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13:51 Posted by Alison
It’s been a stressful day at work and you are standing on a crowded tube, going through the motions of your daily commute home. The lights flicker, the carriage rattles through a tunnel and suddenly you feel like you are about to die.

Your heart begins to race, pressure crushes your ribcage and a sharp pain sears through your chest. Sweating, you try to swallow, only to find your throat has closed up and a wave of nausea hits as you frantically glance around at the blank faces. Your vision starts to blur, you gasp for breath and your fingertips turn white with cold. You’re suddenly aware of numbness and weakness spreading through your limbs and your grip on the nearest pole loosens.

A million diagnoses simultaneously rush through your mind as shaking, and with your voice echoing in your head, you ask a fellow passenger to dial 999. At the hospital, you have an ECG and await the verdict; heart attack? Stroke? The doctors tell you that you are fine and that like more than three million other people in the UK, you have merely suffered a panic attack.

The number of people in the UK who have experienced panic attacks is rising and the current economic climate has undoubtedly had an effect on the amount of people approaching their GPs and being diagnosed. Charity Anxiety UK also says that since the onset of the recession, calls to its helpline have doubled and emails requesting support have increased by 400 per cent, yet panic attacks still remain a mystery to many or provoke inaccurate assumptions and associations. Panic attacks can affect anyone at any time. Many come out of the blue and far from being a sign of weakness or instability, they often impact those who normally see themselves as rational, driven and confident, which makes them all the more frightening.

Physiologically, panic attacks are caused by the body’s fight or flight response; an uncontrollable surge of hormones triggered by a perceived danger or threat. This innate reaction has remained part of our genetic make up during the evolutionary process and while it may have proved useful for our hunter-gatherer ancestors when faced with predators, in today’s modern world, such a primal response is often rendered useless as few are confronted with life or death situations on a daily basis.

Instead, the average person’s fight or flight response is typically triggered by some form of stress or significant life event. The hormone cortisol, which chemically initiates the process, is automatically released when the brain registers fear or feels the pressure to make decisions. Adrenaline and noradrenaline then flood the bloodstream instantaneously in preparation for combat or physical exertion (literal ‘fight or flight’). Within a matter of seconds, these hormones result in the symptoms felt by those experiencing a panic attack (the urge to take deep breaths in order to boost blood oxygen levels, nausea as digestion slows down, numbness as blood is diverted away from extremities etc.).

The sudden onslaught of unpleasant sensations and the mental impact of an unexpected attack makes panic attacks terrifying, despite there being no danger of them resulting in physical harm. However, if left untreated they can reoccur, intensify and begin to disrupt everyday life. The fear of another attack prolongs the stress response and creates a cycle of panic and anxiety that is set off by progressively smaller problems, decisions and actions- a condition known as panic disorder. Some suffers of panic disorder also develop agoraphobia as they begin to avoid situations that they associate with previous attacks and agonise over the possibility of having an attack in public. Others become depressed or develop phobias as a result of traumatic panic experiences.

Yet panic attacks need not lead to further problems and the best course of action is prompt treatment. Medication in the form of beta blockers can help those who have minor symptoms alongside raised blood pressure, mild tranquilizers are sometimes prescribed to those who suffer less frequently from attacks (and are to be taken at the onset of symptoms or before specific trigger situations, such as flying), and anti-depressants have been known to help those who develop low moods when attacks affect their sense of freedom. However, the most widely recommended treatment is cognitive behavioural therapy (CBT), a psychological treatment that focuses on preventing the fight or flight response being activated through rationalising the cause and effect nature of attacks and the negative thoughts that precede them. CBT has a success rate (resulting in diminished or eliminated symptoms) of approximately 80%, has been endorsed by celebrity sufferers Donny Osmond and Kim Basinger, and is available upon referral from your GP.

There are of course steps you can take to help prevent panic attacks occurring by minimising the affect of stress on your body. Taking regular exercise and eating healthily may seem like small steps, but they can make a big difference to your mental as well as physical wellbeing. Setting aside moments to wind down and prioritising tasks using lists are also essential in testing times, so leave the worries of the workplace at your desk and use that next journey to organise your thoughts, get lost in a good book or simply do nothing but daydream away the stops. Hopefully, as the overhead light brightens and you turn a corner, you will suddenly feel alive.
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All original content is ©Alison Rowley 2012. No words or images may be reproduced without permission from the copyright holder.