6 mins

Don’t Panic! Top tips for managing panic attacks  

Have you ever had a sudden thought that you’ve lost your wallet and had a brief sense of panic before finding it? Or noticed a sudden feeling of panic after hearing a loud unexpected noise? We all experience these fleeting moments of panic from time to time, because our body is responding very quickly to a frightening situation. As soon as we know that everything is ok, the panic subsides. This is part of our “fight or flight” response, which enables our bodies to get ready quickly either to confront or run away from a threat.

A panic attack is a sudden surge of anxiety and related physical sensations such as dizziness, heart palpitations, nausea, breathlessness and hot flushes. Often when people experience these sudden sensations, they have frightening thoughts such as “I’m having a heart attack” or “I’m going to faint or collapse”. Others may think they will lose control or even go mad. These are very distressing and threatening thoughts and as such cause even more intense feelings of anxiety. This then makes people believe even more strongly that something bad is about to happen. This vicious cycle can be simply depicted in the following diagram:

Trigger: noticing my heart beating quickly

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Thought: I’m going to have a heart attack

    double_headed_arrow_vertical

 Feel anxious, hearts beats more quickly

Panic attacks tend to last only up to 20 minutes, but for some people can last longer.

Panic attacks are not harmful; your body is responding to a frightening thought.

Often the first time someone has a panic attack it can seem to appear out of the blue. There may be underlying reasons for why you have experienced a panic attack. For example, at times of greater stress or worry, we may be feeling generally more anxious and therefore be experiencing more symptoms of anxiety. If these symptoms are then interpreted in a threatening way, it could lead to an intensification of symptoms which culminate in a panic attack. It could be that your body is responding to poor sleep or new medication, or perhaps you’ve just had too much caffeine.

Panic attacks can feel very frightening, and as a result people may start to avoid situations in which they had previously experienced panic attacks, or may engage in certain behaviours to avoid the feared outcome from happening, such as sitting down if they feel dizzy to avoid fainting, or stopping an activity to avoid a heart attack. However, unfortunately these kinds of behaviours can keep panic attacks going by reinforcing the belief that something bad is going to happen.

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Its important to remember that panic attacks themselves are not dangerous.

There are various things you can do in order to help manage and even stop having panic attacks.

  • Stop Avoiding – if you have started to avoid doing things that you fear may trigger a panic attack, make a plan to slowly start to confront that situation. For example, if you avoid getting the bus, then perhaps you could start by getting the bus when it is not too busy. Stay on the bus until the anxiety you experience has subsided. Then next time, get on a slightly busier bus and again try not to get off the bus if you start experiencing symptoms of a panic attack.
  • Remind yourself, ‘it’s just anxiety’ – it is the threatening thought that is causing you to feel anxious. If you can challenge the thought and remind yourself that you are experiencing a symptom of anxiety, this will help to reduce the intensity of the anxiety.
  • Keep calm and carry on – one way of reducing the intensity of the physical symptoms of anxiety and panic is to use slow breathing; often during a panic attack people may breath very quickly and this can cause even more dizziness. Breathing slowly and in a regulated way, for example by counting up to 5 and then slowly exhaling, can stop this from happening and can make you feel calm and in control.
  • Stop what you’re doing – make a list of all the safety strategies you have started using to try and prevent having a panic attack, and slowly try to stop using these strategies. For example, if you sit down to avoid fainting, try not to do this, and allow the panic attack to subside on its own. This will help you to learn that nothing bad will happen to you and this can help the panic attacks to stop. Remember, it’s the THOUGHT that is causing the fear. Without the thought, the anxiety will not continue.
  • And…relax – regular relaxation is helpful in reducing the general stress you are experiencing, which may be an underlying cause of the panic attacks.
  • Exercise and diet – regular exercise is another good form of stress relief. Likewise, making small changes to your diet can help to reduce your symptoms. For example, reducing the use of any stimulants such as caffeine, and reducing nicotine and alcohol can be helpful, as these substances can often exacerbate symptoms of anxiety.
  • Treat any underlying physical health problems – some symptoms of panic can be caused by underlying medical conditions, such as thyroid problems.
  • Medication – your GP or a psychiatrist can recommend medication that may help with reducing the intensity of panic attacks. However, in most cases they may suggest seeing a psychologist who can help you to make sense of why you may be experiencing panic attacks and find helpful ways of managing them.

If you would like to learn more about panic attacks there are some useful self-help books that take you through a step-by-step guide of what you can do to overcome panic. These tend to be based on cognitive behavioural therapy (CBT), which is an evidence based treatment for panic attacks recommended by the National Institute of Health and Clinical Excellence. You can also contact a psychologist trained in CBT if you think you require extra support with understanding and stopping panic attacks.

Useful links:

http://www.nhs.uk/conditions/stress-anxiety-depression/pages/understanding-panic-attacks.aspx

http://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/panic-attacks/#.V6tLCE-FPCM

http://www.topuk.org/

https://www.anxietyuk.org.uk/

Dr Elena Touroni

Dr Elena Touroni

15 August 2016

"Dr. Elena Touroni is a skilled and experienced Consultant Psychologist with a track record of delivering high-quality services for individuals with all common emotional difficulties and those with a diagnosis of personality disorder. She is experienced in service design and delivery, the management of multi-disciplinary teams, organisational consultancy, and development and delivery of both national and bespoke training to providers in the statutory and non-statutory sector."

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Dr Elena Touroni

Dr. Elena Touroni is a skilled and experienced Consultant Psychologist with a track record of delivering high-quality services for individuals with all common emotional difficulties and those with a diagnosis of personality disorder. She is experienced in service design and delivery, the management of multi-disciplinary teams, organisational consultancy, and development and delivery of both national and bespoke training to providers in the statutory and non-statutory sector.


Having obtained a first degree in Psychology (BSc) at the American College of Greece, she completed her doctoral training at the University of Surrey. Dr. Touroni is highly experienced in the assessment and treatment of depression, anxiety, substance misuse, personality disorder, eating disorders, obsessive compulsive disorder, adjustment disorder and relationship difficulties. She works with both individuals and couples and can offer therapy in English and Greek.


Dr. Touroni has held a variety of clinical and managerial positions including as Head of Service in the NHS. Further she has held academic positions for the University of Surrey and the Institute of Mental Health lecturing on specialist postgraduate Masters and Doctorate programmes.


She is trained in several specialist therapeutic approaches such as schema therapy, dialectical behaviour therapy (DBT), cognitive behavioural therapy (CBT), mindfulness-based approaches and Cognitive Analytic Therapy (CAT). As well as holding a variety of NHS positions, Dr. Touroni is the co-founder of a private practice in Central London that has been a provider of psychological therapy for all common emotional difficulties including personality disorder since 2002. She is the founder and one of two directors of The Chelsea Psychology Clinic.