PART 1: WHAT ARE PANIC ATTACKS?
If you’ve ever had a panic attack, you’ve probably spent a lot of time and energy since worrying about when and where you are going to have another one. That’s because panic attacks are pretty horrible experiences on so many levels.
Firstly they are incredibly uncomfortable physically. Symptoms vary a bit, but typically they start with a flutter in the belly or heart, ora woozy movement in the stomach, which can make you, the sufferer, feel sick. Then your heart starts racing and thumping wildly in your chest. You start breathing hard and fast, and feel like you are suffocating from lack of air, so you breathe harder. You might have the urge to vomit or go to the toilet. You might feel dizzy, and, if upright, sometimes fall onto the floor [which can hurt]. If the attack continues for a long time, parts of your body might start to feel numb or cramped, and your fingers might even curl up uncontrollably into a claw shape. As I said: incredibly physically uncomfortable.
As well as the physical discomfort, there’s the intense emotional fear that accompanies panic attacks. The sensation can be overwhelming. Many liken the experience to feeling like they are about to die. Majorly scary.
What’s worse is the panic attacks often come out of the blue; with no obvious situation or event triggering them. And sufferers often worry that they might have a serious physical condition, or worse still, a mental illness… that they might be going mad.
Then there’s the social embarrassment. It’s bad enough going through all this, but having people watch while you pant and panic can feel devastating, particularly if you’re exposed in a setting where you might feel judged, such as a workplace, or school, or party, or bus, or restaurant… anywhere in public really.
For all these reasons, people who have suffered a panic attack can get very very anxious about having a similar experience, so they obsess about them, and go out of their way to avoid public situations.
Does this sound familiar? If you have been through this, or if you care about someone who has been through this, know that you are not alone. There are literally millions of people like you who have experienced one or more panic attacks, or who love someone who has experienced a panic attack.
So why do panic attacks happen?
A panic attack is triggered by the primitive part of the brain that, amongst other things, reacts to danger and tells the body to get ready for action. This part of the brain automatically sends chemicals into the blood stream that make the heart beat faster, the lungs work harder and the senses go into red alert.
It’s a survival mechanism in the right context. If, for instance, you were being attacked by a wild animal in the jungle, it would be great to have your senses go into hyper-alert, and have extra oxygen pumped to your muscles, so that you could quickly escape, or so that you could fight back with super strength. This is called the fight or flight response. It looks after us appropriately in those sorts of dangerous situations.
Not so when the fear response is caused by something you can’t run away from or fight, such as a gradual accumulation of stress, or a triggered traumatic memory, or, indeed, fear of having another panic attack. These sorts of situations can trigger the body’s fight or flight response, along with the accompanying heavy breathing and pounding heart. But when there’s nowhere to run and nothing to fight, all that extra pumping and breathing can cause distress and, very importantly, can put the carbon dioxide [CO2] and oxygen [O2] levels out of balance in your blood stream.
That chemical imbalance is what makes you feel dizzy and tingly and breathless. It can cause a tight feeling in the body, and even lead to the clawed fingers mentioned earlier.
PART 2: HOW CAN PANIC ATTACKS BE CONTROLLED?
The irony is that, even though you feel like you don’t have enough oxygen and need to breathe in more, you actually need to breathe in less. Slowing down your breath, taking in less oxygen and breathing out more CO2 will correct the chemical imbalance, and quickly restore your body back to normal. None of the physical symptoms of panic are permanent. The worst that can happen is that, in your body’s attempt to stop you breathing too much [hyperventilating], it might make you become faint and pass out for a second. Your body is then able to take over and slow your breathing.
Slowing down your breath when you are conscious and feel like you’re suffocating is not easy. But with a simple strategy, it can be done.
If you feel a panic attack coming on you should first try to remind yourself what’s actually happening – that you are not going mad, you are not seriously ill, and that it’s not dangerous, so you’re not about to die [as long as you’re not balanced on a tight rope at the time]. Then remind yourself that you have enough oxygen in your body, and you need to get rid of some of the used up air [CO2] from your body to correct the imbalance.
Breathing into a paper bag can help you to reduce your intake of oxygen and correct the balance [so it’s not just a myth]. But, whether or not you have a paper bag handy, there’s a simple counting technique that is really effective.
Breathe in slowly while counting to 2 or 3 or 4 [the number’s not important]; hold it in for a second; then breath out as completely as you can to twice the count of the in-breath [4 or 6 or 8]; then hold it out for a second or two, and repeat the process. The idea is that you slow down the rate of your breathing, breathe out for twice as long as you breathe in, and think about counting, rather than focusing on how uncomfortable and scary your experience is. This corrects the O2 CO2 balance and focussing on breathing out completely tricks your brain into thinking that the danger is past; like when you ‘Phew’ with relief.
If you are with someone who is having a panic attack the best thing you can do to help them is stay calm and supportive. Then, without lecturing or patronising, let them know that they are having a panic attack and that it’s not dangerous. Let them know that, contrary to their instinct, they need to breathe in less, and breathe out more. Then help them breathe to a 1:2 in:out ratio. If you can easily find a paper bag for them to breathe into, that would help, but it’s not crucial, and you should be careful of paper printed with toxic ink.
So that’s it. If you are a sufferer, it’s not a bad idea to have a practice session with a support person. Do a bit of panting to bring the first symptoms on, then practice the breath count. In my experience, once a panic attack suffer is confident that he or she can control an attack, their confidence increase significantly and they are able to begin getting back to a normal life.
Remember, tell yourself you are going to be fine, and count your breath, keeping the outbreath twice as long as the in, and you’ll be on your way to freedom from panic.
Lorri Craig, Psychologist
For more information about treating anxiety and panic attacks without drugs go to:
