One in three of us will suffer from anxiety or a panic attack in our lifetime.
The definition of panic is a sudden uncontrollable fear or anxiety, often causing wildly unthinking behaviour.
I have never experienced an attack myself but I have seen friends suffer from one.
At work there can be many triggers to anxiety and panic.
What happens if you can’t shake the feeling of panic?
What happens if the spiral becomes deeper?
How do you deal with a panic attack if it kicks in?
To help deal with the issue of panic it is important to understand what might trigger it.
Recognising the warning signs may help to prevent a panic attack from escalating.
Attacks typically last for 20 – 30 minutes, but can sometimes last for as short as 15 seconds.
At their worst they can continue for hours. In some cases a person can suffer many attacks in a single day.
Panic can be sudden and have no clear triggers – which makes them difficult to manage.
Experiencing panic is a horrible and debilitating feeling.
When panic takes hold many people are convinced they are about to die. This can be especially true if they have not experienced such an attack before.
The history of panic attacks has its roots in evolution.
In more simple times we had little to worry about.
We lived in a cave and our needs were basic.
Forage, hunt for food and start a fire.
Oh, avoid being eaten by a dinosaur was also key.
When danger presented itself we developed a ‘fight or flight’ syndrome.
This survival instinct was perfect in avoiding being a snack at the dinosaur buffet.
The feeling has stayed with us for thousands of years and is impossible to shift. However, it can be managed.
The Inner Brain
The Amygdala is the tiny, primitive part of the brain responsible for our panic attacks.
Its primitive nature means it is world-class at one thing:
Controlling our response to danger.
It swamps the body with adrenaline when we feel threatened. It puts us into a heightened state of awareness, ready to fight or take flight.
When adrenaline is released several things happen:
- Heart rate increases
- Perspiration increases
- Breathing becomes more rapid
Now, here is the real head scratcher.
The Amygdala can not tell the difference between a real threat and one that is imagined, or even non-existent.
The non-existent angle explains why anxiety has such a powerful hold over some people. It is the fear of the future and the unknown.
The Amygdala is a reflex, a muscle, it senses something is wrong so acts accordingly.
Soothing the Attack
In the midst of a panic attack (feelings of death are common) techniques exist to soothe the attack.
It is important to seek medical advice if you suffer from anxiety or panic attacks. There is no replacement for sound professional help.
The techniques will increase your confidence, knowing you have a selection of tools to combat the feeling of panic.
Recognising the Triggers
Recognising the trigger is a big step towards managing an attack.
You can adapt your day or routine to minimise the risk of a trigger.
Knowing you have a number of techniques at your disposal is both comforting and confidence boosting.
Breathing is always a great thing to do!
It becomes even more important when subject to an attack.
Your hear rate increases and your breathing becomes more rapid and shallow.
Over a sustained period this will lead to hyperventilating. It will also lead to the production of Carbon Dioxide.
Breathing helps to prevent both issues increasing the severity of the attack.
Follow the five second breathing technique.
One deep breath in through the nose and breath in for five seconds.
The breath should be deep enough to expand the stomach.
Breathe out through the mouth and the breath out should also last five seconds.
Repeat the cycle several times (as many times as required) to cut the feeling of panic.
If you are at work it may be useful to find some privacy to do this, either in an empty office or toilet cubicle.
Tightening and relaxing the muscles can be an effective strategy in lowering tension and stress.
Start from the feet and work your way up, tightening and holding for five seconds and then releasing.
Remember to breathe throughout.
Another way of adopting this technique is to ball your hands up into fists.
Squeeze both hands as tight as you can, holding for five seconds, then releasing.
Again, remember to breathe otherwise it is likely to make the exercise redundant.
Mindfulness is developing your own awareness of yourself, the people around you and the environment you are in.
It won’t help you in the middle of a panic attack and this is a medium to long term strategy.
Mindfulness allows you to notice and acknowledge your feelings, without acting upon them or standing in self judgement.
It is a great way of self therapy if done well.
Anxiety and panic are linked and in the case of anxiety it is a reaction to events that are yet to happen.
