Are you having panic attacks?

One of the questions I ask clients during an initial consultation is whether they are experiencing, or have ever experienced, panic attacks. The majority of clients we see at the Solution Focused Studio arrive with us because they are experiencing heightened levels of anxiety, but not everyone with high anxiety will also suffer from panic attacks. Conversely, I also hear many people describe quite vivid symptoms of feeling panicked and out of control, but remain unaware that what they are trying to describe is also called a 'panic attack'.

The NHS describe panic attacks as ‘a rush of intense anxiety and physical symptoms.’

In very basic terms, panic attacks - these sudden and intense episodes of fear - can be alarming, scary and happen suddenly, often without a clear reason. However, they are most often in response to a trigger, such as a specific situation, feeling or event that creates a sudden feeling of being overwhelmed and ‘stuck’ in panic. For example, one of the most common places I hear about are supermarkets, particularly from my teenage clients.

Whether it is the harsh lighting, the vast building or the number of people walking around, for some reason supermarkets always seem to be somewhere at the top of the list of places that have triggered panic attacks. Another common report I hear is about panic attacks while driving. One of our past clients described his experience:

'I'll be driving along and if I get an inkling the GPS will take me on the motorway I'll suddenly feel like I can't breathe properly. The traffic seems to be going really fast around me. I can't seem to take it all in and I feel like my body is trying to freeze. I'm convinced I'm going to crash. I start to shake and I then panic about not being able to pull over to find somewhere to calm down. Everything starts to spin and I get really sweaty. I've actually started to hyperventilate before and I get a real sense of doom, like I'm going to crash or cause a crash. It's like I'm not in my body. It's a blind panic and I'm convinced at that moment I am going to die.'

Panic attacks can be overwhelming. I have clients who have even been rushed into hospital with very real physical symptoms, convinced they were having a bigger problem such as a heart attack or stroke, only to find out that anxiety – or specifically this feeling of sudden and intense panic - was the culprit.

The problem with panic attacks is not just in the emotional symptoms of an overwhelming feeling of dread or worry; the physical symptoms can be very strong and temporarily disabling, creating a feeling of not being able to breathe and, in some cases, chest and limb pain – mirroring the symptoms of much bigger and more serious medical problems. As a result, panic attacks can seriously affect a person’s quality of life. Sufferers may be embarrassed or feel overwhelmed, unable to go out as much as they would like, and find themselves feeling ‘down’ or fatigued due to the tiring symptoms. It can also be difficult to explain just how frightened and overwhelmed you feel to someone who hasn’t experienced a panic attack before – and being told to ‘calm down’ during a panic attack generally isn’t much help because the strength of the symptoms and the feeling of fear is very convincing. As someone once told me - never in the history of being told to 'calm down' has anyone ever 'calmed down'.

Signs of a panic attack

Each person will have their own mix of symptoms. A person having panic attacks may experience:

• A pounding orracing heartbeat

• Clamminess or sweating

• Shaking and trembling

• Shortness of breath or struggling to breathe (hyperventilation)

• A strangled sensation

• Chest tightness

• Nausea or a clenched feeling in the tummy

• Dizziness or feeling unable to focus

• Tingling arms or fingers

• Dry mouth

• A sense that there is too much light or movement around you

• A feeling of displacement

You won't usually need to be admitted to hospital if you have had a panic attack, but similarly, doctors won’t be cross with you for genuinely believing you were having a medical emergency, as the physical symptoms can be confusing. Panic attacks usually last from around 5 to 20 minutes. Although it may feel like something is seriously wrong, those feelings aren't dangerous and shouldn't harm you. What causes panic attacks?

