Panic attacks can be extremely frightening experiences which can lead to us feeling overwhelmed and out of control. During panic attacks many people experience intense physical sensations such as: feeling faint, shakiness, sweating, increased heartbeat, sweating, nausea, chills, chest pains, de-realisation or hot flushes. For many it may feel as if they are seriously unwell which can be a terrifying experience. Some people may call 999 or visit A&E as they are worried they are having a heart attack, something is seriously wrong with them or they are going to die.
It is always best to be checked out medically to be sure there is not an underlying health condition. For some panic attacks may be triggered by a specific situation for example it could be triggered by public speaking or having to sit an exam. For other people the trigger for the panic attacks may not be so obvious and they may occur unexpectedly or during the night time. Most panic attacks last a few minutes but they can be longer.
If you are having regular panic attacks/ anxiety attacks and are constantly worried about the impact of the attacks you may have panic disorder. Panic disorder can be diagnosed by a General Practitioner (GP) or a Clinical Psychologist. Panic disorder can sometimes be accompanied by agoraphobia which is a fear of leaving the house.
Panic attacks can impact on our every day functioning and lead to us feeling fearful and afraid to confront certain situations. This can leave us feeling overwhelmed and out of control. This can sadly lead to people withdrawing, avoiding certain situations and isolating themselves. This withdrawal and avoidance then strengthens the cycle of anxiety where further situations are being avoided. This can be very isolating for people and can lead to them being stopped from joining in with the activities that they may have once enjoyed or from socialising.
Panic attacks are different from Post Traumatic Stress Disorder (PTSD) as one of the main symptoms of PTSD is the re- experiencing of a traumatic event whilst also experiencing symptoms such as increased arousal and avoidance of situations associated with the trauma.
Clark’s 1997 Model of panic is helpful in understanding panic attacks, please see below:
Clark’s model of panic can be helpful in understanding the cycle of panic and the how cycle can be stopped and overcome. The model illustrates how the cycle starts of with an event or situation or a trigger of anxiety. This leads to anxious thoughts and feelings, which then leads to physical sensations of panic, which could be a beating heart, feeling faint, feeling chills or sweating etc. These are all normal reactions to anxiety, however when we view these in our mind as terrible or as us being unable to cope with them, the anxiety raises as we can interpret our body sensations as catastrophic. This can lead then to avoidance, or safety behaviours.
An example of this could be a person giving a speech who uses the safety behaviour of not making eye contact with his audience, or avoiding the speech all together. Or it could be a child that is scared of dogs refusing to leave the house as they are afraid of seeing a dog. Safety behaviours are not helpful as they trick our brain into believing that we only avoided the catastrophe because of them when in fact we could have coped and survived.
The avoidance of situations then leads to the cycle of anxiety making it worse and more intense. However, by dropping the safety behaviours and confronting the situations we fear we are able to overcome the cycle of panic. Anxiety is usually at its highest just before we do the thing we fear and eventually it will have to lower. If you can stay in the situation long enough for your anxiety to reduce then the brain is learning that the situation is safe and you are able to cope.
Continuing to cope with these situations and staying in them until the anxiety has reduced will teach the brain that you are able to cope which over time will help your panic attacks to decrease and eventually stop. This is training the brain to overcome the fear and changing the brain circuitry.
Exposure to feared situations and triggers can help in reducing panic attacks, however this is best done with the help of a Counsellor or Hypnotherapist. A Counsellor or Hypnotherapist can work with you at your pace, supporting you to talk about and understand the panic attacks as well as choosing tasks that will support you with exposure to feared situations at a pace that is right for you. Counselling also helps you toward understanding the route cause of the panic attacks and explores your feelings and emotions which helps you to process them. Counselling also builds on your own strengths and resources supporting to you get control and reach your goals.
Tips for what can help whilst experiencing a panic attack:
- Allow it to come and go, don’t try and fight or supress it. Stay in the situation as long as possible if it is safe to do so.
- Remind yourself that these feelings will pass, that you have coped before and are able to cope again. They are only thoughts and sensations and they will pass.
- Stamp your feet on the ground and feel your senses. Notices what you can see, hear, smell, touch, taste, it can be helpful to use techniques to ground yourself.
After a panic attack think about showing yourself some self-compassion. Panic attacks are horrible experiences and are emotionally and physically very tiring. Give yourself some self care and positive affirmations you have dealt with something that is really hard and challenging. You may want to get yourself a warm drink or read a book or a magazine, or do something that is self nurturing. Positive self talk can be helpful.
If you would like to support around managing panic attacks you can contact me by sending me by the link below to find out more or to schedule a free consultation appointment.
References:
W. Dryden (2003) The Vicious Cycle of panic as cited in Counselling for Anxiety Problems, Sage Publications Ltd, London
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