– under the umbrella of issues that anxiety covers. Panic attacks are debilitating. They can make you think you’re dying – so often people who experience them initially think there’s something seriously wrong physically. When I first experienced them, I thought I was having: a heart attack, a stroke, a brain aneurysm. Often you think you’re about to pass out. Let me get this straight first up: YOU ARE NOT GOING TO PASS OUT.
Probably. I’m not a doctor. But many doctors have told me that panic attacks rarely lead to fainting. You might feel dizzy for sure, and the earth might feel like it’s moving beneath you, BUT: during a panic attack, your heart beats faster, and your blood pressure rises. When people faint it’s normally because of a sudden drop in blood pressure.[7] So strike that off your list of worries. I’ve had so many panic attacks I could write a thesis on them, and I’ve never once fainted during an episode. From kissing a boy aged eighteen, sure, but never from a panic attack. Remind yourself of this – it’s important! So many people develop a fear that they’ll pass out and it can bring on the anxiety cycle we talked about earlier. If you feel wobbly, sit down for sure, drink some water, but don’t worry you’re going to stack it right outside Starbucks, because you won’t.
OK, good – moving on. I’m going to write down a list of panic attack symptoms – and you tick the ones you’ve experienced.[8] This isn’t an exhaustive list but these are the very common ones. It’ll be like a fun puzzle exercise, except it’s about mental illness and there’s no fun involved. Tricked you. OK, GO!
Truly horrible bloody things. What’s your worst symptom? Mine is that I can’t breathe. I pull at my throat and gasp a lot. Which makes me think that people must be noticing my freak-out and that can make me more panicky. But here’s the thing. Mostly, panic attacks are happening beneath the surface – like when a serene duck is barely moving on the water but actually its feet are frantically paddling. All the things going on in your mind and in your body feel IMMENSE but are normally not visible to a passer-by. Think about how many times you have seen a stranger having an anxiety attack – I’ve never seen one person experience one and I have them myself. So put that worry out of your head. So many people worry that they’ll cause a scene and look stupid when, in actual fact, human beings are really self-absorbed and barely notice anything you’re doing unless you fall over. Then they notice, trust me (I fall over a lot).
The irony of it all is that actually a really good thing to do when you’re feeling a panic attack coming on is to talk to someone. Make a human connection, look into someone else’s eyes and force your brain to concentrate on something else. And this isn’t only a practical bit of advice. In my quest to get everyone on earth (I’m grandiose like that) talking about mental health, I think it would be amazingly helpful if we could tell a stranger that we’re feeling a bit anxious without feeling silly or ‘mad’. If someone told me they were panicking I’d try and be as helpful and reassuring as possible – as would most people, I think. Wouldn’t it be lovely if we felt able to do that?
There’s lots of advice on how to overcome panic attacks – from your GP to charities like MIND, from eminent psychiatrists to quack practitioners. Some of it’s good, some of it’s unhelpful. I’m not a professional (at literally anything) so all I can tell you is what works for me. And normally it’s a multi-pronged approach – no ONE thing is guaranteed to nail it. What helps is having a toolbox full of things that help and being able to pull them out when needed.
• Focus on your breathing. In situations like this, there’s a right way and a wrong way to breathe. You probably take shallow breaths when you start to panic – and many people start to hyperventilate (inhaling deeper or taking quicker breaths than usually).[9] Normally, you breathe in oxygen and breathe out carbon dioxide (hello GCSE science). But when you hyperventilate, the carbon dioxide levels in your bloodstream drop. You start to feel sick or dizzy, and this provokes more panic. So you need to calm your breathing down. Easier said than done, I know. I begin by taking one big breath and telling myself, ‘I CAN breathe.’ Breathe in through your nose, and put one hand on your chest and one on your stomach. Notice the breath move through your body – you should feel your stomach move but your chest should remain pretty still. Keep doing this for as long as you need to until you’re convinced that you can breathe.
• Find a quiet place to sit down. If you feel like you’re going to faint (even though you’re not), take a seat, but don’t hunch up. Keep your chest broad so that you can keep on taking proper breaths.
• Notice your surroundings. It helps me to focus on the sky, or on an interesting building, or to watch a dog walk past. Anything to centre you back in your surroundings.
• Try not to rush away. The instinct is SO strong to get the fuck out and head for ‘safety’ but, in doing so, you can set up problems for yourself in the future. If you feel scared in a place and leave before you calm down and realise that there’s nothing to really fear, then your brain tends to designate that place as ‘unsafe’. Then you start to avoid places and your world can get really small really fast. So stick it out if you can. Just as an example, leaving the scene of a panic attack meant that I later avoided:
– Planes
– Lifts
– Busy spaces
– The centre of London
– Sainsbury’s
– Theatres and cinemas
– Motorways
– Coaches (not really, I just don’t like coaches. Not enough toilets)
• Focus on your senses. Touch something soft, stroke your own arm, smell the air. Panic attacks can make you feel very far away from your own body – try and reconnect with it.
• Talk to someone – make eye contact. Stroke a dog, smile at a waiter. It can help to make you see that you’re not in danger. If there’s nobody around, call a friend and tell them that you just need two minutes to talk – a little encouragement from my sister really helps when I’m feeling like I might have an attack.
• Expect that afterwards you’re likely to feel exhausted, trembly and sometimes a little teary. The adrenaline has dissipated and your body is wrung-out. Get yourself some food, drink lots of water, sit down for a bit. Keep warm – often panic attacks leave you cold and shivery. Be nice to yourself; don’t berate yourself, don’t tell yourself it’s pathetic. Nobody asks to have panic attacks – it’s not a sign that you’re weak or incapable. Tell yourself that you’re OK, you handled it well, you’ve done well to get through it. Anxious people have minds working against them, the last thing you need is to add fuel to that.
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