Positive Health Online

Dealing with Anxiety and Panic Attacks

According to the Royal College of Psychiatrists, anxiety disorders affect about one in 10 people in the UK. Here, Professor of Psychiatry at Southampton University, David Baldwin, reveals how to spot the symptoms and get treatment to prevent them.

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Anxiety is the feeling of fear we get when faced with threatening or difficult situations.

“Anxiety is normal and can help us to avoid danger. It makes us more alert and gives us the energy to deal with problems,” explains Professor Baldwin.

“But if the anxiety is too strong or is there all the time, it can be a real problem.”

Is Anxiety Different from Depression?

“Anxiety has quite different symptoms from depression; if you’re depressed you’ll suffer from low mood, reduced energy and lose interest in things, but if you’re anxious you’re agitated, have increased energy and can maintain your interests,” explains Professor Baldwin.

“People with depression are self-critical and regret past behaviour, but anxious people worry about the future.”

“However, if you’re anxious you may stop doing things and become isolated and depressed as a result.”

“Anxiety only becomes a problem if it’s interfering with your daily life.”

Panic Attacks

A panic attack is a sudden surge of intense anxiety that can come from nowhere. Whilst feeling panic and anxiety is normal in stressful or dangerous situations, people who suffer from panic attacks can suffer from these feelings at any time, for no apparent reason.

“Symptoms peak within 10 minutes and usually subside after half an hour. They are not dangerous but can feel very frightening,” explains Professor Baldwin.

How Common are Panic Attacks?

“One in 10 people will have a panic attack at some point in their life, one in 20 will have recurrent attacks and one in 50 (2 per cent) will suffer from panic disorder – defined as regular, unexpected panic attacks,” says Professor Baldwin. “Symptoms usually begin before the age of 20.”

Physical Symptoms for Panic Attacks

Symptoms are experienced by the body producing the so-called ‘fight or flight’ hormone adrenaline and include:

1. Heart palpitations
2. Shaking
3. Sweating
4. Breathlessness
5. Rapid breathing
6. Tingling in the fingers and around the mouth
7. Dry mouth

Is It a Heart Attack?

About a quarter of people who go to an emergency department with chest pain, thinking they’re having a heart attack, are actually having a panic attack.

“The symptoms are easily distinguishable,” explains Professor Baldwin.

“Heart attacks are characterised by crushing central chest pain – usually on the left and also in the arm – but in a panic attack there is no pain. Heart attack symptoms will get worse but a panic attack will usually subside after half an hour.”

Psychological Symptoms of Panic Attacks

People experiencing a panic attack will feel intensely worried, agitated and fearful. They often describe feeling like they are going to die or frightened they’re 'going crazy' or losing control.

What causes Anxiety and Panic Attacks?

No-one knows for sure – but there are certain triggers. These include:

1. Your genes: Some of us are born worriers. This tendency might be inherited.
2. Stressful events: Divorce, money worries, bereavement, redundancy and exams are obvious triggers for anxiety, but usually when the problem disappears, so does the anxiety. But other traumatic events such as car crashes, assaults and fires can leave you feeling nervous and anxious for months or years – known as post-traumatic stress disorder.
3. Drugs: Illegal highs from amphetamines, LSD or ecstasy can make you anxious – as can excess caffeine.

Treatments

If you’ve only ever had one panic attack, your doctor is unlikely to prescribe treatment, as 50 per cent of patients never experience another attack, but if you have a recurrent problem you may need either drugs or psychological therapy or a combination of both.

Psychological Therapies

1. Cognitive behavioural therapy (CBT), or talking therapy, can alleviate feelings of anxiety and panic and help change how you think and act. CBT focuses on current problems rather than things that have happened in the past;
2. Exposure therapy: “If your panic attacks or anxiety are triggered by a specific fear, such as fear of enclosed spaces, you can use CBT techniques to help expose yourself to your particular trigger for a short period,” advises Professor Baldwin.

Medication – Advice from nhs.uk

If the psychological treatments above haven't helped or you'd prefer not to try them, you'll usually be offered medication. Your GP can prescribe a variety of different types of medication to treat anxiety. Some medication is designed to be taken on a short-term basis, while other medicines are prescribed for longer periods. Depending on your symptoms, you may need medicine to treat your physical symptoms, as well as your psychological ones. If you're considering taking medication for anxiety, your GP should discuss the different options with you in detail before you start a course of treatment, including:

• The different types of medication;
• Length of treatment;
• Side effects and possible interactions with other medicines.

You should also have regular appointments with your doctor to assess your progress when you're taking medication for anxiety. These will usually take place every 2 to 4 weeks for the first 3 months, then every 3 months after that. Tell your GP if you think you may be experiencing side effects from your medication. They may be able to adjust your dose or prescribe an alternative medication.

Self-Help

1. Talk your fears through: Tell someone you trust who has had the same problem or knows someone who has;
2. Join a support group: The charity Anxiety UK runs a helpline (08444 775 774) and online support.

Further Information

For more information on treating anxiety, please visit AXA PPP healthcare.