This booklet was written by Anne Mathie (Information Officer) SAMH Information Service Cumbrae House, 15 Carlton Court, Glasgow G5 9JP Tel:

Transcription

1 1 This booklet was written by Anne Mathie (Information Officer) SAMH Information Service Cumbrae House, 15 Carlton Court, Glasgow G5 9JP Tel: Website:

2 Panic Attacks How to Cope

3 PANIC ATTACKS HOW TO HELP PANIC ATTACKS: How to cope Panic attacks can happen to anyone at anytime and are commonly a sign of stress. A panic attack may hit you when you are outside in a wide open space, inside, or in an enclosed space. You might be on a bus or just watching TV. You could be standing in a shop and suddenly you feel you must abandon your shopping and escape from the shop. Panic attacks can strike at any place and any time, whether you are alone or in a crowd. The act of leaving any of these situations is how your body copes with this fearful feeling. If, for instance you stayed put rather than leave, you would be resisting your brain s way of coping with this, the fear would mount and you would start to feel panicky. The panic attack is now imminent, unless you can change your thought patterns. Panic attacks, as the words imply, are frightening events. The symptoms may be so severe that those who suffer them may fear that they are having a life-threatening attack. Panic attacks however, are not generally life threatening. Ironically, they are a result of one of the body s own defence mechanisms working. When we are very anxious or afraid, the body produces more of a hormone called adrenaline. Adrenaline can make us quicker, stronger and more alert. The body can interpret an adrenaline rush in two ways. We can get ready to confront our fear or fight it or we can retreat from our fear and take flight from it. This is known as the 'fight or flight' response. The additional adrenaline helps us 'fight' or 'flee' and then it disperses and our systems return to normal. Working properly, adrenaline can help people facing apparently insurmountable events to perform incredible acts. There 02

4 HOW TO HELP PANIC ATTACKS is a case of a woman in the USA for example, whose child was trapped under a car. The fight response kicked in and the woman found the strength to lift the car and free her child. If the stress producing the adrenaline is not relieved then more adrenaline is produced, heightening the sense of fear or panic. Here the system does not return to normal. When you have a panic attack, your first symptoms are likely to be feeling flushed or hot, sweaty palms, a feeling that you can t catch your breath or your are breathing too fast. When you are breathing in this way what you are doing is reducing the amount of carbon dioxide that is in your lungs which creates these symptoms which can be terrifying. These may include: A thumping heartbeat Trembling Tingling in hands, arms and face Dizziness A feeling you are about to die Chest pain Breathlessness Feeling unable to swallow Blurred vision Intense fear Cold hands and feet 03

5 PANIC ATTACKS HOW TO HELP This fear prompts the body to produce more adrenaline, which in turn lead again to all the above symptoms and over breathing. This over breathing is called hyperventilating and once you start this, you can quickly find yourself in a vicious circle, the more quickly you breathe the longer you panic, the longer you panic the more quickly you breathe and so on. To stop this process you have to raise the levels of carbon dioxide in your blood. You can do this in two ways. A B It will help to breathe in your own exhaled air, as this will quickly increase the carbon dioxide. Get a paper bag and hold it firmly over your mouth and nose so you can breathe out and in into the bag, inhaling your own exhaled air. Try to breathe normally but slow the breaths down. If you feel that you are still breathing too quickly, then keep bag over your mouth and make your lips form an O. Gently take in the air. You may feel that the air wants to move quicker from your lungs, try to count the air into your lungs. Try breathing to a count of three, hold for a count of three and exhale for a count of three. You will begin to calm down because of the carbon dioxide you are inhaling from the bag. If a bag is not available then you should try to control or slow your breathing so that you breathe in less air. 04

6 HOW TO HELP PANIC ATTACKS With your mouth closed, start to breathe in slowly and smoothly through your nose (You could cup your hands over your nose) hold it for three or four seconds if you can and then open your mouth slowly releasing the air through it. You may start to take deeper breaths but don t keep that up as a deeper breath will increase the oxygen in the lungs again. Go for slowing the breaths you take. If you feel that you need to swallow the air, resist this. However if you do swallow a couple of times, that should alleviate the need to gulp. If it doesn t and you do gulp hold it for about five or six seconds and when exhaling try to do it slowly and gently through your mouth. For example: IN OUT One... Two... Three... Four.. HOLD ONE.. TWO.. One... Two... Three... Four... IN OUT One... Two... Three... Four.. HOLD ONE.. TWO.. One... Two... Three... Four... Once the body recognises the pattern of slow, even breathing you should become more relaxed. You can also try a cold compress on the pulse points. Icy water on the face and neck promotes what is called the diving reflex. This slows down the heart rate and makes you feel calmer. Maintain this by breathing through the nose, releasing the air slowly through the mouth. 05

