Living with panic attacks: 'When I was heavier, I was very uncomfortable with people looking at me I'd often arrive in a state of panic'
One in five people experience panic attacks. Arlene Harris asks experts how to manage stress in high-pressure situations
Stress is a fact of modern life, with more of us feeling anxious than ever before. But sometimes things can become too much, with one in five experiencing panic attacks.
For those who haven't suffered an attack, it can involve a feeling of panic so overwhelming that the person feels totally engulfed with fear and often finds it difficult to breathe or think logically.
Michelle Whelan Kennedy, psychotherapist with BiBo (a branch of Mental Health Ireland), says symptoms and length of attack can vary and affect anyone.
"Panic attacks can be triggered by ongoing high levels of stress or one-off stressful situations," she explains. "There are links with depression, anxiety and obsessive compulsive disorder, but they can affect anyone.
"During an attack, thinking rationally goes out the window. It can last for a few minutes or up to half an hour, but can seem endless and take some time to calm down after it has passed.
"The body goes into survival mode and feels intense fear or extreme anxiety with no direct known cause. Some of the symptoms are racing heart, tingling or numbness in the hands, sense of terror, chest pains, breathing difficulties, sweating, trembling, nausea, feeling unsteady and a sense of losing control. Any or all of these symptoms vary as part of a panic attack."
Jessica Spencer knows only too well how frightening a panic attack can be as her anxiety became so great, she had to take a year out of college in order to focus on her mental health.
"My first panic attack coincided with an exam, during which I became nervous and had a tickle in my throat," she says.
"Once I had finished (the paper), I started coughing and nothing would ease it. Everyone was looking at me and I asked to leave the room.
"The attention caused a choking sensation, bringing about more coughing as I needed air. It was a vicious cycle - the more I coughed, the more eyes that were on me, leading to more stress and coughing. I went outside with one of the teachers and once I hit the fresh air, the panic subsided."
Over the course of a week, she experienced similar incidents in all but one of her exams. Neither water nor medication helped, so during a second week of tests, she began to suspect anxiety was at play.
"I soon realised that the coughing fits were isolated to my exams," says the 22-year-old. "I tried to calm my breathing and distract myself from the urge to cough, but at times it was overwhelming. I worried I was disturbing my friends and was concerned about how my own exam performance would be affected.
"It was difficult to calm myself when I didn't even realise I was experiencing panic - I had been living in constant fear so the panic was always there, so much so that I didn't recognise it for what it was. I was so disconnected from my emotions that I couldn't tell this wasn't normal. It was only months later that I started to investigate the possibility that I was suffering mentally."
Once Jessica realised that her feelings were associated with stress, she was able to pinpoint the activities which kick-started an attack.
"Most of my triggers were everyday issues," she says. "A common one would be walking outside alone, particularly along busy streets or places I'm unfamiliar with, where I could be seen by anybody. I've a general fear of randomly bumping into someone I know - particularly authority figures, such as lecturers or past teachers - outside of the environment I'd see them in usually.
"When I was a stone heavier, I was very uncomfortable with people looking at me, so walking to college would mean I'd often arrive in a state of panic.
"I have missed many days as the thought of walking five minutes from my bus stop to the college door was too stressful and overwhelming.
"I have even not attended classes although I was in the building as I wasn't early enough to be one of the first few in the room and the thought of everyone watching me walk in was too much - my mind raced with embarrassing scenarios, such as falling in front of the group."
Jessica, who was studying Film and Broadcasting at DIT before taking some time out (while working in a market research facility), is now doing well and would encourage others to seek help if they begin suffering from panic attacks. "At the moment, I'm on medication as anxiety had such a large impact on my life," she says. "I also attended counselling for over a year, which proved to be highly beneficial."
Michelle Whelan Kennedy says there are three approaches to dealing with panic attacks:
• short term - getting through the panic attack as best you can. Breathing is always a great exercise as your breath can anchor you. Using your senses by watching clouds or smelling something calming can be soothing, as can touching different parts of your body to stay in touch and connected with it;
• medium term - stress is inevitable so figure out how you can work towards creating more positivity and well-being in your life. Shift the focus from what results in panic attacks to looking deeply to what is creating well-being and joy in your life.
• long term - if you have anxiety and/or panic attacks, you need to have practices over your lifetime that will comfort and support you such as mindfulness, meditation, yoga or breathing work.
Dr David Carey is Director of Psychology at City Colleges and Dean of the College of Progressive Education. He says lifestyle changes can help to eliminate anxiety but people should seek help if their attacks are frequent and prolonged.
"Panic attacks can be quite severe at times and sometimes people fear they are going crazy or losing their minds," he says. "If they occur only once or twice in a lifetime, there is nothing to worry about - if they are frequent, they are most likely a part of panic disorder, which is twice as frequent in women as it is in men.
"The best way to prevent panic attacks is to incorporate regular relaxation and breathing exercises into your daily routine.
"Eat a healthy diet, get regular exercise, such as walking, and reduce stress when possible. Attacks can also be treated effectively with a combination of cognitive behaviour therapy and relaxation therapy, but sometimes medication is needed.
"In short, if panic attacks are frequent and severe, seek help from your GP as soon as possible. If mild or irregular, try to change your lifestyle with more relaxation exercises and proper breathing techniques."
Michelle Whelan Kennedy is speaking at Mental Health Ireland's 50th Anniversary Conference on Resilience, Mental Health and Well-being on November 21 and 22 in The Royal Marine Hotel.
Dealing with a panic attack in the moment
Psychologist Dr David Carey has some advice for what to do in the event of an attack:
“If you are having a panic attack, try as best as you can to find a place to sit down,” he says. “Breathe deeply and slowly for several minutes. If someone is with you, have them take your hand while you are breathing.
“Say to yourself, over and over: ‘This will pass, it is only a passing feeling, I am going to be OK.’ Take a moment to ground yourself by looking around you and naming five things you can see, five things you can smell, five things you can touch and five things you can eat.
“This may prove difficult, but by concentrating on the external world, you switch your focus of attention from the distressing sensations you are experiencing.
“In the long term, people with panic attack difficulties can benefit from lifestyle changes. Getting regular exercise is helpful. It does not have to be stressful exercise. Walking is quite beneficial. Get out and walk, a brisk walk, for 30 minutes three to four times each week. Cut down on caffeine intake and avoid any other sorts of stimulants.
“Eat properly and sensibly — four or five small meals a day is often better than gorging on a huge evening dinner.
“Cut down on alcohol consumption. If you are interested in a form of mindfulness, take a class — it can be hugely helpful.”
The Dublin-based expert offers a few simple ways to alleviate stress:
* regular exercise such as walking;
* taking a mindfulness class;
* eating sensibly;
* reducing caffeine and alcohol intake;
* getting out and socialising with friends;
* focusing on what is good and healthy in your life;
* if symptoms are severe, consult your GP.