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Panic Attack

Panic Attacks: What Is It and How To Manage It?

According to the Institute of Mental Health (IMH), about 20% of adults experience at least one panic attack in their lives; many of them reported that their first episode occurred in their late 20s and early 30s.

Someone having a panic attack experiences apprehension or intense fear suddenly when triggered by a stressful situation, or for seemingly no reason. It can last between 20-30 minutes, even though some people also experience it in waves over hours.

Diagnosed with Generalized Anxiety Disorder (GAD), the following is my personal experience and some helpful methods I am using to manage my panic attacks and anxiety.

These tips should not be used as a substitute over professional opinion, and we highly recommend you to consult a doctor if you are experiencing disruptive episodes of panic attacks. The Mental Health Helpline is available 24 hours at 6389 2222, as well as the Emergency Department of the IMH should you require immediate medical attention.

My first vivid memory of a panic attack occurred when I was around 14. I remember feeling an intense fear after being reprimanded by my uncle. I started blaming myself for my mistake, and eventually broke down in tears where my breathing intensified into hyperventilation.

While there was a trigger in one of my earliest memories of an anxiety attack, there have also been instances during my adulthood, when I experienced a panic attack out of the blue.

A panic attack for me begins with a feeling of heaviness on my chest, and I feel unable to breathe. I sometimes also feel nauseated, which intensifies my fear. By the time I am breathing rapidly and feeling numbness on my face and fingertips, I know that I am experiencing a full-fledged panic attack.

There were also more serious instances where I fainted and required medical assistance.

What are the signs of a panic attack?

I have learned to recognize the early signs of an panic attack as mentioned earlier. These signs can vary across individuals, although the symptoms usually are:

  • Tightening of chest
  • Pounding heart
  • Difficulty breathing, choking, or rapid shallow breathing
  • Dizziness or feeling light headed
  • Nausea
  • Fear of going crazy, or losing losing control
  • Uncertainty of what is real (distortion of reality)

Fear and Anxiety are common natural responses to a perceived threat.

Learning to identify potential stressful triggers and warning signs of impending panic attack may require some practice initially. However, mastering some coping skills will prove to be helpful in learning to manage fear and anxiety before it escalates.

Stress management and relaxation techniques will also be helpful in reducing one’s risk of stroke and heart attack. If left unmanaged, anxiety has been found to be related to one’s long term risk of stroke.

Focus on one thing

One of the first things I learned during therapy is mindfulness. One way to do this, is to find one thing in my vicinity and focus on it.

For example, if you are in the office, you may notice your coffee mug in front of you. Draw your attention to it with your senses. Reach out to touch it, feel the warmness of the cup, observe its colour(s), hold the mug closer to you and inhale the aroma of your drink, or even take quick sips of it to help regulate your breathing back to normal.

Breathe

Someone having a panic attack may be breathing rapidly and feeling breathless. If you notice that this is happening, learn to perform deep breathing exercises, counting to 3 as you inhale, and counting to 3 as you exhale. Repeat this until you feel like you can breathe normally again, or when the fear has subsided.

Distract Yourself

Fidget spinners are the craze these days as they help distract some individuals by keeping their hands busy. But if you don’t have a fidget spinner, you can distract yourself in other ways like spinning a pen, playing a game on your mobile device, or listening to music. It may also be helpful to change your environment for a while by leaving the room or office, paying attention to the pleasant change of surroundings.

Personal Mantra

Another thing that has helped me cope in overwhelming situations is to mentally recite a personal mantra. Some examples are:

  • “I can do this.”
  • “I am safe.”
  • “I am feeling fear. This is normal. It will pass”
  • “I will be okay.”

Imagine a Safe Space

Is there a place you have visited before that makes you feel happy and calm? It could be your home, the beach, or simply a picture you have come across on the internet. Try to picture that in your mind, and think of how it makes you feel – calm, happy, peaceful, excited, safe, etc.

You may also find it helpful to keep a picture of it at your desk or in your phone so that you can look at it.

What can I do to help someone with a panic attack?

If you notice a loved one having a panic attack, remember that it is a scary experience for them. Keep calm, and:

  • Stay with them
  • Ask them what they need, or how you can help
  • Practice some of the coping techniques with them, as described earlier
  • Reassure them that help is available

I personally find that what helps me most, is when someone tells me “you are safe.”

When Does a Panic Attack Become a Problem?

  • Affects daily functioning in life
  • Unable to go to work, attend school, or refusing to get out of bed

I eventually sought help and was diagnosed with GAD when I realized that it was affecting my life.

I was reluctant to get out of bed in the morning, often imagined the worse case scenarios even before arriving at the venue, and would often find excuses not to turn up at social gatherings or events at work and school. And if I did eventually turn up, I would often experience such intense apprehension, that I would have an anxiety attack which worsened my fears of going out.

If you notice yourself having panic attacks as frequently as several times a week, intensifying with every subsequent episode, or to the point where life has been disrupted, it may be time to reach out for help.

Help is available.

Consult your family doctor and if possible, make a list of physical symptoms that you have experienced.

With counselling and medications, I am now more mindful of stressors and warning signs to a potential panic attack, as well as equipped with techniques to manage my intense fear and anxiety.

Experiencing panic attacks frequently is also an indication that one is undergoing a stressful period, which should be assessed by a professional since this can also increase one’s risk of stroke or heart attacks. In addition, anxiety may sometimes manifest as emotional or aggressive outbursts that may cause harm to your loved ones and hurt relationships.

When in doubt, it is recommended to err on the side of caution and seek the opinion of your family doctor.

You are safe.

References

  1. Institute of Mental Health (2012). Managing Panic Disorder. Retrieved from https://www.imh.com.sg/wellness/page.aspx?id=555.
  2. Anxiety and Depression Association of America (2018). Panic Attack Symptoms. Retrieved from https://adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms.
  3. Better Help Online (2018, December 14). Learn How to Stop a Panic Attack in Its Tracks. Retrieved from https://www.betterhelp.com/advice/panic-attacks/learn-how-to-stop-a-panic-attack-in-its-tracks/.
  4. American Heart Association (2019). Anxiety Linked to Long Term Stroke Risk. Retrieved from https://www.goredforwomen.org/en/about-heart-disease-in-women/latest-research/anxiety-linked-to-long-term-stroke-risk.

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