the signs of an impending attack often report that they have learnt how to stop a panic attack before it has even started. The signs of a panic attack will vary between people, but most people will know their own warning signs. Learning your triggers and getting to know the feelings you experience in the run up to an attack will help to alert you when another one may be on the cards.

When these signs occur, whether that’s a dry mouth, elevated heart rate, or your attention skipping quickly between topics, there may be an opportunity to stop the onset of a panic attack in its tracks. You can use similar techniques to those outlined above to reassure yourself emotionally and take control of physical symptoms.

Alternatively, if you know you are heading into a situation that you feel is likely to trigger an attack, you can take pre-emptive action. If alcohol or caffeine are known triggers for you, you may wish to avoid them in the run up. If possible, you could take a trusted friend or family member along with you for reassurance. You can arrange a get-out plan for if you feel you need to make your excuses and leave a particular situation. Or you can make sure you have certain items with you that you know will help, such as water, your phone or simply an object that has special meaning to you.

How to help someone having a panic attack

When someone is clearly in distress, it can be difficult to know what we can do to help. It can be daunting deciding whether or not to intervene in case we make matters worse. Here are some tips for when you suspect someone is experiencing a panic attack:

Approaches that can help

Listen to them
The easiest way to discover what can be done for the best is by listening. If they wish to be left alone, then your job is done, they may have their own private coping mechanism and wish to be left to handle it on their own. If they are able to request space, water, a lift home etc. then you’ll know exactly what to do.

Engage them in conversation
Not only might this allow you to discover how you can help, but it can also help the sufferer to come out of themselves and break the cycle of negative thoughts. Don’t force it if the person is distressed by the interaction, but gentle coaxing and reassuring talk can help bring them out of the attack.

Appreciate how difficult it is for the person to rationalise in the moment
While you’ll want to engage the person and let them know that everything’s alright, it’s important to appreciate that their perspective is profoundly affected by the experience they are having. It will take time for the sufferer to regain their usual balance, so patience and reassurance are crucial.

Be prepared to help them to leave a situation
When a sufferer’s experiencing an attack, they may be anxious to escape the situation they’re in. By suggesting that you go with them to get some air, go for a walk, fetch a drink or even give them a lift home, you could help them to get away from a distressing set of circumstances and help them to feel safe again.

Approaches to avoid

Saying “don’t panic”
Or “stop panicking.” It’s highly unlikely to be helpful – if sufferers were able to snap out of it at will, they most certainly would! “Calm down” or “relax” are unlikely to be met with success either. Asking questions instead of giving instructions will allow you to learn more about how you can help in a constructive way.

Making them the centre of attention
Try not to draw attention to the person experiencing the attack. If you feel you need assistance in helping them, seek it out discreetly rather than calling out. Attracting a crowd is the last thing that the sufferer wants, and it could exacerbate their symptoms.

Becoming exasperated or annoyed
The person suffering didn’t ask to experience a panic attack, and they are probably feeling self-conscious and about what’s happening to them. It’s an obvious one, but displaying any sign of irritation may worsen those feelings for the sufferer and contribute to the feedback loop that’s created when they feel that their anxiety is causing people to judge them, which in turn causes further anxiety. Reassure the sufferer so that they feel safe and supported.

Can lifestyle, diet & exercise help to prevent attacks?

Some people report that alcohol or caffeine can contribute to their attacks, either as an immediate trigger or as a background cause during times when they’re consumed routinely on an ongoing basis. So, if you are experiencing regular panic attacks, it can be worth experimenting with dropping those out of your diet to see if it improves your situation.

Sleep and exercise are also known to aid in cutting down both the frequency and severity of panic attacks. Getting a good night’s sleep can be easier said than done, especially for those diagnosed with panic disorder that are experiencing anticipatory anxiety too. However, getting into good sleep habits will undoubtedly help with panic disorder, and combining that with exercise can create a routine that results in a calmer and healthier mind.

Panic attack treatment with Therapy For You

For anyone affected by this issue, Therapy For You offers panic attack help in Essex. Though we may not be able to banish your panic attacks for good, by working together we can help you to learn simple and effective ways to manage them. One-on-one therapy can be a great help but if you don’t have the time or resources to arrange that, it shouldn’t stop you from getting the treatment you need. That’s why Therapy For You has created free online video treatments that use CBT approaches to help you battle your panic attacks.

Cognitive behavioural therapy has been shown to be the most effective means of treating panic attacks. CBT outperforms other therapies including medication time and again in scientific studies – and it forms the basis of the treatment offered by Therapy For You.

You’ll learn panic attack help techniques that will provide you with tools to make powerful changes to your thinking and help you accept and control the symptoms you experience. So if you‘re experiencing panic attacks, NHS treatment from Therapy for You lets you participate online – at a time and place that suits you. There’s no rush, and we’ll be here to support you as you progress through the course.

Have a look at Therapy For You’s online course designed to help those experiencing panic attacks, or get in touch to book a Telephone Assessment with one of our qualified therapists.