When panic attacks strike …

By psychologist Angie Willcocks

Q: Dear Angie, About four months ago I had my first ‘panic attack’, and since then have had five more. These attacks seem to come out of the blue, in fact the last one I had was when I was relaxing in front of the TV. At first I thought that the attacks might have been a symptom of menopause, but my GP did all kinds of medical tests and then told me straight-out that I was having panic attacks which really surprised me as I have never had anything like this before. My GP prescribed me with some anti-anxiety medication but I am reluctant to take that unless I really have to. I live in a remote mining town without a resident psychologist and so I was wondering what would you recommend? – Penny, QLD

A: I do get quite a number of letters from people experiencing panic attacks – this reflects the fact that about one in 10 Australians suffer from panic attacks at some point in their life.

Penny, I am so glad that you went to see your GP to rule out any physical causes, because that is always the first step I suggest. A common symptom associated with panic attacks is the belief that something terrible may be wrong with your body, so it is really important to deal with this practically and thoroughly from the outset with a visit to your GP. Other symptoms are hot flushes or cold chills, chest pain (or a tight feeling in the chest), racing heart, numbness or tingling in part or all of the body, dizziness, shortness of breath or difficulty breathing, sweating, fear of dying and a sense of being out of one’s body.

The panic attacks that you describe (coming ‘out of the blue’) are what are known as spontaneous panic attacks, meaning that they are not associated with particular situation(s). You have probably heard people talk of another kind of panic attack that is associated with specific situation(s), such as flying or being surrounded by people (as in social phobia). Both kinds of attacks are caused by the same biological process, which originates deep in a very primitive part of the human brain. The panic attack is really an evolutionary hangover from when humans really needed a ‘fight or flight’ response to a life-threatening situation (like a lion).

The part of our brain that triggers the panic response is designed to help humans survive, not make complex decisions. One result of this is that the thinking part of the brain is kind of ignored once the panic cascade has started and this is why people often feel ‘out of control’ when having a panic attack. Thankfully though, we can teach our thinking brains to take control of the nonsensical emotional response. The psychological technique that is usually used to help regain thinking control is called Cognitive Behavoiural Therapy. Some general practitioners have skills in these techniques, and any registered psychologist will certainly be able to help you deal with your panic. There at least two very good Australian websites with ‘self help’ tips for dealing with panic (see below) and a number of very helpful books available on panic attacks.

In the meantime, I think that it is important to know that panic attacks are generally part of a wider problem of anxiety, so a very important step is dealing with the level of daily anxiety that you are experiencing. Let me give you an example: imagine that you have a container inside you that is called your ‘anxiety bucket’, and at the top of this bucket is a flip-top lid. When the bucket is full to overflowing, this flip-top lid is going up and down all the time. Now imagine that above the flip-top lid is a ‘panic switch’ and every now and then the lid catches this switch thereby setting off the panic.

Obviously, an important step in reducing the likelihood of the panic switch being triggered is to reduce the level of anxiety in that bucket, so the lid can stop flapping up and down. For some people the panic is a strong sign that they (and their bodies) can no longer maintain the general level of anxiety in their life that they may have thought was ‘normal’ – this is particularly so with spontaneous panic attacks.

While you are considering this response, I would ask you to consider the following questions: In what ways can you reduce the level of anxiety in your bucket? Was there some reason four months ago that the level of anxiety suddenly went up? Talking about this with a friend, or writing in a journal may help you to make sense of the panic attacks at this time in your life.

I hope that helps Penny. If you would like further information or support, please contact any of the following:

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