Each person suffering from panic attacks will have their own trigger or triggers and potentially anyone can experience them – we have had teenagers and octogenarians reporting symptoms of panic attacks to us. We hear about panic attacks happening when they are driving on motorways, sitting exams, getting onto a plane or, as mentioned earlier, walking into a supermarket. Some of these people may also be experiencing high levels of stress, following on from an event like a divorce or bereavement, creating major change or loss of confidence. In our experience, people who suffer from panic attacks often have other symptoms of a generalised anxiety, but that is not to discount the panic attacks people suffer as part of a specific phobia, when the panic attack occurs because of exposure to one specific trigger. Put simply, the physical symptoms of a panic attack are caused by your body going into ‘fight or flight’ mode. Your brain, which can occasionally be spectacularly bad at understanding the difference between reality and imagination, mistakes the level of danger and sets off the extreme emergency survival mode we have had since primitive times, first developed to get us out of the way of genuine physical danger or death. When the brain - more specifically the amygdala, thinks there is danger, the equivalent of a 'panic button' is pressed, releasing the neurotransmitter adrenalin into the system, physically preparing the body for fight or flight. The effect of this is that we feel our heart rate speed up significantly, as the body tries to take in more oxygen for our limbs to use – hence the pounding heart, the quickened breathing, the impending sense of doom and shaky limbs. At that very moment, we are being primed to escape as quickly as we can, or stand to fight our dangerous foe.As useful and life-saving as this response is, we certainly don't want to be having it when we are trying to do our shopping, give a speech or get on an aeroplane. As we feel more out of control, we can become tense and self-conscious, worried that people will see us behaving like this – and before we know it, the panic has snowballed, leaving us in an even more overwhelmed state. It is very scary indeed when you feel out of control of your responses. But at the very root of the panic attack is the brain's misunderstanding of a situation - it sees great danger when in reality, you might just be feeling a little vulnerable. The fight or flight response is jumping in to save you at the wrong time. Should you see your doctor about panic attacks?Even though the symptoms make you feel like you're about to collapse or even die, a panic attack is usually harmless. However, in some cases, you may need medical advice to rule out an underlying physical cause and this will help reassure you that there isn’t a bigger medical problem. You can also talk to your GP about any anxiety you are experiencing and he or she may refer you for talking therapy or counselling if they feel it is necessary. How do I stop panic attacks?At the Solution Focused Studio we regularly help clients to conquer their panic attacks so they can focus on getting on with their lives. We concentrate on helping clients to understand their brain and how to cope better in the situations they have previously found difficult. In short, we help people to reduce their anxiety and learn to rationalise their responses, getting the brain and the panic response back under control in the long-term. With our breadth of experience it is very temping to list our ‘ten top tips’ on how to calm a panic attack, however, while you could choose to tackle them on your own, we firmly believe that it is better to talk to a trained professional as a first step. Working with a professional therapist can speed up the process of getting things back under control and make the results longer-lasting. There are lots of suggestions out there on the internet about how to breathe you way through a panic attack, but this won't necessarily stop the brain running out of control the next time you are exposed to that trigger. Our advice is that you need to tackle to root cause of the panic attack and that is done by understanding the workings of the brain.

The good news is that you don’t have to live with panic attacks.

While they feel incredibly intense and beyond our control while they are happening, remember that they are, in the vast majority of cases, very ‘fixable’. Also, remember that you are not alone – they happen to more people than you may think. Indeed one of our wonderful past clients, a lady in her sixties*, came to see us after suffering from panic attacks on public transport for nearly 40 years, building up expensive taxi bills through having to avoid travel on trains or buses. At a lunch gathering she decided to ‘come clean’ and tell her friends that she was working on the problem, and to her surprise found that half of the people at her table admitted to having had panic attacks at some point in their lives too. Needless to say, she found this very comforting after having felt very embarrassed, thinking she was, in some way, ‘weaker’ or less able to cope than her friends. She is now regularly travelling to see friends by train, able to relax, read her kindle and enjoy the journey!

So if you are having these episodes of panic, why not seize the moment now and contact a therapist who will be able to help you. We don't have to put up with these symptoms and, speaking as someone who used to suffer from panic attacks, you'll be very glad you made the effort to get your anxiety levels under control!

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