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Hannah’s helpful hints: Panic attacks

What is a panic attack?

A panic attack can feel extremely scary and overwhelming, particularly if it feels like it comes out of nowhere without a cause.
So what is a panic attack?

Panic attacks are a fear response to perceived danger or threat. A panic attack is an exaggerated intense physical reaction.
Thankfully, despite being distressing they cannot harm us, and treatment for panic is highly effective.
This blog will help you to better understand panic attacks – the signs and symptoms, the causes and treatment.

What are panic attack signs?

The signs of panic attack include:

  • Intense physical symptoms lasting from 5 to 30 minutes
  • Feeling like you are losing control
  • Difficulty breathing and tight chest
  • Fear that you will pass out, have a heart attack, go mad or die
  • Avoiding places/situations for fear of the symptoms happening again

What are the symptoms of a panic attack?

The list below is of the most common symptoms of a panic attack.
Each person’s experience can vary, so this is not an exhaustive list.

  • Heart palpitations or heart racing
  • Difficulty breathing, struggling to catch your breath
  • Tight chest, chest pain or discomfort
  • Sweating
  • Hot flushes or cold chills
  • Trembling or shaking
  • Dry mouth
  • Nausea or stomach churning
  • Feeling dizzy, unsteady, faint, or light-headed
  • Numbness, tingling, or pins and needles
  • Feelings that objects are unreal or that you are not really here
  • Fear of losing control
  • Fear of passing out or fainting
  • Fear of having a heart attack
  • Fear of dying

Panic Disorder and Agoraphobia

Because panic attacks are so overwhelming, it is understandable that we might become anxious about them happening again.
This is when Panic disorder develops.

Common changes in how we act can include:

  • Trying to control breathing
  • Drinking water
  • Carrying mints
  • Taking diazepam/propranolol
  • Opening windows
  • Sitting down/holding on
  • Going outside
  • Monitoring heart rate
  • Avoiding activities that create symptoms that feel like a panic attack e.g. exercise

If you have experienced a panic attack in a particular place or situation, you might find you start associating this as being the trigger, and therefore want to avoid it. This is what is known as Agoraphobia, avoiding situations that we fear we cannot easily escape from and worry a panic attack will happen in.

Common situations that are avoided include:

  • Public transport
  • Shopping places
  • Sitting in the middle of a row, e.g. at a cinema/gig
  • Town centres
  • Places away from home/comfort zone
  • Busy places with lots of people

What are the causes of panic attacks? The fight or flight response

To understand the causes of panic attacks, we need to first understand our survival mechanism – the fight/flight/freeze response.
This survival response is there to protect us from danger, it enables us to perform to our maximum capacity whether that is to run (flight), battle (fight), or stay still (freeze). This is an amazing system that we have as humans. For our body to function in this superior state, it needs to go through several bodily changes.

To deal with danger our body:

  • Redistributes our blood moving it away from our extremities (fingers, toes and head) towards the major muscle groups (this can make us feel lightheaded, dizzy, have pins and needles or tingling)
  • Pumps our heart faster to increase blood flow (this can make us feel like our heart is racing)
  • Tries to take in more oxygen (this can make us feel short of breath and tight chested)
  • Cools our body down (this can lead to sweating or clammy feelings)
  • Stops digesting food as this is not a priority (this can lead to stomach churning sensations)

All the changes that our body goes through as part of the fight or flight response are there to enable us to deal effectively with danger – to fight the danger, run away from the danger or the third (often less talked about response) to keep us still (freeze). You will hear testimonies of people at disaster events describing running faster than they’ve ever run, or lifting things they never knew they could lift, or freezing still without getting any cramps. Our body is performing to its optimum ability. If there was a real danger, we would be so thankful.

Unfortunately, sometimes this message is false – it’s a false alarm. Our brain is incorrectly been told there is danger when there isn’t. This is what happens with anxiety, the brain has had a false message that we are in danger (when we are not), and therefore suddenly sends us the fight/flight response in case we need it. All these bodily changes happening at once can be really scary.

How can I get help with panic attacks?

The first thing to know is that the fight/flight response can’t harm us, it’s not going to lead to death or us passing out or having a heart attack. As said above, it’s there to protect us, our body can sustain this response for a prolonged period of time.

If we know that there is no danger, we know that it’s a false alarm.
The good news as well is that therapy is highly effective and relatively short term.

CBT for panic looks at providing education, helping you to challenge your thoughts/worries, and teaching you how to respond differently when the false alarm happens, which ultimately will lead to a reduction in this happening at all.

What are the options for treatment for panic attacks?

The recommended treatment for panic attacks is Cognitive Behavioural Therapy (CBT).
CBT is available through the NHS via a GP referral or self-referral https://www.nhs.uk/service-search/find-a-psychological-therapies-service/

You can also access CBT for anxiety privately.

There are also a number of helplines for panic/anxiety:

If you would like to find out how I can help you to achieve Freedom from panic, get in touch on

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