Panic attacks: Symptoms, triggers and treatment

In her latest online article, renowned chartered counselling psychologist Melanie Phelps delves into panic attacks. Melanie explains the typical symptoms of a panic attack, the potential triggers, and how you can alleviate symptoms.

What are the typical symptoms of a panic attack, and how can I differentiate them from other medical conditions?

Panic attacks can be terrifying, as symptoms come on suddenly and intensely. Many people understandably fear they are having a heart attack or that something is seriously physically wrong with them because symptoms can be similar.

Although symptoms vary from person to person they typically include:

• feeling short of breath
• dizziness
• feeling faint
• being aware of a pounding heart or a fluttering heart
• tingly feelings in the body
• choking sensations
• temperature fluctuation (some people experience hot flushes, others feel cold)
• nausea
• trembling or shaking
• a general feeling of dread.

Worrying about the symptoms perpetuates them and can mean the panic attack lasts longer.

Whilst it is important to consult a doctor to reach a diagnosis and rule out any other medical conditions, after having experienced a panic attack, most people can then recognise them when they next occur as symptoms of other medical conditions may be more persistent and linked to other activities. However, if there is any doubt it is important to seek a medical opinion.

Are panic attacks triggered by specific situations or events, or can they occur randomly?

Panic attacks occur out of nowhere, however certain situations can make them more likely to occur. Panic attack triggers can be linked with daily activities such as eating, drinking, and exercising as well as environmental factors.

For example, when we haven’t eaten in a while or when we are dehydrated (eg. first thing in the morning), when blood sugar dips before meals, after heavy exercise (especially with bright lights and loud music at the gym), and after drinking alcohol, energy drinks or caffeinated drinks.

Large brightly lit places (e.g. large offices, supermarkets) which overwhelm the senses can be triggering.

Additionally, lack of sleep, feeling tired, stressed, and emotional all have a part to play. Fear of having a panic attack can prompt a panic attack.

What role does anxiety play in the development and recurrence of panic attacks?

Experiencing untreated or unresolved anxiety can predispose and sensitise people to panic attacks.

How long do panic attacks typically last, and what can be done to alleviate symptoms during an episode?

Panic attacks usually last 5 to 20 minutes but can last longer. Whilst focusing on the symptoms can perpetuate them, recognising and naming the panic attack and choosing to “ride the waves” of it can help enable it to pass.

Most people take shallow faster breaths during panic attacks, therefore deliberately taking deeper, longer, and slower breaths (for example slowly counting the breath in and out, utilising breathing techniques) can help. As the body feels under threat (and the body’s “fight or flight” response is activated), moving the limbs (e.g. marching on the spot, if able, using both the arms and legs) can help feedback a message to the brain that the person has “run-away” from the “threat” and prompt the panic to settle. Maintaining kind, reassuring, and compassionate self-talk (speaking to yourself in a calm, reassuring, steady voice: e.g. “I am safe, this will pass”) is a good strategy.

Are there long-term consequences or complications associated with frequent panic attacks, and how can they be prevented?

Experiencing panic attacks can be debilitating and can have negative impacts on relationships, family and social life, work, physical health, and overall quality of life. There is a link between anxiety, panic attacks, panic disorder and depression which could develop or worsen the longer the panic attacks continue.

Therefore, talking to your medical practitioner (e.g. GP) to rule out other medical conditions, and discussing the usefulness of any medication in your case is a great first step. Seeking psychological help from a psychologist or psychotherapeutic practitioner who understands and is used to dealing with clients experiencing panic attacks, and considering healthier lifestyle changes (eg. practising yoga, tai chi, meditation, mindfulness, self-care and self-compassion) all help too.

Melanie Phelps is a well-respected and highly-experienced chartered counselling psychologist based in Camberley, Surrey, also working remotely. If you would like to book a consultation with Melanie, you can do so today via her Top Doctors profile.