Experiencing a panic attack is our body’s natural way of alerting us of danger. It is a type of intense fear response and is normal to experience that arises due to stress, excitement and danger. Nevertheless, this feeling is uneasy and unpleasant and there are many ways to manage and cope with it. Here we will discuss a few tips such as relaxation exercises, distractions techniques, and physical activities.
What is a panic attack?
A panic attack is a ripple effect that is caused by anxiety. It is a feeling of intense fear which develops unexpectedly and can be immobilising. During these experiences you may feel like your heart is pounding, you can’t breathe or you are going to die in extreme situations. Many people may only experience panic attacks once or twice in their lifetimes. However, for some, it may occur frequently. If you have recurrent panic attacks and have an intense fear of experiencing another attack happening, you may have a panic disorder.
From an evolutionary perspective, our body has evolved over time to react to the current environment we are in.1 For example, in the past, encountering a tiger would make us fearful. This intense fear would then provoke a fight or flight response. This response would enable us to protect ourselves as quickly as possible unconsciously. This instinctual reaction arising from fear is advantageous to us as humans in order to survive and reproduce. Similarly, the same concepts can be applied to anxiety. Anxiety provokes individuals to worry about danger which in turn causes people to take fewer risks, seek safety and focus on performing well. 2
How common are panic attacks?
Panic attacks are fairly common, and approximately 1.5% of the population has a panic attack during their life.3 Panic attacks that do not come under the official diagnostic criteria are 2 to 3 times more prevalent.3 The commonality of panic attacks/ panic experience is rarely reported, therefore, the statistical data collected may not be accurate.4 Hence, real-time panic attacks can be experienced more frequently than expected in the general population.
Who might have panic attacks?
Panic attacks may be determined due to many reasons and anyone can experience a panic attack. However, the following factors could play a role in panic attacks arising.
Age- Panic attacks are more prone in teenagers or young adults. However, people of all ages can experience panic attacks including children.
Gender- People assigned female at birth (PAFAB) are twice as likely to develop a panic disorder in comparison to people assigned male at birth (PAMAB).
What causes panic attacks?
The reasons for individuals experiencing panic attacks are still unidentified. Being able to manage and handle your anxiety is dependent on your brain and nervous system, since they enable us to perceive and handle intense fear/ anxiety.
However, you may be at risk of a panic attack if you have:
- A family history of anxiety disorders
- Mental health issues and substance abuse problems (alcoholism and drug addiction)
Symptoms of a panic attack
There are many different symptoms of anxiety disorders which may lead to a panic attack such as:
- Being unable to sleep due to anxious feelings
- Intense fear of dying
- Shaking or trembling
- Shortness of breath
- Fast heartbeat or heart palpitations
- Changes in mental state
In summary, panic attacks, anxiety attacks and anxiety disorders that cause a panic attack share the same symptoms such as a sense of danger, shaking and a fast heart rate.
How to treat panic attacks
Panic attacks can be treated through various methods such as:
- Psychotherapeutic Interventions (Cognitive Behavioural Therapy)
- Stress management techniques
- Breathing techniques (Taking deep breaths)
- Relaxation techniques
- Learning to problem solve
- Physical activity and eating healthy
- Good sleep hygiene
- Biofeedback therapy
- Talking to friends or family about feelings
- Using Support Services such as the Samaritans
- Listening to soothing music
Can you prevent a panic attack?
You can prevent your panic and anxiety attacks by:
- Carrying out regular breathing exercises, to help prevent and relieve anxiety attacks
- Regularly exercising aerobic exercises help manage your stress response
- Eating and sleeping well
- Avoid caffeinated drinks such as coffee, tea or energy drinks
- Use self-help tools
- Cognitive Behavioural Therapy
Please consult GP for further input before making healthcare decisions.
How to stop a panic attack?
The following techniques will help to stop a panic attack.
This technique is derived from Dialectical Behavioural Therapy. This skill is usually used when individuals are in high emotional states. However, these skills are also useful when experiencing insomnia, anxiety, ruminating thoughts or when experiencing low moods. This technique can immediately control emotions or feelings as it targets your physical sensations.
TIPP stands for:
Temperature: Change your temperature by squeezing ‘ice’ between your hands or place it on your face or having a cold shower. This helps shock the body bringing you back to the present. You can also use hot temperatures such as a hot bath. Speak to your doctor if you have heart problems, recently had a heart attack or any medical condition before using this skill.
Intense exercise: Going for a run, jumping jacks or any exercise for 20 minutes can help.
Paced breathing: Using breathing exercises helps to control your breathing. For example, Box Breathing is a method that involves breathing in for 4 seconds, holding the breath for 4 seconds, and then breathing out for 4 seconds. Adjust the seconds accordingly to how you feel comfortable.
Progressive muscle relaxation: Tensing up particular muscles and then relaxing them, helps to relieve muscle tension that is commonly associated with stress, anxiety and fear.
This is another technique to bring yourself to a safe place. Various scripts available can help you imagine the beach or forest or places you may feel safe.
This technique helps ground you when feeling anxious
- FIVE- notice five things you see around you (objects or colours)
- FOUR- notice four things you can touch (your face or the floor)
- THREE- notice three things you can hear (the wind or the cars)
- TWO-notice two things you can smell (perfume)
- ONE- notice one thing you can taste (gum or coffee)
Using distraction techniques can help you such as:
- Try counting backwards from 100 to 1
- Take care of yourself (reading or doing a facemask)
- Paint by numbers or colour by numbers;
- Go for a walk, watch a movie that creates an opposite emotion like horror or comedy
- Play with stress balls
- Listen to music
- Punch a pillow or punching bag
- Go to the gym, do yoga and exercise
- Visit the beach
When should I call the doctor?
It is important to seek medical help if symptoms indicate a panic and anxiety attack. It is also important to be aware of illnesses causing panic and anxiety-like symptoms such as diabetes, asthma, hyperthyroidism, cardiac conditions and post partum hyperthyroidism.
In conclusion, panic attacks and anxiety attacks are normal and everyone will experience it at some point in their life. It is important to remember you are not alone and various help is available. Carrying out simple mindfulness, relaxation and distraction techniques can help ease panic and anxiety attacks. If panic or anxiety attacks persist it is advisable to seek medical help especially if you have a medical condition. You may also be diagnosed with a long term disorder which may require therapy or medication to manage the anxiety symptoms.
- LeDoux JE. Evolution of human emotion. Prog Brain Res [Internet]. 2012 [cited 2023 Sep 5];195:431–42. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600914/
- Bateson M, Brilot B, Nettle D. Anxiety: an evolutionary approach. Can J Psychiatry [Internet]. 2011 Dec [cited 2023 Sep 5];56(12):707–15. Available from: http://journals.sagepub.com/doi/10.1177/070674371105601202
- Weissman MM, Klerman GL, Markowitz JS, Ouellette R. Suicidal ideation and suicide attempts in panic disorder and attacks. N Engl J Med [Internet]. 1989 Nov 2 [cited 2023 Sep 5];321(18):1209–14. Available from: http://www.nejm.org/doi/abs/10.1056/NEJM198911023211801
- Batelaan N, De Graaf R, Van Balkom A, Vollebergh W, Beekman A. Thresholds for health and thresholds for illness: panic disorder versus subthreshold panic disorder. Psychol Med [Internet]. 2007 Feb [cited 2023 Sep 5];37(2):247–56. Available from: https://www.cambridge.org/core/product/identifier/S0033291706009007/type/journal_article