Practicing mindfulness can be an effective tool in allowing thoughts and feelings to float into your mind and then float away again.
In doing so you take the sting out of anxiety and minimise the chance of an attack.
Cognitive Behavioural Therapy
I have friends who have found this useful and others less so.
CBT is an extention of mindfulness. It is important to know that CBT will not give you a conveniently gift wrapped answer.
CBT is a talking therapy and can help manage your problems by changing the way you think and behave.
An example of questions you may be asked in a CBT session are:
- Based on your anxiety, what are you most afraid will happen?
- What evidence supports this theory?
- What else could be driving this thought pattern?
It is often worth looking at the support your employer provides.
Many business leaders value the aspect of wellbeing in the workplace.
Often they will offer (in some cases it will be free) access to counseling services and/or CBT sessions.
It may seem like a no brainer but exercise really is one of the most effective ways of dealing with anxiety and minimising the risk of attacks on a regular basis.
Exercising releases endorphins (the same feeling you get if you eat chocolate) and is a well-known stress buster.
I worked with someone who was suffering with anxiety and depression. She was off work for some time and during her time off she developed a habit of walking daily. The area she lived in was hilly and in the countryside. The walking developed into hiking and became a consistent part of her routine. Although she was in regular contact with her GP she felt the exercise was a big reason in helping to manage her condition.
The social aspect of exercise is also an important but sometimes forgotten aspect.
Having a support network and perhaps with people you do not know that well can be hugely beneficial in dealing with anxiety.
When you feel the onset of anxiety or worse, a panic attack, distracting yourself can be a powerful way of managing the issue.
There are a number of techniques to distract:
- Humming/singing a song
- Reciting a phrase or saying that helps to calm you
- Counting the fingers on one hand by tapping your thumb with each finger.
- Count your breaths
- Draw or do something creative
- Write – journaling how you are feeling creates an ability to refocus and adjust your emotions
I have listed several techniques you could try to help deal with a panic attack.
In the moment of an attack how will you remember any of these techniques?
The T.I.P technique is one way of recalling an easy three-step process to combat anxiety and/or panic.
Using this technique can tip the scales in your favour and stop the initial wave turning into a full blown attack.
So, how does it work?
If anxiety or panic sets in find a tap and use cold running water to cool yourself down.
The most simple and effective way to do this is to keep your wrists under the cold water.
In an attack your body is going into ‘fight or flight mode.’ As we have outlined the body can react in several different ways.
Some or all of which will increase the temperature of the body. When this happens the feeling of panic increases. You feel uncomfortable and this contributes to the feeling of panic. Adrenaline is starting to flood your system and it can start to feel like the room is closing in on you.
Something cold helps reduce the symptoms of the attack.
Using a running tap also has the added bonus of distracting you.
Focusing on the look, sound and feel of the running water will help to calm and focus your emotions.
If you can’t get to a running tap and it is cold outside then head outside.
The cool air will have a similar effect.
We have touched on the benefit of exercise and how the release of endorphins help battle the symptoms of anxiety and panic.
Intense exercise is a proven way of fighting the symptoms.
It may be tricky in a work situation but you could try:
- Running on the spot
- Jumping jacks
- Shadow boxing
Again the spare empty meeting room could be your friend. If this is not an option then the toilet cubicle.
It may seem strange to carry out this type of activity at work but better to do this then suffer a panic attack that could last some considerable time.
If you can’t bring yourself to do any of the above a brisk walk, outside, is a good compromise.
As I mentioned earlier, it is always good to breathe.
Follow the five second rule as outlined and remember to ensure your stomach expands on the inward breath.
Repeat several times and the impact of this will help you focus and take the edge of the attack.
Following the T.I.P technique will ensure you have an easy to follow coping mechanism. It can be used when you start to recognise the early signs of anxiety or the onset of a panic attack.
We have covered a lot and I hope it has been useful to you.
I hope you never experience the viciousness of a panic attack.
Panic attacks do not have to rule your life.
There are steps you can take to control how you feel, the environment you work in and to limit the chances of an attack triggering.
I wish you a healthy 2017.
Believe and take action,