Panic attacks

What are panic attacks?

Panic attacks are sudden periods of intense fear or extreme anxiety.  They occur when the 'fight or flight' response is triggered, although there is no sign of danger. 

The fight or flight response is a survival system that your body uses - it means that when your brain thinks it is in danger, your body gets ready to fight or run away.  If you are experiencing a panic attack, the body will react like you are in a dangerous situation even though you are not.

Panic attacks can happen without any warning. The attack could last for a few minutes or up to half an hour.  After the attack, it might take some time to start to feel ok again. 

It is not unusual for someone to experience a panic attack - one in five people will have at least one in their lifetime. 

After experiencing one panic attack, it is not uncommon to worry about having another. You might even start avoiding situations or activities that you think might trigger an attack, like shopping centres, public transport, aeroplanes, lifts or being alone. 

What are the effects of a panic attack?

The effects of a panic attack vary from person to person. Some effects may include:

•  sweating
•  feeling short of breath, like you can't get enough air
•  pounding heart
•  chest pains
•  feeling unsteady
•  feeling like you're choking
•  dry mouth
•  hot or cold flushes
•  tingling 
•  feeling faint
•  trembling 
•  nausea or diarrhea 
•  feeling like you're losing control or you can't escape.

If you are experiencing any of these effects it is important to look after yourself.  See the section on how to manage panic attacks for more info.

What causes panic attacks?

The causes of panic attacks are still being researched. However, there is evidence that different types of stress such as ongoing stress or a one off stressful event is associated with panic attacks. The stress alters the chemicals in your body that influence the fight or flight response. 

There are some illnesses such as diabetes, asthma, or inner ear complaints that have similar symptoms to panic attacks so it is a good idea to check with your doctor to see if the symptoms are due to the illness. 

Depression, anxiety, and obsessive compulsive disorder have also been associated with panic attacks. For more information about depression, anxiety or obsessive compulsive disorder check out the fact sheets listed on the left hand side of the page.

How can I manage panic attacks?

Self-talk

Remind yourself that this is only an uncomfortable feeling and it will pass. To help it do so try and distract yourself by thinking about something different, like counting backwards in 3s from 100 or sing the lines of your favourite song, or see if you can concentrate on your breathing, so you have to focus your attention on something else.

Diet

Be aware that stimulants, like coffee, coke, anything else with caffeine in it (for example, energy drinks), drugs, alcohol, and smoking can all act as triggers for a panic attack. 

Exercise

When you start panicking, a lot of hormones start pumping like adrenaline. They keep you feeling panicky.  A way to help get rid of those hormones is to exercise, especially doing something that raises your heart rate. Regular exercise can help lessen panic attacks.

Relaxation

Relaxation techniques are a really good idea. If you are having a lot of panic attacks, it can help to get a relaxation CD, and listen to it for half an hour (or however long you like) every day. This can help to reduce your overall stress. Check out the Relaxation fact sheet.

Other forms of relaxation are also useful, such as yoga, Tai Chi, meditation, swimming, and going for a walk.

Slow breathing

This is something you can practise while you're not having an attack, and when you get good at it, try to use it while panicking to slow your breathing down:

• Hold your breath and count to 10, then breathe out.
• Breathe in through your nose for the count of 3, then out through your mouth for the count of 3. Continue this for one minute.
• Hold your breath again for the count of 10. 
• Do this for about 20 minutes a day (and you could break it up, like doing 4 5-minute sessions), and any time you're feeling panicky.

Seek help

If you are having a lot of attacks, or if they are getting in the way of your lifestyle, it is possible that you are suffering from a panic disorder.  It can help to see a psychologist, especially one that specialises in anxiety disorders.

Cognitive behavioural therapy, and in some cases medication, can both help ease panic attacks.  Check out the Cognitive behavioural therapy fact sheet for more info about this form of treatment.

Panic attacks can be frightening experiences, but if dealt with properly, can be overcome. The important thing is that you look after yourself and seek help to avoid future panic attacks.