What is happening to me?

Panic attacks often start without warning and can last for minutes or hours. They arise as a natural consequence of extreme stress, anxiety or fear when adrenaline is released into the bloodstream preparing you for 'fight or flight'. Symptoms can be intense, you may experience rapid breathing, racing heart, light-headedness or dizziness, sweating, dry mouth, feeling sick, tingling or numbness in face and hands, weakness in the limbs and exhaustion. The symptoms themselves can be very frightening: people often fear they might do something uncontrolled or that they are going mad (you're not) and, once a panic attack has occurred, feel panic at the thought of one reoccurring!

If you are having panic attacks you are sending a powerful message to yourself; something is wrong and you can no longer avoid noticing. Panic symptoms become easier to manage if you can understand their meaning.

This is not always easy to do alone and it can be helpful to get support from someone you trust or someone whose professional role it is to offer calm, understanding and unbiased help.

Your symptoms may be telling you that you have been pushing aside painful thoughts or strong conflicting feelings - anxiety, trauma, loss of confidence, disappointment, anger, rage, extreme frustration or fear - for a very long time. Perhaps these thoughts and feelings have become 'unthinkable' and now you are experiencing them in a different way, a way you can no longer avoid taking notice of.

Unfortunately we often come to associate the anxiety with particular situations, which we then try to avoid at all cost, creating a cycle of self-limiting behaviour and panic reaction.

There are things you can do to help yourself

You will need to practice and be patient with yourself. When the panic feelings begin, try to focus away from the symptoms. Breathe deeply and slowly. Find something that distracts you. It may be through noticing your surroundings, the feel of the ground or of the chair beneath you, or the background sounds. Alternatively, you may find it helpful to count in your head, clench and relax your fingers or toes, or have a textured object or cold pebble in your pocket which is comforting to hold. For a few people focussing on breathing or bodily reactions makes things worse, not better. If this applies to you, try other things that might be more effective. Try not to 'catastrophise', instead you might say some comforting or encouraging words to yourself. Some people are helped by imagining a place which is safe and secure and they then call this image to mind when feelings of panic arise.

Practice deep, slow breathing

• Hyperventilation is a major symptom of panic. Breathing into cupped hands or a paper bag for a few minutes will increase carbon dioxide levels and may help reduce symptoms. Panic sufferers have found the following technique very useful:- put one hand on your upper chest and the other on your tummy (at navel level) and breathe in such a way that only your lower hand is moving as you breath slowly and deeply. Focus on the out-breath, letting the in-breath follow naturally.

Exercise

• Go for a brisk walk, run on the spot or up and down stairs a few times. This will help deal with the 'fight or flight' adrenaline in your blood stream. Don't forget to breathe deeply while doing this. Try to build regular exercise into your life.

Learn relaxation

• There are many good commercial tapes available. Learning relaxation techniques is an invaluable skill, useful in all kinds of stressful settings. Be conscious of developing a relaxed manner, walk, talk and eat more slowly. Take up Yoga, dancing, tai- chi or meditation and practice it regularly.

Plan to take time off

• Rest and creative interests are important. Reward yourself, and build pleasurable activites into your life. What are your tastes in music, film, art, literature? When did you last take a luxurious bath by candle light or cook yourself something special?

Listen to yourself

• This is important and worth spending a little time on. A panic attack is an extreme form of communication and if no-one else is listening to you at least you can begin to listen to yourself. Can you find it in you to be kind to yourself? It is OK to feel good about even the smallest achievements and important to reward youself as well as trying not to give up too easily.

Develop your assertiveness

• Learn to say NO. Avoid taking on things that will create extra pressure - protect yourself. Are you plagued by 'oughts' and 'shoulds'? Stop, think and check out if you really want to say yes before you say it.

Important for panic sufferers

Remember we cannot always change what happens to us but we can change how we perceive and think about the things that happen to us. Try to control the urge to keep thinking, What if or,If only and focus your attention on the small manageable steps you can take in the present. And finally, please remember do seek help for problems you cannot cope with.

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