Whether you’ve personally experienced one, or know those who fall victim to them frequently, you’re probably familiar with the symptoms of a panic attack. The sudden rush of adrenaline; the feelings of panic, nausea and shakiness. The sweating and the sudden shortness of breath.
A panic attack can, unfortunately, be a common occurrence for many. They can be frightening and, without the right coping strategies, debilitating. According to Bupa, 1 in 3 people will have a panic attack at some stage in their life.
And, given the rising stats surrounding anxiety across the UK – with new research from the Mental Health Foundation reporting that over 60% of adults feel like their anxiety impacts their day-to-day – that number could continue to climb.
More concerning still is the advice surfacing on social media where, on TikTok, the hashtag #panicattack has over 1.4 billion views and countless videos offer up hacks to stop or prevent the symptoms.
While it can be helpful to know that you’re not alone, it’s important to seek advice from a trained professional – to find out more, we spoke to leading health psychologist, CBT and EMDR therapist, Dr Sula Windgassen, about the best coping strategies, plus, how to stop a panic attack from taking hold in the first place.
Firstly, what is a panic attack?
According to the NHS, a panic attack is the 'feeling of sudden and intense anxiety’ and is defined as a panic disorder. The NHS cites both mental and physical symptoms, which include everything from shaking, feeling disorientated, nausea and irregular heartbeats to having a dry mouth, breathlessness, sweating and feeling dizzy.
“A panic attack is an acute state of emotional and physiological arousal,” says Dr Windgassen. “It might be experienced as intense palpitations or chest pain, hyperventilating (breathing really fast), feeling incredibly hot or a sense of urgently needing the toilet or feeling dizzy.”
These are the more common symptoms, she says, but there are others such as feeling disassociated that can also be linked to a panic attack.
Nobody is exempt from a possible panic attack, either. “It is the product of our autonomic nervous system (responsible for regulating certain processes in the body) going into overprotection mode,” shares Dr Windgassen, who says that anyone, no matter their mental health condition, could experience one at some point in their life.
Symptoms can last up to 20 minutes or longer, she adds, with people often reporting that they feel wiped out, shaken or disoriented for a while afterwards.
What causes panic attacks?
“The trigger of a panic attack will be unique to a person and the situation,” she says. What could bring on a panic attack in one situation may not in another. “This is because panic attacks tend to be the product of accumulating triggers but we only notice the ones that happen right before we have the panic attack.”
She adds: “If someone has a panic disorder, they have experienced panic attacks and then they worry about experiencing further panic attacks, this essentially keeps the vicious cycle going – known as the panic cycle – as both the brain and body become hypervigilant to the sense that a panic attack may be coming again, causing more stress and therefore contributing to more panic attacks.”
An out-of-the-blue panic attack is probably because your brain has detected a stressor or threat before you are even aware of it, but some might also happen as a result of other mental health conditions like post-traumatic stress disorder.
How to survive a panic attack: what are the best coping strategies?
First, try and understand your panic cycle, says Dr Windgassen, referring to the vicious cycle of anxiety. “Understanding the physiology allows you to ease into the sensations when they come up without severe fears of losing control or being in danger and, in this way, the panic attack will pass quicker.”
There are free resources on the NHS website to help you better understand your panic attacks, she says, or you can unpick your panic cycle and triggers with a qualified cognitive behavioural therapist. “There is lots of good research showing how effective CBT is for panic disorder,” she adds.
“With panic disorder, we want to stop any avoidance that might be going on because again this only serves to keep the panic cycle going,” she adds. “Finding safe and gradual ways to expose yourself to things that you fear – without the use of ‘safety behaviours’ – will gradually allow you and your nervous system to adjust.”
Your ‘safety behaviours’, explains Dr Windgassen, are designed to keep you safe but actually end up keeping the cycle of symptoms going because they reduce your confidence in functioning without them, she says. “For example, if you always close your eyes and grip the seat on the tube because you worry you will have a panic attack, you inadvertently signal to your nervous system that you are in danger, making it more likely to have a panic attack.”
Methods of distraction like coping visualisation could also fall into the safety behaviour trap, she adds. “Essentially you want to be exposed to the panic attack without distraction; to allow your body to habituate. If you don't, it makes it more likely that your body and psychology will become more hypervigilant and fearful.”
What you can do, though, is engage in something that is grounding and allows you to stay in the present moment right after, or during, the panic attack. “This helps your body feel safe again,” she adds, citing things like reading your book or listening to music after the panic attack has happened.
“I also help my clients with attentional focus practices, which allow them to gently readjust hypervigilant focus on the body, to be more present and integrated in what is going on,” she adds. “Instead of distracting yourself in some way from what is going on with your body, try and connect with it and work with it.”
Breathwork, for example, is a great tool to turn to when it comes to panic attacks. To help reduce stress, the NHS recommends counting steadily from 1 to 5 on each in-breath and each out-breath, closing your eyes and focusing on your breathing.
You could also try the 4-2-8 technique, says Dr Windgassen, a breathing sequence that's been touted for its ability to help reduce stress and aid sleep. “The simplest and most effective thing is extending the exhale out longer than the inhale and slowing down breathing,” she shares.
Simply breathe in for 4, pause for 2 and extend the exhale for 8. ‘"This activates that parasympathetic nervous system to help calm things down."
As with all coping strategies, there's never going to be a catch-all cure. The solution to enduring a panic attack and indeed preventing them in the future will differ from person to person.
Remember: what works for somebody might not be the answer for someone else. As Dr Windgassen points out, understanding your panic cycle is a key starting point as is looking for the right solutions that help ground you as opposed to any unhelpful methods of distraction.
