Nine tips about panic attacks

Panic attacks are a sudden and overwhelming experience of anxiety and fear. They can be an abrupt escalation of pre-existing anxiety or can seemingly arise out of the blue.

One study found one in four people reported having had an anxiety attack at some point in their life, but other sources have suggested that  as many as a third of Australian university students reported suffering a panic attack.  Women are more prone to them, and though they can be experienced at any life stage the typical onset is between 25 and 30.

Symptoms range from dizziness or trembling, to a racing heart or rapid breathing, sweatiness of feeling extreme hot or cold. The manifestation is so intense and physical that sufferers do not realise it is prompted by psychological factors. In the moment, many believe they may die.

Adrenaline plays a significant role in panic attacks, with physical symptoms occurring when the body is flooded with the hormone in response to a perceived threat. Associate Professor Vijaya Manicavasagar, an anxiety and panic expert who heads up psychological services at the Black Dog Institute in Sydney, says: “The hormones that flood your system are finite and need to be replenished. So an attack can only last 15-20 minutes before your body starts to return to normal. If you can ride it out you will start to feel better.”

Psychologists recommend a range of strategies to help you contain the symptoms of a panic attack. This may include deliberately breathing slowly, or breathing into a paper bag (just as in movies of old), or trying simple distraction, such as turning on a TV show or piece of music or calling a friend.

Associate Professor Manicavasagar says that sufferers who can identify the factors that contributed to the attack generally fare better. “It is a good thing to pin a reason on the attack.  If you are able to reassure yourself that it was prompted by, say, that exam or your worry about you mum’s health, you are less like to catastrophise and worry that another will strike at any time”.

Many lifestyle factors – such as over-consumption of coffee, lack of sleep, stress or underlying health issues – can trigger or contribute to the attacks. Addressing these triggers and ensuring a healthy lifestyle can help keep other panic attacks at bay.

It is possible to have one or two panic attacks and then experience no re-occurence. However, panic attacks left unaddressed can lead to a panic disorder, which is defined as several panic attacks a month and/or a disabling fear of experiencing further panic attacks. Associate Professor Manicavasagar calls this a ‘fear of fear’ and it has been linked with the development of agoraphobia.

Psychologists use cognitive behaviour therapy to help suffers identify and alleviate the symptoms of panic attacks or panic disorder. Associate Professor Manicavasagar says: “Many sufferers are still reluctant to seek help, and it is thought many suffer for years because of stigma, but CBT can give people the skills to understand their triggers and manage the symptoms so these attacks don’t adversely affect their lives.” In other cases, psychologists use a form of exposure therapy, in which they guide sufferers through exposure to places or experiences they feel may trigger attacks.

 Associate Professor Vijaya Manicavasagar is author of the forthcoming book Overcoming Panic (Little Brown).