Your heart is racing so fast that it is beating irregularly. You are drenched in sweat but feel cold. You are trembling and the tips of your fingers are tingling. No matter how quickly you breathe, you can’t seem to get enough air and you are feeling nauseous and dizzy. You wonder if you are having a heart attack and this terrifying possibility only makes things worse. Your legs turn to jelly and as you slump to the floor you are convinced that you are dying.

Only you’re not. You’re having a panic attack.

Panic attacks are terrifying for the person experiencing them (and those around them) but are not dangerous. People don’t die from panic attacks, although the physical symptoms can be very distressing at the time. A panic attack is one of the body’s ways of dealing with a stressful or anxiety-inducing situation. It originates from a part of our brain called the amygdala whose primary role is processing memory, decision making and emotional reactions. During situations of extreme stress, the amygdala triggers the hypothalmic-pituitary-adrenal (HPA) axis and takes over from the rational part of our brain. To put it simply, our brains automatically trigger a means to protect us from the threat. Our bodies go into ‘autopilot’ with what is known as the fight-flight-freeze response. This is the primitive survival instinct in all of us. Some people have described it as their ‘inner-caveman’ which seeks to either fight the perceived threat or run away from the it (flight). The ‘freeze’ aspect comes from a mixture of ‘fight’ and ‘flight’ signals which overload the brain and lead to us being incapable of either response.

Physiologically, what happens to our bodies during a panic attack is very clever. We take more breaths in order to flood our bodies with oxygen to prepare for any physical exertion (such as fighting or running away). Our hearts race because of the surge of adrenaline that is released for the very same reason and this can also cause our muscles to tense up. We sweat in order to make ourselves more slippery so any potential predator or enemy cannot get a firm hold on us. Although these facts might not help to reassure you when you are breathless, tense and sweaty, it can be helpful to understand why your body responds in this manner.

So what can you do when you have a panic attack? The first thing you need to remember is that it will pass. It might feel extremely unpleasant at the time but it will come to an end. Running away from the situation that is making you anxious is not going to help. Confronting what is making you anxious is challenging but is more likely to prevent another attack the next time you are in a similar situation. Panic attacks can last between 5 and 20 minutes and you may be able to bring it under control by taking deep, slow breaths rather than short, quick ones. Focus on your breathing by trying to count up to five with each in-breath and out-breath. Remember that what you are feeling is merely the symptoms of anxiety.

Taigh Sàmhchair: professional counselling and psychotherapy
Hereward Proops MBACP, registered member of the British Association for Counselling and Psychotherapy
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