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Panic & Anxiety (part 1)

Everyone feels anxious at some time in their life, indeed, a degree of anxiety is necessary for us to perform well in situations that require high concentration and skill. However, some people suffer from such severe anxiety symptoms that it may become a disability that interferes with their day to day life. In some cases, they may develop episodes of sudden and intense anxiety, known as panic attacks.

If a person suffering from intense anxiety or panic attacks, does not seek treatment (as many do not), they may mistake their symptoms for a physical illness such as a heart attack or a stroke, as many of the symptoms are physical. They may try to treat the symptoms on their own by the use of alcohol or drugs, or just suffer in silence. Over time, the experience of panic attacks leads people to avoid situations where they fear that they may experience further attacks. For example, someone who has a panic attack in a shopping centre may then avoid ever going to a shopping centre again, for fear of a reoccurrence and this anxiety will often spread to exclude other crowded and noisy places.

What are the Symptoms of a Panic Attack?

A panic attack is a sudden burst of acute anxiety that may last from 2 -30 minutes, but at the time it feels as though it is lasting for ever. Afterwards, the sufferer may feel weak and exhausted. Attacks can occur several times per week or even several times a day. Everyone experiences them differently but these are some of the most common physical symptoms:

Difficulty breathing
A feeling of choking
Tightness or pain in the chest
Trembling, weakness
Sweaty palms and excessive perspiration
Tingling or numbness in the hands and feet
Palpitations or pounding heartbeat
Dizziness, faintness
Feeling out of touch with your body
Nausea, churning in the stomach or lower bowel
Feeling hot and cold or flushed

In addition, people may experience emotional symptoms or distressing thoughts:

I am going insane/crazy
I am going to lose control
I am going to faint/collapse
I am having a heart attack/ stroke
I am going to start screaming and make a fool of myself

The likelihood of any of these things happening is remote but the fears during the attack are very strong.

How do I Reduce my Panic Attacks?

Seeking professional help is always advised but there are things that you can do by yourself, to both reduce the anxiety and regain a feeling of control.

Make a list of your major symptoms of anxiety/panic
List the major known triggers for your anxiety/panic
Monitor your panic attacks: Keep a daily list for at least one week.
Reduce physical stres s by r egular exercise, which will increase your mental tolerance of stress. Note the following points before you determine your exercise regime.
- Choose an exercise that you enjoy
- Make sure you have the right equipment & clothing
- Start with light exercise
- Exercise with a friend if it suits you
- Establish a routine
- Reward yourself for exercising during the first 2 weeks
- Be tolerant of interruptions but return to your plan as soon as possible

Improve your nutrition: Eating sensibly will also reduce stress. Regular meals mean that you will not experience wide swings in blood sugar levels which can produce similar symptoms to anxiety.
- Drink plenty of fluid throughout the day, especially water
- Avoid crash diets and fasting
- Eat regular meals, 5-6 small meals a day are better than 1 large one
- Limit or give up coffee and tea (other than herbal)
- Keep alcohol consumption very low
- Give up smoking if possible or strictly limit it
- Avoid stimulant or mood altering drugs unless prescribed by your doctor
- Eat a healthy diet with plenty of fruit and vegetables
Get plenty of sleep. Most people need between 7 -9 hours sleep per night. If you are constantly tired or wake feeling unrefreshed, you may need to work out the problem areas so you can improve the quality of your sleep.

How do I Control my Panic Attacks?

(A) Dealing with hyperventilation:

There are 2 methods which can help you to slow down your breathing, which may stop a panic attack from arising.

Slow Breathing
- Focus attention on your breathing
- Practice abdominal breathing by placing your hand on your stomach and gently expand the muscles in that region every time you breathe in. At the same time, try to reduce movements in your chest and shoulders whilst breathing
- Now on your next breath, hold it to the count of 10
- Now slowly exhale
- Now breathe in to the slow count of 3, and then out to the slow count of 3
- Continue breathing at this rate for at least one minute
- If you still feel panicky, hold your breath for a further 10 seconds then repeat the exercise
Paper Bag Technique
- When you feel panicky, place a small paper bag over your nose and mouth. Keep it firmly in place with your hands
- Now breath slowly and regularly into the bag until the panic attack subsides
- A similar effect can be achieved by cupping your hands around your mouth and nose and breathing slowly

(B) Distraction techniques:

Rubber Band Technique
- Wear a rubber band loosely around your wrist
- When you feel a panic attack starting stretch it out and let it snap back on your wrist
- Often the short sharp pain will be enough to redirect your attention away from the panic or give you time to start breathing techniques
Counting
- By counting objects in your environment you may be able to distract your self from a panic attack
- You could count the number of white cars passing, a number of windows in a building, the number of people with red hair etc.
Visualising
- Imagine your self in an enjoyable setting, either real or a fantasy
- Think of a place that is special and safe and make all the details as possible e.g. sounds, smells and sights
- Practice the same scene over and over again to make it easy to slip into this place when you start to panic
Everyday activities
- Simple things like talking to a friend on the phone, watching TV or listening to music