It’s Not All In Your Head: I Had A Panic Attack But I Thought I Was Dying!

Have you ever had a panic attack? 5% of the UK population can suffer from regular panic attacks, and these are very physical and emotional experiences. Sometimes there can be a long build up to it, with stress and tension happening for days or weeks beforehand, but often it can feel like it comes out of nowhere, and is a big shock to the system.

Many of my patients have suffered from a series of panic attacks or had one which has been so big, they felt they were having a heart attack and may have ended up in A&E in hospital. Whatever the reason for the attack, most people come for help because they are very frightened about losing control and causing it to happen again. These feelings are completely understandable, and anyone who has experienced one will know how terrifying and overwhelming it can be. But as with a lot of psychological reactions, knowing what is happening to you is half the battle to conquering it, and not feeling frightened about it goes a hugely long way to controlling it.

The symptoms of a panic attack are very physical and include some or all of these:

• Difficulty breathing
• Palpitations
• Dizziness
• Nausea
• Chest pains
• Sweating
• Visual disturbance
• Feeling “unreal” or dissociated
• Shaking

What causes panic attacks?

A panic attack is an exaggeration of the body’s normal startle reaction to a dangerous or fearful situation. If you are driving and a dog runs out in front of you, your adrenaline would help you to break quickly. You would also experience some of the above symptoms, with pounding heart, sweaty hands, very tense muscles and breathing very fast. However, once the danger is over, your body would calm down and you may thank your lucky stars that no one was hurt and you can carry on with your day. This was a natural, and helpful reaction.

But what if that reaction happened when you were just going around the supermarket, doing your weekly shop? Or sitting in the cinema waiting for a film to start, or even thinking about leaving the house and having a panic attack? It is likely that you will try to make sense of the situation, and jump to conclusions about why it has happened. You are also likely to avoid the situation that apparently caused the fear to try and stop it happening again.

This results in your fear reaction becoming hyper-sensitive and being easily triggered by events which remind you of the awful feelings. So, you stop going to the supermarket, or to the cinema, or even going out of the house.

When you worry about something it can be hard to distract yourself and it can become very persistent. One worry can lead to another and so on, and lots of negative thoughts will cause your mood to be low, to feel more tired, and that can affect your coping resources and make you more susceptible to anxiety. Anxiety and fear can also be made worse by substances like alcohol, nicotine, caffeine or hunger.

Is Panic Dangerous?

No, no one can die of a panic attack. The feelings may be horrible but they are actually a normal reaction (which would usually keep you safe from harm), but which have been unfortunately triggered by a normal situation. You are not having a heart attack, or going mad, or going to faint. You need low blood pressure to faint, and a panic attack with raise your blood pressure, not lower it, due to increased heart rate.

Five Tips For Coping With A Panic Attack:

1. Remind yourself that panicky feelings are normal reactions, just in the wrong place – they won’t hurt you.
2. Take some slow deep breaths, in through your nose and out through your mouth. Tell yourself that you are safe and nothing bad is happening.
3. Rate your anxiety between 0-10, where 10 is extremely high, and monitor your level over a few minutes. It should start to come down as you start to slow your body down.
4. Notice which muscles are tense and stretch them out to help them relax. Pull your shoulders down, unclench your hands, if your mouth is dry sip some water.
5. Stay with the situation. Try not to get away from it or avoid it. Once your brain understands there is nothing dangerous going on it will calm down and be much better next time.

Dr Sue Webb

Chartered Clinical Psychologist

August 2022