“I feel like I am going to die”, “I feel like I’m going to lose control”, “I feel like I am going to go crazy” “I think I’m having a heart attack”, “I feel like I can’t cope”, “I feel like something terrible is about to happen” “I need to leave this place right now”
A racing heartbeat, feeling faint, sweating, hot flushes, nausea, an upset stomach, chest pain, shortness of breath, trembling, shaky limbs, chills, choking sensations, excess gas or belching...the list goes on.
Do any of these statements or symptoms sound familiar to you? Maybe even reading them you feel a sense of anxiety or dread if these are feelings you have felt before? Have you ever experienced thoughts like these accompanied by some of the physical symptoms mentioned above which in turn make you feel like you are in immediate danger and this comes with a sense of panic?
While some of these symptoms may have a medical explanation and we always recommend getting a check up with your local GP to rule out medical causes, they also may be caused by what’s known as a panic attack.
Panic attacks are actually more common than people realise and are not dangerous or life threatening and with the right treatment, panic attacks can be addressed and effectively dealt with. Maybe you are reading this blog because you already know it’s panic you are dealing with, or maybe you are reading this and realising now that it isn’t actually a heart attack or that you are going crazy or that you are in danger and that it may actually instead be the “panic attack” I am currently speaking of that may be the case for you.
Regardless of which category above you fall into, the following blog will aim to provide you with information on why we have panic attacks and what we can do about them.
In my work with clients, we often see a lot of clients experiencing anxiety or anxiety related issues present themselves for treatment at Evolve. Alongside anxiety, we often see clients presenting with panic related issues or panic attacks and clients may present at varying intensities of symptomatology, all treatable - but with varying requirements of durations of therapy and other individual additional needs. Alongside varying levels and frequency of symptoms, we also meet clients with varying levels of understanding or knowledge as to what is actually going on for them, and I always start with educating the client on what is going on - because I truly believe awareness is more than half the battle in dealing with mental health difficulties and it can bring great relief for a client to make sense of this often terrifying experience which comes with panic.
To simplify what happens during a panic attack I have put together the following and broken down what exactly occurs during the panic attack.
Panic attacks often have a sudden onset and come without warning, however - it is important to note that certain situations can trigger panic attacks and when fear is associated with an environment we previously have had a panic attack in, the cycle can repeat in anticipation and fear of an attack happening in the same place as last time which further creates a cycle of repetitive fear and panic without recognising this and getting appropriate support. Without support or appropriate interventions these attacks can frequently reoccur and becoming debilitating.
Research shows us that during panic attacks our body enters what’s known as a fight or flight state. An example of this fight or flight response would be if you were in a situation where a wolf or a lion was facing you and seemed like he was about to attack you. In this situation your heart rate would increase and your breathing may become shallow amongst other physical and psychological changes as your body would prepare itself to cope with a situation which was an immediate threat to life and these bodily changes may actually save your life in helping you respond to the threat by perhaps fighting, running away or freezing and staying still.
However, during a panic attack, often we are not facing an immediate threat like a wolf or a lion about to pounce on us, yet our body triggers the same response as if a threat was present and so we feel like we need to escape or respond to this perceived urgent situation. But wouldn’t you agree that if there isn’t a wolf or a lion about to eat us or there is no major threat to our life in this very moment of overwhelm and panic and we are just in our bedroom, on the bus, or in the classroom to name a few - that this response isn’t helpful and doesn’t serve a purpose besides creating discomfort and worry?
I highlight and underline the word perceived in the above paragraph when I say a “perceived urgent situation”, as I know my colleague Patrick Fitzgerald here at Evolve would agree with me when I say that a vast percentage of the work we do with clients is focussing on perception, and the impact our perceptions and beliefs or interpretations can have on our lived experience. our perceptions can either have a beneficial or negative impact on our mental well-being dependent on what we believe or perceive.
I understand so far there may be a lot of information to take in and process but again to simplify things, essentially what I am saying is, a panic attack is basically a situation where we believe we are in danger due to cognitive distortions or irrational beliefs, however, the fact is we are not in danger and it is all in our belief or perception about what is happening which causes the intensity of our distress and results in a panic attack.
So what can we do about this you may ask? Maybe you understand everything I have said so far but are still thinking, “I know this but I still have panic attacks, what can I do?”.
The rest of this blog will now focus on how we can work through these negative interpretations we have to reduce the intensity of our panic attacks and help us cope more effectively. I have broken these steps into 3 sections.
3 tips to help you cope with panic attacks
Understanding feared bodily sensations - When we experience a panic attack and the physical sensations which accompany them, we can often misinterpret what these bodily sensations are. We can often believe they are something rather than what they really are such as a heart attack or health complaint which leads to further panic. Cognitive Behavioural Therapy can help you restructure these thoughts or beliefs and begin to recognise when thoughts are rational versus when they are irrational. A common method we recommend to clients for this process outside of sessions is keeping a thought record. Keeping thought records provide a reflective space to identify our negative/irrational thoughts, rate the intensity of thinking this way has affected us, followed by coming up with an alternative healthier, more realistic thought and then acknowledging how believing the new thought may ease the intensity of how we are feeling. Like most methods this is not a one time fix and requires practice and often works best when working with a qualified professional.
Facing feared bodily sensations - When panic attacks and their symptoms become persistent, avoiding places and situations can often become an issue and I often see clients associate these situations or places with the panic attacks which is an evident cause of this avoidance. The client then avoids the situation in belief that this will protect them from further attacks. Why avoidance becomes a problem is that it perpetuates and affirms a persons belief that panic attacks are dangerous, when in fact they are not. This belief and avoidance then prevents the individual from realising that they can in fact cope with this and are not in actual danger. Facing these feared situations is called exposure and within a CBT context, I believe it to be one of the most effective treatments for fears and phobias and i have seen results with exposure techniques on both a personal and professional level. Exposure is essentially reclaiming your life from fear and panic. It may be a scary idea to face your fears but I promise you the reward of facing up to them feels much better in the long run than staying in the grips of perpetual anxiety.
Relaxation strategies - When stressed psychologically we can become physically stressed. Mind and body are directly connected and so learning to relax your body can be a beneficial part of anxiety and panic relief. Tense muscles and shallow breathing contribute to bodily discomfort which often causes further mental distress and there are many relaxation exercises which can help. When working with clients I often focus on two simplistic methods in particular. First is basic and essentially involves creating a rhythmic flow with your breathing, counting as we breathe in for 4 seconds, holding that breath for a further 4 seconds and then breathing out for a count of 8 seconds. Repeat this process for a prolonged period of time as you allow the body to relax and regulate. I call this the 448 method. Focussing on regulating the breath and counting can help ease physical and psychological distress. Secondly I like to use progressive muscle relaxation which involves a systematic process of tensing and relaxing various muscle groups in the body. Many PMR exercises can be found on YouTube and I would encourage you to give them a go. Later this year at Evolve we will also be launching a section on our website where we will be sharing our own meditations and relaxation audio and video files. All of these techniques like anything in life require practice and the more you practice them, the more effective they will be.
If you have read this far, I hope you have gained something beneficial from this blog. If you would like professional help with what you are going through with panic attacks or any other mental health related concern or issue, please feel free to get in touch with us by email at firstname.lastname@example.org or reach us using our contact us page.
Until next time, God bless.