HypoPit HypoTips
Anxiety and Panic Attacks

HypoPit HypoTips: Anxiety and Panic Attacks

Although this is not exactly specific to hypopit patients, I felt this subject deserved a mention.

Stress and Anxiety

Anxiety, at its simplest, is your body’s reaction to stress. Everybody feels anxious at some point in their lives, and this is generally fine; if you stress about missing the bus, you get to the bus stop earlier. If you stress about school exams, you study harder. If you are stressed about a job interview, you prepare more beforehand.

As someone with a long-term medical condition, you have extra things to find stressful, like attending hospital appointments, running out of medication, or my absolute least favourite - blood tests. In addition to the everyday stresses that everyone else is feeling, you have this untold burden that no one else quite understands. It is still perfectly normal to feel anxious about these things, but perhaps you don’t always admit them. You don’t want to seem weak, or worse, different.

Anxiety is different from just feeling anxious under stress, and this makes it hard for people who haven’t experienced it to understand. Anxiety could be in reaction to something rational as described above, or in reaction to something completely irrational, like feeling stressed about what to order at a restaurant, or feeling stressed about attending social events. Anxiety comes from thoughts that go round and round your head, until you feel like you can’t cope with the situation.

Your body interprets the feeling of anxiety with danger, and this triggers the “fight or flight” reflex.

“Fight or flight”

The “fight or flight” reflex is designed to keep you safe; you’ve perceived danger, so your body prepares to overcome it. The word “fight” refers to facing the danger head on; the word “flight” means running away from the danger. Your body gets ready for this, creating a number of physical effects.

First, your heart races, supplying plenty of oxygen to your muscles, getting ready to run. In order to maintain this, you breathe harder and faster, which makes you feel light-headed and shaky. Less blood goes to your fingertips, making them feel cold and tingly. Your body stops paying attention to less urgent functions, so your digestive system slows down, causing nausea and dry mouth. Your muscles tense, which makes you shaky, and you start to feel aches and pains. You sweat, your body trying to keep itself cool, ready for physical exertion.

For someone who has experienced anxiety, the effects of this survival mechanism may seem familiar, and this is because you go through the same reaction when you have a panic attack.

The Panic Attack

Your heart pounds as you gasp for air; you feel sick, numb, and weak. You feel vulnerable, your pupils dilate and you become more alert – you are looking for danger, waiting for something to happen. Your body is experiencing the “fight or flight” response, but you are not in danger and there is nothing to fight or run from, and as a result you cannot escape this sensation.

A panic attack typically lasts 5 to 10 minutes, though it might seem a lot longer. They are harmless, but at the time you feel very uncomfortable or like you are going crazy. The first time you experience a panic attack, you believe you are going to die. Your frame of mind tells you that you cannot cope, and you feel totally out of control. You might even feel a pain in your chest and believe you are having a heart attack, but this is just an ache from your muscles being tensed and is totally harmless. Despite how you may feel, you are still taking in enough oxygen and you are still in control. Most of the effects will not be noticed by people around you, and the feelings eventually fade away as you calm down.

The panic attack ends as your body runs out of energy. You feel exhausted and weak, and possibly humiliated. It is a good idea to have a glass of water and concentrate on your breathing for a moment before going back to whatever you were doing.

Managing Anxiety

If you know you suffer from anxiety, the temptation is to avoid doing things that make you feel anxious, to reduce the chance of a panic attack. However, there is no guarantee that this will work, and this could stop you from going out and living a normal, fulfilling life. Instead, it is better to equip yourself with the tools to recover quickly from a panic attack in case it does occur, and to carefully reintroduce yourself to environments that may have previously triggered your anxiety.

Techniques to recover from a panic attack

Here are three simple but effective techniques that will help during a panic attack:

  • Focus on breathing
    • Breathe in through your nose as slowly and as deeply as you can.
    • Breathe out through your mouth, again keeping it as gentle as possible.
    • You may prefer to close your eyes and only focus on your breathing, or count to 5 for each breath in and out.
  • Drink some water
    • Sipping slowly on water can help further control your breathing, as well as soothing you.
    • Avoid taking deep gulps – draw the water into your mouth steadily and concentrate on each mouthful, this will distract you and help with the nausea.
  • Tense and relax your muscles
    • This works best if you are sat in a chair.
    • Push your heels into the ground as hard as you can, tensing the whole of your legs.
    • Clench your fists as tightly as possible and feel the tension throughout your arms.
    • Count to 30, then release the tension by relaxing your arms and legs.

Maintaining a healthy lifestyle

Never let anxiety prevent you from accomplishing day to day tasks or achieving your personal goals. You can reduce the chance of having a panic attack by maintaining a healthy lifestyle – this means regular exercise, a balanced diet and limiting your intake of caffeine, alcohol and cigarettes.

Slowly reintroduce yourself back into situations you may find stressful. You may prefer to do this with the support of a friend or by yourself, but take it at your own pace and make small incremental changes rather than giant leaps. Be aware of your own limits, and don’t feel disheartened if you find things are too much for you at first.

Seeking help

If you experience panic attacks regularly, you may wish to seek help. There are plenty of resources available online, but you can also speak to your doctor, or find out about panic support groups, such as No Panic (http://www.nopanic.org.uk/).

In terms of treatment, cognitive behavioural therapy (CBT) is highly recommended, aiming to identify and change the negative thought patterns that lead to your panic attacks. If you think you would benefit from CBT, have a chat with your GP who can refer you for NHS therapy, or possibly recommend a private local therapist.


Helping someone with anxiety

The first thing to know when you want to help someone experiencing anxiety is that even if the danger is not real, the reaction is real. The person in front of you feels the same as if they were chained to a hungry lion, or falling from the top of a skyscraper. They feel trapped in a situation in which they cannot cope, and even if that situation is as simple as choosing what to order in a restaurant, their body believes that they are in danger.

There is no way of knowing what works for someone going through a panic attack. If you know someone experiences panic attacks, you can support them by finding out what they would want you to do. Some people may wish to have physical contact (like a hug or holding hands) and others may prefer to be alone. I personally do not like being touched at all, and prefer to be on my own, so the most helpful thing for people around me to do is to give me some space and perhaps make a cup of tea for me to have when I’ve calmed down. Being supportive does not mean being right beside them the whole time, it means respecting their wishes and being available for them if they do need you.

Things to do:

  • Believe that what they are experiencing is real (to them) – do not try to reason away the cause of the anxiety. Even if the cause is irrational, the reaction is real, and questions may create more stress for the person having a panic attack.
  • Listen to what they ask you to do – if someone knows they have panic attacks, they might know what they want from people around them in that situation.
  • Reassure them continuously – during the panic attack, reassure them that you are there, that you can help, that they will be alright. Let them know there is nothing to worry about. After the panic attack, reassure them that you are there for them, and try to help them return to normal.
  • Don’t take it personally – even if they are angry or shouting or crying, remember that none of this is directed at you, this is all originating from stress and will probably disappear when they calm down.

Hopefully with this advice you will be able to understand the physical and emotional changes that happen to someone experiencing a panic attack, and help them through this stressful experience.

Further advice is available on the NHS website: http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/coping-with-panic-attacks.aspx