Extract from ABC News
For the nearly 40 per cent of Australians who will experience them, panic attacks can feel a little like having a heart attack: a pounding in your chest, dizziness, trouble breathing.
That's just what Claire Eastham thought the first time she had one, in the middle of a job interview ten years ago.
She was nervous, as many would be, but while walking down the corridors to the interview room, her nerves took on a different tone — she felt "off-kilter".
The panic attack hit her once the interview started, but she didn't know that's what it was. She felt sure she was dying.
"I've never been that frightened in my entire life," the UK mental health blogger and author tells ABC RN's Life Matters.
"It was almost like liquid terror was injected into my veins. My heart started hammering against my ribcage, so much so that it was painful. I couldn't get a deep breath. I was getting blurry vision. My tongue was really dry, as my mouth was," she says.
Claire's panic attacks kept coming after that first one but their power diminished as she learnt what to expect – and what she could do about them. She's keen to share with others what has, and hasn't, helped along the way.
What exactly is a panic attack?
Panic attacks are "our body's response to some perception of threat", says Peter McEvoy, professor of clinical psychology at WA's Curtin University.
The threat might be real – a road accident near-miss, for example – or it might be perceived, such as in a job interview. But panic attacks can also come out of the blue, for no apparent reason at all.
They can entail a quickening of breath, shortness of breath, increased heart rate, beginning to sweat or a rush of adrenalin through the body. These are our bodies' "resources" to deal with threat, Professor McEvoy says.
He says younger age, being female, smoking and alcohol problems, experiencing early stressful life events, and family history of mental disorders "are consistently associated with panic disorder".
He explains that although the symptoms of a panic attack can feel incredibly uncomfortable, they aren't harmful. And paying attention to that fact is important if you're in the middle of an attack.
"If we respond to them with catastrophic thoughts and interpretations about what they're going to lead to – Is it a heart attack? Is it a stroke? Is it going to lead to another panic attack? – then that increases the perception of threat and escalates the anxiety."
It's knowledge Claire wishes she had at the time of her first attack, and it's since helped her. She says she entered a journey navigating panic attacks "blind", and because she didn't, at first, know what she was experiencing, she couldn't reassure herself that "nothing bad is going to happen".
"I didn't know that at the time, so I was just terrified, [thinking] I don't want to feel like that ever again. And of course, that meant it would come back."
Panic attacks aren't fun but the symptoms won't harm you
For Claire, understanding her panic attacks has enabled her to diffuse them.
"It's almost like getting off the roller-coaster. You're armed with enough knowledge and enough information to know that this is incredibly uncomfortable, but it's not dangerous."
She says she's learnt not to try to ignore the attacks – "panic will not be ignored," she says – but rather to trust that she'll be ok and to think, "we'll just wait it out".
Professor McEvoy says understanding panic is an important step in learning to manage it, and a treatment called exposure therapy can really help.
It hones in on the "fear of the fear" – the idea that the more fearful we are of having a panic attack, the more likely we are to have another one.
"If we learn to reinterpret those symptoms as actually benign, as just normal fluctuations of the body that occur to most people, that they will pass after a few minutes. We just need to allow them to follow that course, then it's a circuit breaker for that loop, and it won't escalate the anxiety in the same way."
Through exposure therapy, a person is gradually confronted with or exposed to some of their panic attack symptoms as they are intentionally brought on, in a controlled and supported environment, and then they're taught "how to master them".
"[It's] learning how to genuinely accept the symptoms – not fight them [but] allow them to come and go in their own time."
Professor McEvoy admits that's easy to say and hard to do, but it's worth the effort. "It is one of the most effective ways of helping people manage their anxiety," he says.
It sounds cheesy but self-care helps
One of the tactics that has helped Claire manage her panic attacks is self-care.
"It sounds incredibly cheesy to an extent. But you should never think that self-care is innate. Because it isn't. A sneeze is innate," she says.
For Claire, it includes not working too much, having proper lunch breaks, sleeping enough and not taking her phone to bed.
And when she feels certain anxieties building up again, she doesn't ignore them because now, she says, "I know what will happen".
Professor McEvoy says now more than ever, self-care is something we need to pay attention to.
He believes it's likely there are more people in the community experiencing panic attacks for the first time, or having them resurface, as a result of the stresses related to the COVID-19 pandemic, including experiencing lockdowns, economic stress and working from home.
But, it's also because regular small acts of self-care are now harder to maintain, for example walking to the bus stop, seeing friends or even just having a chat with people at the shops.
Professor McEvoy says different people will identify different things as helpful in self-care.
"Lifestyle is really fundamental to our wellbeing more generally – things like sleep routine, eating well, being mindful of how hard we're pushing ourselves and the stresses and pressures in their life," he says.
"The less attention we pay those things, the more easily triggered a panic attack is going to be."
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