Managing Panic Attacks and Anxiety

Please note, this page is printable by selecting the normal print options on your computer.

What is Anxiety?
Feeling anxious is normal when we think that we are in danger or when we are stressed. It can make our bodies feel different. Symptoms may include:

  • Tense muscles
  • A racing heart
  • Sweating
  • Rapid breathing

People are normally anxious for short periods of time. If we are anxious a lot of the time, even when there is nothing to be anxious about, it can become a problem. It is then that the feelings we have can get worse and we can just think about how worried we are.

We get caught up in a circle of anxiety:

When we think about our worries too much we can get upset, which makes us worry more. It is easy to become stuck in this circle which can make it very difficult to manage and control our anxiety.

What is a panic attack?
During a panic attack, you may experience a range of different symptoms including:

  • Feeling short of breath
  • Breathing very fast (hyperventilation)
  • Your heart beating very fast
  • Feeling sick or as if you have ‘butterflies’ in your stomach
  • Feeling faint or dizzy

These symptoms usually come on suddenly and are accompanied by feelings of anxiety and fear. They may also be accompanied by thoughts that something terrible is about to happen. Panic attacks are very common and are not a sign of serious mental illness. There are a number of things that you can do to help manage anxiety and panic attacks.

Overcoming Anxiety and Panic Attacks
There are a few things we can do to stop us feeling anxious. It is helpful to practice these as the more we practice, the better we are likely to feel. Everyone is different, so some techniques will work better for you than others. Find which ones help you best and use the ones that suit you.

Managing our thoughts
First we need to find out what it is we are worried about. When we know this, we can ask ourselves these questions to find out how important the worry really is:

  • Will it still matter in six months or a year?
  • How likely is it that the thing we are worried about will actually happen?
  • If it did, what would that mean?
  • Is there another way of thinking about your worry – for example, how might someone else see it?
  • What would you say to a friend if they had this worry?

It might be that you are worried about something very real. If this is the case, ask yourself the question: ‘can I do something about it?’

  • If the answer is ‘yes’, start to write down ways of solving the problem.
  • If the answer is ‘no’ write down all the ways that might help you cope, for example: I will get support from friends/family by telling them how I feel etc.

This will help you to think about the different ways you can cope with your worries. The other skills explained below can be helpful in managing anxiety and panic, but in the long run, it is most helpful to address the thoughts that trigger your anxiety.

When we are anxious, our bodies tend to become tense. The best way of controlling tension is through deep relaxation. If our bodies are relaxed, it is harder for our minds to remain worried. One method of relaxing that can work well is called Progressive Muscle Relaxation. This requires you to tense, and then relax each muscle group:

  • First, find a time and place when you won’t be interrupted.
  • Either sit or lie down – whichever feels most comfortable.
  • Then, focusing on one part of your body at a time, tense each set of muscles for about 5 seconds and then relax them for 10-15 seconds.
  • You can work from head to toe, tensing and relaxing in turn the forehead, eyes, jaws, neck, shoulders, upper back, upper arms, forearms, hands, chest, tummy, buttocks, thighs, calves and feet. Or you can begin at the feet and work up the body.

People feel stress in different parts of their bodies and you can pay most attention to the muscles that you feel need it most. When you have worked through all the muscles, try and stay relaxed for
a few minutes and enjoy that feeling. There are different ways of relaxing and lots of books and apps available.

Hyperventilation and Controlled Breathing
When we are worried and anxious, we don’t always breathe the way we should. This is what can make us feel lightheaded. Dizzy or short of breath. We can stop this by learning to breathe properly. This exercise should be carried out for about 4 minutes to work:

  • Place one hand on your chest and one hand on your stomach. When you are breathing properly the stomach should rise and fall, rather than the chest.
  • Now breathe in to a count of four and out to a count of four.
  • Don’t breathe too deeply – just try and keep it nice and even.

Breathing exercises like this can be carried out anywhere, whenever you start to feel anxious.

Using your imagination can be a helpful way to relax. Picture a scene that is calm, quiet and safe, somewhere you would like to be. It could be a real place that you have been to or it could be an imaginary place. The most important thing is that it feels good to think about it. Now imagine every detail, eg if you’re imagining a garden, you need to picture:

  • All the plants and where they are
  • The shape and size of the garden
  • The sounds of birdsong
  • The smells and colours
  • The warmth of the sun, the touch of the breeze. Then picture yourself walking around it, smelling the flowers. Perhaps imagine sitting on a bench for a while and seeing the birds and butterflies. The more detail you can imagine, the more relaxing it will be. Allow yourself plenty of time to do this.

Distraction/thinking of something else
When we are anxious, we tend to think about our worries and this makes us feel worse. However, if we can think of something else, we won’t feel so anxious. There are three ways of doing this: thinking exercises, physical activity and thinking of other things.

  • Thinking exercises can include saying the alphabet backwards or counting down from 100 in sevens.
  • Physical activity could include walking and other forms of exercise, but it could simply be making ourselves busy doing something else, such as clearing out a cupboard or mowing the lawn.
  • Thinking about other things might include looking at people and making up a story about their lives, e.g. imagining what they do for a living, how they like to spend their leisure time etc.

What you do to distract yourself depends on where you are and what you are doing when you become worried.

Distracting yourself is the best thing to do when you are very, very worried and the other things are too difficult to do. Like everything else, it takes practice and you should do it for at least 4 minutes for it to work.

It is easy to get caught in a circle of anxiety. We need to develop skills to break that circle. These include:

• Managing our thoughts
• Relaxing our bodies
• Controlling our breathing
• Using our imagination to take ourselves to nice places
• Distracting ourselves from our worries.

Sources of Help
There are a range of resources available to help you manage panic attacks and anxiety.

Internet based resources – An interactive programme on anxiety/stress and mood management and includes helpful ways of managing it yourself. – A youth telephone helpline charity, which aims to help people suffering from anxiety and panic attacks.

Self-help literature

  • Overcoming anxiety: A self-help guide using cognitive behavioural techniques by Helen Kennerley. ISBN: 1 85487 422 5
  • Overcoming panic: A self-help guide using cognitive behavioural techniques by Derrick Silove, Vijaya Manicavasagar. IBN: 0 85487 701 1
  • Manage your Mind: The Mental Fitness Guide by Gillian Butler and Tony Hope. ISBN-10 0198527721

Professional Help
Although the information and sources of further information above may help you to understand and manage your panic attacks better you may also need professional help. Ask your GP about this in the first instance.