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by Lucy McCarraher & Annabel Shaw


Living with Anxiety and Panic Disorder

Panic Attacks are very sudden episodes of intense anxiety in the absence of real danger, and they often occur out of the blue with no obvious immediate trigger. Panic attacks have very strong physical sensations such as heart palpitations, nausea, shortness of breath, dizziness, hot sweats and a feeling of imminent danger.

Where do panic attacks come from? Deep in the the Limbic part of the brain lie two almond shaped pieces of tissue called the amygdala (the latin for almond seed). These are understood to be largely responsible for our experiences of fear and anxiety. The amygdala processes information received from our senses and decides whether we are in imminent danger; if it decides that we are in danger it alerts us to the potential threat. This effect is remarkably swift - it’s there to save our lives, after all - and takes effect well before the frontal cortex can analyse the situation in a more considered manner. It's very rare for our lives to be so threatened and in the normal course of events the amygdala is not often called on to save our lives in this way. However, in some cases the amygdala is overactive and appears to detect danger when none is present. Panic disorder is thus a malfunction of a system designed to keep us safe from threats.

Experiencing a panic attack is extremely frightening and many who experience a panic attack for the first time often believe that they are having a heart attack. When this happens more panic sets in because they mistake these very strong physical symptoms as potentially life threatening. This then sets off a vicious circle as these misinterpretations lead to more anxiety, leading to heightened physical sensations. Because panic attack symptoms can resemble life-threatening conditions, such as a heart attack, it’s important to seek an accurate diagnosis the first time you experience the symptoms listed above. The advice on how to cope with panic attacks given below is applicable only once your doctor has confirmed your diagnosis.

How are Panic Attacks treated?
For many years, anxiety related disorders such as panic attacks were treated with tranquillizers such as Valium. During the 1970’s Valium was the most widely prescribed drug in the US reaching a peak of 2.3 billion tablets dispensed in one year alone; then it was called ‘mother’s little helper’. Today a new class of anti-depressant (SSRIs, of which Prozac is one) is very often prescribed. This is despite robust evidence that a psychological therapy such as cognitive behaviour therapy (CBT) is  more effective for anxiety related disorders. But CBT is expensive and the waiting list for treatment can be many months. GP’s are often under pressure to prescribe anti-depressants when they would prefer to prescribe a non-drug treatment were it more readily available.

What you can do to help yourself without resorting to drugs
There are a number of tips for dealing with panic attacks, some of which I will list below, but perhaps the single most important thing to keep in mind when experiencing a panic attack is that the symptoms commonly last approximately forty minutes and it is very unusual for them to last longer than an hour. Knowing that the attack will end soon and that it is not life threatening will do most to reduce the panic and thus lessen the physical sensations. It’s also worth knowing that very many people suffer from panic attacks, so you are not alone.

Many experienced sufferers treat panic attacks with some of the following methods and techniques. The next time you have an attack try them and see what effect they have on you.
  • Diaphragmatic breathing or abdominal breathing - breathe slowly through the nose using the diaphragm and abdomen. Focus on exhaling very slowly. This will correct or prevent an imbalance of oxygen to carbon dioxide in the blood stream.
  • Stay Focused in the present - rather than allow yourself to imagine the worst case scenario (“I’m going to die!”), remind yourself that the attack will soon pass and is not life threatening. Do not think about the future at all but stay focused on your breathing.
  • Acceptance and acknowledgement - many people say that accepting and acknowledging their susceptibility to panic attacks helps them not only deal with the symptoms when they happen but also allows them to see the attacks as a part of who they are. This is especially important for those of us who have tried but failed to eliminate the attacks altogether from our lives.
  • Floating with the symptoms - allow time to pass and “float with the symptoms” rather than trying to fight them. This is another very successful technique for dealing with the unpleasant sensations as they happen.
  • Smiling helps - I find, and I consider myself an ‘expert’ having lived with panic attacks for many years, that if I smile as I go through the attack this helps -  perhaps because it’s hard to smile and panic at the same time.
  • Coping statements —  repeat “coping statements” as part of an internal monologue to help you keep focused on the present and to remind yourself that you’re going to be OK. Here are some suggestions;” No one has ever died from a panic attack.” “I will let my body do its thing. This will pass.” “I can be anxious and still deal with this situation.” “This does not feel good, but I can deal with it”.

For many people a panic attack may occur less than a couple of times in their life, whilst for others panic attacks happen quite frequently. If you experience attacks very frequently then you will have a condition known as a panic disorder. Cognitive behaviour therapy is extremely successful at helping with panic disorder and should always be tried before resorting to drugs.

Talking with other sufferers can be hugely helpful. I remember once in the staff tea room of a busy hospital I asked an assembly of colleagues, not all of whom I knew at all well, if anyone else - apart from me - ever suffered from panic attacks. The response was incredible. I was not alone and many of those who ‘admitted’ to having the odd attack came up to me later to thank me for being brave enough to talk about my attacks and making them feel less alone in their own affliction. Of course, it may not be appropriate where you work, but worth asking friends if only to make them as well as you feel a bit less anxious.

If you are a sufferer and have any advice to add to the list above then please leave a comment.

There are more exercises in The Real Secret which will help you take control of anxiety and panic, and are a useful start if you are waiting for therapy to start. You can get the book in either paperback or Kindle format from or

Posted by Annabel

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