Five tips for coping with panic attacks

Panic is an overwhelming feeling of anxiety which occurs suddenly, without warning, and often for no apparent reason, and comes on in a wave of feeling, known as a panic attack.

What does a panic attack feel like?

There is a rapid build-up of physical panic attack symptoms, such as:

• Palpitations: a pounding heartbeat that can be felt
• Sweating
• Nausea
• Feeling unable to breathe or experiencing a choking sensation
• Feeling faint or dizzy
• Numbness or pins and needles
• Chest pains or tightness of the chest
• Having shaky limbs
• An urgency to go to the toilet

These symptoms are unpleasant and can be very frightening because of their intensity. They can cause people to feel like they're going to die (for example, from a heart attack) or faint. As a result of this fear, the person can become scared of experiencing the next panic attack. This can lead to their physical symptoms of panic getting worse, affecting overall mental health.

No-one wants to experience panic attacks and so the person may start to avoid situations that might cause panic attacks, such as crowded places, public places, open spaces, enclosed places or places far away from home.

Please be aware that the physical symptoms of a panic attack will not result in a heart attack or cause any physical harm.

How long do panic attacks last?

Panic attacks usually last from 5 to 20 minutes but can last up to 1 hour, although this can be because the first panic attack has triggered another.

It's important to remember that the symptoms of a panic attack will pass and you will be OK. Panic attacks can often feel like they have no end, but they will.

How to deal with panic attacks

Dr Donna Grant, Consultant Psychiatrist at Priory Hospital Chelmsford, offers some top tips to help you cope with panic attacks:

Stay where you are

If possible, you should stay where you are during a panic attack. As the attack could last up to 1 hour, you may need to pull over and park where it's safe to do so, if you're driving. Then pause for moment, observe your thoughts and tell yourself that your mind is reacting to these thoughts and anxiety. These feelings are normal - it's just the body's alarm system doing its job when it doesn't need to.

It's important to see the situation through. Stick with the panic; it will pass.

Learn to control your breathing

People often hyperventilate during a panic attack. This means taking deeper breaths than normal which results in you feeling short of breath, causing a feeling of dizziness, disorientation and chest pains.

By learning to slow your breathing down, you can help prevent the uncomfortable physical symptoms and stop the panic cycle.

Try to get a slower and more stable breathing rhythm by breathing in for 3 seconds, holding your breath for 2 seconds, and then breathing out for 3 seconds. As you breathe, ensure that your stomach expands as you take each breath as this helps to ensure the breathing isn't shallow, which can add to the problem.

Learn to use positive coping statements

When you're feeling anxious and panicky, it can be helpful to have 'coping statements' which can be used to remind yourself that panic isn't dangerous or harmful.

Such statements could be:

• Panic is simply high levels of anxiety
• By remembering these symptoms are nothing more than anxiety, I can prevent further symptoms occurring
• My anxiety and panic will pass naturally given time. It doesn't last forever
• I can continue without needing to escape or avoid
• I have never fainted, choked or had a heart attack

Reminding yourself of these facts can help to prevent further panic cycles happening.

Shift your focus

Many things can go through your mind during a panic attack, often very negative thoughts, for example, thinking about disaster or death. Rather than focusing on these, try to concentrate on something else such as looking at a flower or a picture or something that interests or comforts you.

Alternatively, you could try creative visualisation. To do this, think of a place or situation that makes you feel relaxed or comfortable. Once you have the image in your mind, focus your attention on it. This can distract you from the panic and help ease your symptoms.

Challenge unhelpful thoughts

The way we think about things has an impact on panic. Many of these thoughts are out of our control and can be negative and unhelpful. It's therefore important to remember that they are just thoughts and are not necessarily facts. Even though we may believe a lot of the unhelpful thoughts during a panic attack, these thoughts should be challenged as they are often based on incorrect assumptions. For example, misinterpreting the physical changes in the body during panic as 'I'm having a heart attack'. To challenge and answer this negative thought, you could ask: what could you have said to yourself that would have helped?

Becoming aware of the common patterns that unhelpful thoughts follow can help you recognise that you have them. Keeping a diary of what happens each time you panic can help you to spot patterns in what triggers these experiences for you, so you can think about how to deal with these situations in the future.