7 PANIC ATTACKS HOW TO HELP A further approach is to try to change your thought pattern to focus your mind on something other than your panic. For example, you might try to remember the dates of birth of all your family members. Once you learn to change your train of thought, gradually what you are thinking takes over from what you are feeling. With enough practice it will become automatic when panic sets in. You will be able to transfer attention away from the actual panic attack on to what you have focussed on. Try to occupy yourself at this point, do something that is simple but requires a little concentration. It only takes seconds to change patterns when in a state of panic and something as simple as filing your nails / applying nail polish for instance, can have the desired effect. Some people find it helpful to keep a diary of their feelings and writing down how you feel whilst having a panic attack can also help you identify and change patterns. Anything that takes your mind off the attack will make the duration of the attack shorter. Remember that if the breathing is kept slow and even, the panic attack will not be able to take hold. This is harder to achieve once the attack has started and you cannot even think straight. Making sure that you have a plan or procedure that stops attacks from becoming so serious is the first step to slowly taking control of them. You may have panic attacks where hyperventilating does not occur. You may feel you have to get away from a certain situation and in doing this feel you remove the threat which was the trigger for the panic 06

8 HOW TO HELP PANIC ATTACKS attack. You perhaps feel that something terrible is about to occur, that you are about to die. By learning to stay in that apparently threatening situation and changing the thought patterns, it is possible for you to gain control of the attack. It can take time to master this, but it is important that you give yourself credit each time you manage to stay in the situation even for a little longer. If the attacks are becoming frequent and you haven t already consulted your doctor, then you may want to seek advice. There are a number of treatments that are available and treatment does not have to be drug based. Cognitive Behavioural Therapy (CBT) may be considered. CBT is a way of changing the way that you perceive the things that make you anxious. It teaches you to change thought patterns that have become routine when panic or anxiety set in. With CBT you can eradicate the negative thoughts and replace them with positive. Psychotherapy is where you can speak to a suitably qualified therapist and try to identify possible contributing factors and develop better coping mechanisms. Getting in touch with a support group or self-help group can be greatly beneficial, because the people there understand from experience what you are going through, and may be able to share approaches, which have been helpful to them. 07

9 PANIC ATTACKS HOW TO HELP A number of drug therapies may be used to treat the symptoms of panic attacks. These include: A mild dose of tranquillisers given until the symptoms subside but there can be dependency problems if tranquillisers are prescribed for a sustained period of time. Beta-Blockers, which are not tranquillisers and act by blocking the production of adrenaline in the large quantities that can set off panic attacks. Some people are given a beta-blocker before a driving test because it stops all the unpleasant symptoms of nervousness i.e. sweaty palms, palpitations. Some of the newer antidepressants, Selective Serotonin Re-uptake Inhibitors (SSRIs) have sedative properties in them and these may be prescribed. These drugs may also have dependency problems. Drug therapies alone will only suppress the symptoms associated with panic attacks, not teach you different coping approaches, unless combined with one of the above. They can have risks attached to them - side effects, the risk of addiction and withdrawal. If you decide that you want to take this form of treatment, discuss these elements of risk with your GP. 08

10 PANIC ATTACKS HOW TO HELP Many people find complimentary therapies such as massage and aromatherapy helpful in managing stress, either on their own or in conjunction with some of the treatments above. Decide what is most helpful to you and in time you will find that you can cope. Once you learn that the panic attacks are not going to harm you, the urgency of fighting the symptoms is reduced and dealing with them practically becomes second nature. 09

11 PANIC ATTACKS HOW TO HELP USEFUL CONTACTS Stresswatch (Scotland) 23 Campbell Street Kilmarnock, KA1 4HW Tel: Web: Provides advice, information and Support to sufferers of panic attacks Anxiety, phobias and other stress Related problems No Panic 93 Brands Farm Way Telford, Shropshire England, TF3 2JQ Tel: (Information line only) Helpline: No Panic aims to aid the relief and Of those people suffering from Panic Attacks, Phobias, Obsessive Compulsive Disorders, Other related anxiety disorders, including Tranquilliser withdrawal. They also offer Support to sufferers, their families and Carers

12 HOW TO HELP PANIC ATTACKS WASP- We Are Seeking Progress The Secretary PO Box Edinburgh, EH12 8ZA Tel: Helpline: Web: This is a group for people suffering from Agoraphobia, Social Phobia, Panic Attacks And stress related disorders. 11