Panic attacks - nothing to panic about

You feel cold and clammy; your heart is racing and you have tight pain across your chest. Is it a heart attack - or could you be the victim of panic attacks? Read on to find out.

You feel cold and clammy; your heart is racing and you have tight pain across your chest. Is it a heart attack - or could you be the victim of panic attacks? Read on to find out.

Panic attacks - what are they?

Panic attacks are scary - it's official. In fact, a period of intense fear, usually lasting for at least 10 minutes, is the single feature you have to suffer for a doctor to say you're having a panic attack. They're due to high levels of adrenaline, which naturally goes up when you're scared. This prepares you for 'fight or flight' - running away or standing to fight someone attacking you. In panic attacks, nobody is attacking you - your body is responding to a 'false alarm' of danger.

Since the symptoms of panic attack can be similar to those of a heart attack, it's hardly surprising that many of my patients are convinced there's a serious underlying problem. They're often astonished when I bring up the Patient UK information leaflet on panic attack and they see that they have a 'full house' of symptoms for panic attack. But don't forget that your body believes there's something serious going on, and responds accordingly. That's exactly why there is so much overlap between the symptoms. Having panic attacks does not increase your risk of heart attack.

Having said that, you should never assume chest pain or palpitations are due to a panic attack unless you've had the same symptoms before and you've had your heart checked out. The symptoms of heart attack and panic attack - including sweating and light-headedness - can be similar. However, your GP can often reassure you on the basis of hearing the history of your symptoms and examining you. If they're in any doubt that there could be a physical problem underlying your symptoms, they'll send you for further tests.

What causes them?

Panic attacks often start under stress - but they can happen out of the blue. Usually, though, you will have been going through a lot of stress in your life, and a small anxiety can trigger them. Recurring panic attacks may happen at particular times - such as when you travel on buses, go into crowded places, etc.

Some medical conditions such as overactive thyroid or low blood sugar can cause pain attacks. So can suddenly coming off some medications like painkillers and antidepressants.

Who gets them?

They are more common than you might think. About one in 60 people have regular panic attacks, and more than one in 20 people have them at some point in their lives. They often run in families.

What are the symptoms?

Fear is the first feature of panic attack. Others include any four or more out of:

  • Feeling short of breath
  • Choking sensation
  • Pounding, rapid heartbeat
  • Feeling shaky
  • Numbness or tingling, usually in your hands, feet or lips
  • Feeling sick
  • Hot or cold flushes
  • Chest pain
  • Sweating
  • Feeling dizzy or faint
  • Feeling things aren't real (like you're in a dream)
  • Feeling you're going crazy
  • Worrying you might be dying

What should I do?

If you've had a physical cause for your symptoms excluded, you can learn techniques which help control your symptoms in the short term. You also need to look at what thoughts are triggering a panic attack, and how you can 'challenge' those unhelpful thoughts. That's where Cognitive Behavioural Therapy (CBT) comes in (see more below).

In the short term, controlled breathing can help control panic attacks. Concentrate on your breathing, and breathe in slowly (over four seconds) through your nose. Then breathe out gently through your mouth over six seconds. Keep doing this for several minutes. It can be easier said than done when you're feeling anxious and already short of breath, so practise first when you're calm.

Relaxation techniques which help relax your muscles (yoga or tapes of relaxation techniques are good) and distracting yourself as soon as you feel anxious may also help.

CBT - it's good to talk

Cognitive behavioural therapy helps in many anxiety and depression-related conditions. The idea is that unhelpful thought processes can trigger behaviour that keeps a vicious cycle of anxiety or panic going. A therapist can help you challenge those thoughts and change your behaviour. In panic attacks, for instance, you might get panicky when you get on to a crowded bus. You're terrified you're having a heart attack. You leave the bus and the panic attack settles, so your brain tells you that avoiding buses will stop you having a heart attack. CBT helps you 'challenge' the thoughts that you're having a heart attack, and the natural tendency to avoid situations where symptoms happen.

With thanks to 'My Weekly' magazine where this article was originally published.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.