Anxiety and Panic Attacks
Anxiety can interfere with every day life, making life less enjoyable.
A little bit of anxiety can be useful, as it can help motivate us to do our best, but for some people feelings of anxiety get out of control, and instead of being motivated, the person is debilitated. These people may get to the point when their anxiety - or the fear of becoming anxious - means that they avoid giving a tutorial paper, sitting an exam, going on a date or looking for a job. The good news is that there are a number of ways of getting over such anxiety so it stops being a problem
Anxiety can occur in different degrees and for different reasons.
A bit of anxiety can be helpful, as it might help us be motivated to perform well or look for signs of danger. An actor will usually have a bit of anxiety before a performance and consider that a good thing. Too much anxiety however can be very debilitating.
Some people get anxious in social situations. Some get anxious about specific things (like flying or public speaking) and some find the anxiety is more general, and hangs around and seems to attach itself to all sorts of situations.
At the more extreme end of anxiety, some people suffer panic attacks. The intensity of the attack can be extremely severe and many people feel they are having a heart attack and are going to die, or that they are going crazy. It is not unusual for people to become fearful and chronically anxious about having another panic attack.
Symptoms of panic attacks can be very intense and may include difficulty breathing properly, racing heart, sweating and even fear that you might be dying.
The symptoms of Panic Attack are related to the “Fight or Flight” response, which is a natural response that occurs in humans and animals when faced with danger. This is something which is useful in an evolutionary sense, as we have adrenalin released and other body changes that help in running away or fighting better. The brain also goes into something of a short circuit, so that we can notice and respond to danger well, but not be very creative or think quite as clearly as usual. All of this is a great help if you happen to stumble across a tiger in the jungle, but not so helpful if you are about to give a talk to a tutorial group.
Avoidance: Because severe anxiety or panic attacks feel dreadful most people do whatever they can to avoid them. This makes sense but tends not to help much in the long term, as the fear tends to build up, the longer whatever causes the fear is avoided. Often this inadvertently makes it worse. Sometimes the fear just sits there until the same trigger for the fear is met again some time later, when it all comes up again.
Drinking: In some cultures having a drink is a pretty common way to help with social nerves at a party. Generally, however, if people start to rely on alcohol or other drugs to cope with anxiety it can be quite dangerous. The symptoms may be alleviated in the short-term, but in the long-term the problem doesn’t go away and the effects of alcohol and drugs upon physical and mental health can be quite serious.
Awareness: Generally it helps to learn a bit about anxiety and panic and to realise that some of it is shared by all of us. When it does get out of control it still helps to know it is a normal body process, which is just happening too strongly when you don’t want it.
Acceptance: Recognising the feeling, naming what is happening to you and allowing a bit of time for it to pass sounds too simple but does often help. People who suffer from problems with anxiety usually become anxious about being anxious, and so a feedback loop develops which makes it much worse. If you can just notice and name it and just keep breathing, that usually helps.
Exercise: Exercise doesn’t ‘solve’ anxiety but it can help to release the physical tension that goes with it. The usual guideline is to do at least thirty minutes with your heart rate raised. This might be jogging, riding a bike, going to a gym or just walking at a brisk pace. Exercise seems to shift the body out of the ‘fight or flight’ state and bring it back to a more normal resting state. It tends to ‘flush’ through the body chemicals like adrenalin that go with anxiety, and to release a few endorphins, one of the body’s ‘feel good’ chemicals.
Balance: Practical steps can also help, such as checking your work load and making sure you are not overloaded with study, or with things that are emotionally demanding. Doing too much for too long without proper breaks can tend to build up stress and lead to anxiety. Taking some breaks and balancing your schedule can help.
Think about thinking: Usually when people are getting very anxious there is an initial anxious feeling which leads to a whirlpool of anxious thoughts, which leads to a massively increased anxious feeling. It can help to acknowledge that there is some anxiety, but then to stop the anxious thoughts that follow on from it. Try to notice the thoughts and let them pass, or have something positive to say to yourself, or remind yourself of what your goals are in the situation so you can focus on them.
Controlled Breathing: It may sound a little strange but the breath is a remarkably powerful mind-body link and a good place to start in controlling anxiety. Although we don’t usually notice it, our patterns of breathing change with each different emotion we are feeling and this is also true of anxiety. Generally people who are anxious tend to breathe high into the top of the chest, breathing in only a little then holding the breath. A panic attack might be different, still breathing high in the chest but rapidly, which can lead to hyperventilation. Doing a few slow deep breaths can have a physical effect to lower the anxiety a little. If it can be cranked down a notch or two, then it is easier to think through what is best to do next to help manage it. The Counselling Centre has a separate handout on controlled breathing for those who might like to explore this further.
Counselling and therapy are generally very helpful for overcoming anxiety and panic attacks. This usually involves looking at the sort of thoughts that are happening with the anxiety, ways of changing unhelpful thoughts, ways of recognising strengths you can draw upon and ways of relaxing. It often then involves taking small steps to face whatever triggers the anxiety in a safe and controlled way. This sort of help is available at the Counselling Centre.
For severe anxiety some people find medication helpful and speaking with a GP can be a good idea. Anxiety can sometimes be affected by physical conditions and talking with a doctor can help respond to this or to rule it out.
Self help groups. Some people find it helpful to talk to others who have gone through the same thing and a centre offering that help is: Panic Anxiety Disorder Association (PADA) (2004), P.O. Box 83, Fullarton, South Australia, 5063. www.panicanxietydisorder.org.au [accessed 25.5.2004]