How to spot the signs of anxiety in kids
If you've ever had a panic attack, you'll know how scary and exhausting they can be. In the moment, it's hard to believe that the feeling will pass. So, as a bystander, a friend or family member who witnesses someone having a panic attack, how can you help them through it?
"An anxiety or panic attack is usually characterised as an episode of sharp, intense anxiety where extreme physiological and psychological symptoms are experienced," says Nicky Lidbetter, CEO at Anxiety UK. "It is also often described as a sudden rush or spike of intense anxiety."
Some people may experience panic attacks on a regular basis if they have a panic disorder or anxiety triggered by a certain issue or situation, especially if they feel 'trapped'. Other people may only have one panic attack ever which seems to come out of nowhere. Even if someone regularly has panic attacks, that doesn't mean that they'll find it any easier to deal with, although they may be able to develop coping mechanisms.
"Panic attacks can affect individuals at any age and people can experience a panic attack at any time in their life," says Lidbetter.
Responding to panic attacks
Even if you don't experience panic attacks yourself, knowing how to support someone going through one is really valuable.
"It's understandable to feel daunted if you are with someone when they experience a panic attack - particularly if it seems to happen suddenly," says Stephen Buckley, Head of Information at Mind. "It can help if you gently let them know that you think they might be having a panic attack and that you are there for them. Try to stay calm and encourage them to sit somewhere quietly until they feel better."
One of the best ways you can help is by encouraging them to breathe slowly and deeply. "It is important to breathe deeply to ensure your body is getting enough oxygen," says Lidbetter. "But a very common symptom of panic attacks is hyperventilation which can result in further feelings of panic. By taking long deep breaths (always ensuring that the out breath is longer than the in breath), the body receives the oxygen it needs and makes the person feel calmer."
There are certain strategies you can use to make this easier. "It might be helpful to count out loud or ask them to watch while you gently raise your arm up and down. Encourage them to stamp their feet on the spot," suggests Buckley. "Never encourage someone to breathe into a paper bag during a panic attack as this isn't recommended and might be unsafe."
Whilst you'll want to do all you can to help someone who is having a panic attack, this doesn’t mean you should try to force them to do anything. They may feel too overwhelmed or frozen with panic to follow directions.
"Try not to pressure your friend or family member to do more than they feel comfortable with at any given time," says Buckley. "It's important to be patient, listen to their wishes and take things at a pace that feels okay for them."
After a panic attack
Most panic attacks peak after ten minutes and end after twenty to thirty minutes, although in some people they may last several hours. After a panic attack, someone may feel tired, upset and shaky.
"It's understandable to want to help them face their fears or find practical solutions, but it can be very difficult if they feel they're being forced into situations before they feel ready," says Buckley. "This could even make their anxiety worse."
Supporting someone long-term
In the long-term, considering solutions to their anxiety and supporting them to explore treatment and management techniques may be beneficial.
"Find out as much as you can about anxiety to help you understand what they are going through - reading personal experiences, books and information pages can all be helpful," says Buckley.
"Remember that although there can be common features of different people's experiences, everyone is different. You could ask about their experience, to help you understand how they feel and what you can do to help. You could ask them how anxiety affects their day-to-day life, and what makes it better or worse."
It may be that there are certain triggers for their anxiety or panic attacks, such as a fear, certain situations or a panic disorder. Being aware of these triggers can help you to help them avoid or manage their anxious response.
"Your friend or family member may already know ways you can support them. By asking what they need or how you can help, you can support them to feel more in control themselves," he continues.
They may have developed their own calming or coping strategies for panic, such as listening to music, meditation or certain breathing techniques. "Knowing that there is someone around who knows what to do if they start to feel panicked could help them feel safer and calmer."
Naturally, if you notice that someone's anxiety is becoming a problem for them, you could encourage them to seek help from their GP or a therapist. Making that first step can feel less daunting with someone supporting you.
"You could offer to help them arrange a doctor's appointment. If they are scared of leaving the house, you could suggest they ring their GP to find out if they will do home visits," says Buckley.
"You could offer to go with them to their appointments and wait in the waiting room. You can also help them plan what they'd like to talk about with the doctor."
There are lots of different techniques people use to reduce and manage anxiety, including mindfulness, medication and therapy.
"Cognitive behavioural therapy (CBT) can be very effective in helping to control feelings of panic and helping the individual to feel able to cope with panic attacks when they arise," explains Lidbetter. "CBT focuses on how people think and how these thoughts affect feelings and, ultimately, behaviour. It works to empower people to assert control over negative emotions and to change the way they behave."
CBT isn't the only treatment available. "Help them research different options for support, such as community services or peer support groups like those run by Anxiety UK and No Panic," says Buckley. "You could also call Mind's Infoline to find out more about local services."
In the UK, you can self-refer for talking therapy on the NHS without seeing your GP.
It's easy to become overwhelmed, tired or anxious yourself if you are worrying about a friend or family member and supporting them with their mental health condition. Recognising your own needs is just as important as recognising others'.
"Remember to look after yourself," says Buckley. "It can sometimes be really challenging to support someone with a mental health problem - but remember you are not alone. It is important to look after your own mental health too, so you have the energy, time and distance you need to be able to help.
"If you become unwell yourself you won't be able to offer as much support," he says. Speak to the person you're supporting and those around you to voice any concerns or worries.
"Set boundaries and don't take too much on. It is important to decide what your limits are and how much you feel able to help. Share your caring role with others, if you can. It's often easier to support someone if you're not doing it alone."