Warning: This piece includes graphic descriptions of what it’s like to experience a panic attack, which may be triggering for some readers.
“There were times when I genuinely thought I was going to die,” Emma tells me, describing how utterly terrified she feels during a panic attack. It will cause her to sweat and struggle to catch her breath and the floor will feel like it is moving beneath her, forcing her legs to cave in. This feeling – like you’re going to die – isn’t uncommon. According to the mental health charity Mind, a person having a panic attack may also fear they’ll faint, have a heart attack or lose control.
Dr Antonis Kousoulis from the Mental Health Foundation tells HuffPost UK the issue is more widespread than you might think – of more than 2,200 people surveyed by the charity about their mental health, a quarter of respondents said they’ve experienced panic attacks. Anxiety UK believes the figure may be even higher with one in three people impacted.
Panic attacks are an exaggeration of the body entering “fight or flight” mode – as a person tries to take in more oxygen, their breathing quickens and their body releases hormones like adrenaline which causes the heart to beat faster and muscles to tense. Attacks are more common in women than in men and can begin before the age of 25, but tend to occur in people in their 30s or older.
Different people will experience attacks for different reasons, in different ways and for varying lengths of time. Some will experience them regularly, while for others they’ll be a rare occurrence. But there is a light at the end of the tunnel – with the correct management and treatment, some people can be free of them.
“Many people have experienced a panic attack at some point in their lives and experiencing a panic attack is not a mental health problem in itself,” says Dr Kousoulis. “However, they can be a lifelong issue for some people, in which case recurrent panic attacks and overwhelming fear of experiencing panic attacks can be a symptom of an anxiety disorder such as panic disorder.”
Sarah*, 21, likens her panic attacks to feeling like she’s trapped in a river under a sheet of ice. “You can’t find the same hole you fell through. You’re in a blind panic and you can’t get out from it no matter how hard you try,” she says. “To me it feels as though the panic is consuming you, your mind goes at a million miles an hour and everything just goes through your head so fast that you can’t process it.”
Over the years Sarah, who lives with general anxiety disorder and used to struggle with social anxiety, experienced several different kinds of panic attack which would last up to 15 minutes – from hyperventilating to physically throwing up, to being sat in a room full of people and freezing on the spot.
According to the NHS, panic attacks can last anywhere between five and 20 minutes, although some people’s symptoms persist for up to an hour, and can include: a pounding heartbeat, feeling faint, sweating, nausea, chest pains, feeling unable to breathe, shaky limbs, a dry mouth and a feeling of disconnection from your body.
Emma, 33, has been taking medication for anxiety for over five years now and also struggles with panic attacks. She says that while they rarely last longer than half an hour, she’ll often feel the effects for days afterwards – and likens it to a hangover. “The lead up to it is so shit and you feel like death, then you are sick” – this is the panic attack, she explains – “and then you still feel like shit but there is a sense of relief. You continue to feel like shit for a couple of days but the worst is over.”
Not everyone will know they’re having a panic attack, especially when they happen for the first time, which is why it’s important to be aware of the symptoms and seek help from a professional who can provide advice on how to manage the situation if if occurs again.
People might have specific triggers or experience a completely random panic attack that strikes for no clear reason. With Sarah, for example, she’s identified two key triggers: small confined spaces and finding herself in confrontational situations. At one point she was having panic attacks daily and, looking back, acknowledges it was because she wasn’t giving herself enough time to process what was going on in her head.
“Because of this, I now get up at 5am and go to the gym or do yoga,” she says, “or sometimes I just sit and read as this gives me enough time before I start work to think about everything – especially things that may be worrying me.”
Matthew, who is 25 and lives with depression, social anxiety and borderline personality disorder, says anything that causes him to have emotion-overload will send him spiralling out of control – from a disagreement with a friend to watching a distressing film. “Your body reacts to some nonexistence lingering darkness,” he says. “I found that my body goes very heavy and numb.” The feeling can continue for up to 40 minutes.
