PANIC - How to beat panic attacks

About one-third of all Australians will suffer from a panic attack at some point in their lives. So why aren't we talking about it?

 

David Thompson* vividly remembers the first time he had a panic attack. He woke up in the middle of the night with his heart racing and could hardly breathe. "I thought I was dying of a heart attack," the 41-year-old father of two says. He has been experiencing panic attacks for the last 10 years, although he has now learned to recognise and control them. "It's extremely common to think you're dying the first time you have a panic attack," says consulting psychologist Lorraine Corne. "The first experience is very sudden and frightening, but the good news is that later attacks are never as bad as the first."

What causes panic attacks?

Professor Don Jefferys, from the department of psychology at Deakin University, says panic attacks usually stem from a fear of entering a certain situation or location, such as travelling down the freeway or walking into a cinema. "They can happen anywhere, at any time," he says. "Even when you are relaxing or sleeping." He says that nocturnal attacks, such as the ones Thompson experiences, can be the most terrifying ofWhile the trigger for a panic attack is psychological, the process that occurs is physiological.

According to the Victorian Government's Better Health Channel website, when the body is faced with immediate danger, the nervous system activates a "flight-or-fight" response. The body is then flooded with a range of chemicals, including adrenaline, that trigger physiological changes such as palpitations, a pounding heart or accelerated heart rate, feelings of nausea or dizziness, chest pain, shortness of breath and chills or hot flushes. There can also be feelings of losing control and a fear of dying.

Who does it affect?

Panic attacks can happen to anyone, although Professor Jefferys says they are more common in females than males and are mostly likely to occur in people aged 18 to 35. But he adds that children and the elderly can also suffer from them.

Corne says certain personality types can be more vulnerable than others. "If you're a bit of a perfectionist and you put a lot of pressure on yourself and others to get things right, this builds up anxiety and stress, which can lead to panic attacks," she explains.

A vicious cycle

Frequently, when a person starts to experience panic attacks, they will try to avoid situations that might trigger an attack. "One of the most common situations where panic attacks can occur is when someone drives through the Sydney Harbour tunnel," Corne says. "So if you've had an attack while driving through the tunnel, the next time you have to do it, you'll think, 'I'm going to be trapped, there's no way out, I'll crash into the wall'. So you will avoid routes that include having to drive through the tunnel."

What happens next is that your body will recognise the adrenaline signals and start to go through the motions of a panic attack. In short, panic attacks are driven by the fear of having a panic attack. "It's a vicious cycle," Corne says. Professor Jefferys agrees, saying this avoidance can lead to agoraphobic behaviour. "Most people with a panic disorder are concerned about a lack of oxygen. So if a panic attack sets in, the first thing they want to do is rush outside for air. Therefore, they'll avoid places they can't escape from quickly, such as large shopping malls or aeroplanes."

How panic attacks can be treated

Although panic attacks can be extremely frightening and upsetting, the good news is that no-one is untreatable, Professor Jefferys says.Cognitive behavioural therapy (CBT) is the most widely used psychological therapy in the treatment of panic attacks. It teaches patients how to identify their anxiety and change thoughts such as, "I am feeling dizzy, this means panic", to, "This is only dizziness, l can handle it". This helps patients to rationalise and deal with the symptoms they are experiencing, rather than letting them spiral out of control.

Corne says that after just three or four sessions, a patient will usually start to get a handle on the process they go through that creates the panic attack. "The next thing we do is to expose them to the experience that they fear - the one that causes the attack," she says. So, for example, if the patient's fear is of driving through a tunnel, Corne works with them to the point where they actually feel like they can attempt it.

Medication is another option. However, some anti-anxiety drugs are very potent and can produce side effects, so this option should always be given careful consideration. Also, while medication such as Zoloft and Prozac can give short-term relief, it is important that other strategies are used as well, including CBT and education about the condition.

Complementary therapies, diet, exercise, relaxation techniques and meditation can also help. The key is to find out what works for you. Thompson says focusing on slow breathing has helped him. "When I have an attack, my wife does slow breathing techniques with me, and keeps physical contact by holding my hand or touching me for reassurance."

Marisa Galetta*, a 38-year-old small business owner from Sydney's inner west, has suffered from panic attacks since she was just six years old. She says a combination of CBT and medication have helped, but adds that since she's got into the habit of looking after her health and wellbeing, the attacks have become fewer and further between.

"I'm careful with my diet, I exercise regularly and I make sure I get enough sleep," she says. "I'm also very organised. If I know I have a stressful period coming up at work, I diarise down time, including regular massages, and I make sure I don't drink too much to offset the stress. 

Reaching out

Understanding you're not alone, and reaching out to those around you for support, is vital, Professor Jefferys says. "It's important to have people around you can trust, because a lot of people who suffer from panic attacks have a fear that they'll be left alone somehow - a feeling of abandonment."

Charlotte Moore*, a 34-year-old graphic designer, says that when she suffered her first panic attack, she told her mother and partner immediately. "My mother was fantastic," she says. "She called a doctor to the house that very first night, kept a diary of my panic attacks and tried to find information to help me manage them. My partner at the time was a wonderful naturopath and helped me immensely with supplements and herbal concoctions."

Professor Jefferys explains: "Once someone has been treated for panic attacks or panic disorder, a whole new world is opened up to them - one they don't want to lose. So while the chance of a relapse is always there, it's easy to treat with a few 'top-up' sessions.

"I had a patient who suffered from panic attacks for around 20 years. He had become very agoraphobic and could only drive from his home to work and back again. His life was very limited and he couldn't go on holidays. We worked together for around 18 months and he has since gone on to travel overseas seven times - alone. He now has a whole new lease of life."

* Names changed.

How to cope with panic attacks

1. Breathe into a paper bag. Inhaling your exhaled carbon dioxide can quickly balance your blood gases and ease symptoms.
2. If you don't have a paper bag, hold your breath for the count of 10, then take slow and deep breaths using your abdomen rather than your chest.
3. Avoid "self-talk" that focuses your attention on your symptoms - don't tell yourself to "stop panicking" or "relax".
4. Remind yourself that the symptoms of a panic attack are uncomfortable, but not life threatening. Reassure yourself that you've felt these feelings before and nothing bad happened to you.
5. Focus your attention on something outside your own body and symptoms. For example, distract yourself by counting backwards in threes from 100, recall the words from a favourite song or concentrate on the sights and sounds around you.
6. Fleeing from the situation will only reinforce the perception that your panic attacks are unbearable. If you sit and allow the symptoms to pass, you will gain confidence in your ability to cope.

Source: Victorian Governments Better Health Channel website.

Source of this article: http://www.bodyandsoul.com.au/