People who experience regular panic attacks with no obvious explanation should speak to their GP, as they may be diagnosed with panic disorder, an anxiety disorder where you regularly have sudden attacks of panic or fear. The number of attacks people experience will depend on how severe their condition is – some might have them once or twice a month, others, several times a week. Anxiety UK says the long-term anxiety condition often centres on “fear of fear”.
Symptom management plays a huge part in keeping panic attacks at bay. The Mental Health Foundation says the most helpful thing to do is try a combination of things that help manage stress, like doing regular exercise, eating well, and moderating intake of caffeine, alcohol or cigarettes.
Complimentary therapies like yoga and aromatherapy might also be beneficial in relaxing your mind and body. “For people who are struggling or often experiencing such episodes, psychological therapies that work through thoughts, feelings and behaviours can be helpful,” says Dr Kousoulis, who recommends getting in touch with your GP for a referral.
Cognitive behavioural therapy (CBT) can be “very effective” in helping people to control feelings of panic and find coping mechanisms when attacks arise, says Anxiety UK. This form of therapy focuses on how people think and how these thoughts affect feelings and, ultimately, behaviour – yours and other people’s.
While medication is an uncommon route for people who have isolated panic attacks, it might be offered to those who have more intense cases and a diagnosis of panic disorder. “Medication would be recommended to treat an underlying or coexisting issue, like depression or anxiety,” Dr Kousoulis explains, “or to control the more dangerous symptoms of an attack, like evening out an irregular heartbeat.”
What To Do During An Attack
Identifying the signs and confronting the emotion of fear can be helpful during an attack, says Dr Kousoulis – “and it’s more easily done if someone is there to reassure you.” Because of the varied nature of panic attack symptoms, some people find help from others helpful while others find it more anxiety-inducing.
“Even just having one person try to address the issue (though I really appreciate it) makes it worse as that panics me,” says Sarah. “I’ll continually worry about what they will be thinking and this adds to the problem instead of omitting it.” But Calli, 20, disagrees. “It helps a huge amount because if I’m not in control they can do it for me,” she says. “If I’m on my own, I’ll usually ring a family member to help me out, they’ll stay on the phone whilst I’m having the panic attack, and won’t get off the phone until they know I’ve calmed down.”
Breathing techniques can be particularly useful for those who are prone to hyperventilating. One exercise that might help is breathing in as slowly, deeply and gently as you can, through your nose; and then breathing out in the same way. Some people find it helpful to count steadily from one to five on each in-breath and each out-breath.
Another useful technique which helps a lot of people is diverting their attention elsewhere. Sarah, for example, finds it useful to focus on the five senses to distract her mind. “Look for something and focus on it,” she says of this technique. “Try to smell something and focus on it, touch something and focus on it, listen to something and focus on it and – if you can – taste something and focus on that.” Experts recommend this approach, too.
Emily, 28, lives with generalised anxiety disorder and PTSD, and says the latter is often linked to her panic attacks, which she’s been having since she was a teen. They usually start with her heartbeat and breathing speeding up. “I then either do one of two things – I’ll start crying and get really hot or my brain will just say ‘Nope!’ and I’ll get really dizzy and have to sit down before I pass out and hit the deck,” she explains. When Emily feels a panic attack coming on, she tries to practise mindfulness – where she focuses her mind on the here and now. She will try to disrupt her own thoughts, telling herself her brain is sending out the wrong signals, before counting down slowly from 10.
“A therapist taught me a great calming technique called ‘leaves and clouds’ which works pretty well if you’re panicking,” she adds. “Hold your hands out in front of you, one above the other, palms facing you. Then slowly move them from left to right, then place the bottom hand above the top one and repeat this while breathing and focusing on the slow movement.”
*Some names have been changed upon request.
Useful websites and helplines:
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)
- The Mix is a free support service for people under 25. Call 0808 808 4994 or email: firstname.lastname@example.org
- Rethink Mental Illness offers practical help through its advice line which can be reached on 0300 5000 927 (open Monday to Friday 10am-4pm). More info can be found on www.rethink.org.