What are panic attacks?

Panic attacks are sudden periods of intense fear or extreme anxiety. They occur when the “fright, fight or flight” response is triggered, although there is no sign of danger.

The “fright, fight or flight” response is a survival system that your body uses – it means that when your brain thinks it’s in danger, your body gets ready to fight or run away. If you’re experiencing a panic attack, the body will react like you are in a dangerous situation even though you’re not.

Panic attacks can happen without any warning. The attack could last for a few minutes or up to half an hour. After the attack, it might take some time to start to feel ok again.

It’s not unusual to experience a panic attack – one in five people will have at least one in their lifetime. After experiencing one panic attack,it’s also normal to worry about having another. You might even start avoiding situations or activities that you think might trigger an attack, like lecture halls, shopping centres, public transport, airplanes, lifts or being alone.

If you notice that you’re doing that, it might be a good idea to consider talking to someone about how you’re feeling, and getting some support to manage it. Check out face-to-face help.

What are the effects of panic attacks?

The effects of the attack vary from person to person. Some effects may include:

  • sweating
  • feeling short of breath, like you can’t get enough air
  • pounding heart
  • chest pains
  • feeling unsteady
  • feeling like you’re choking
  • dry mouth
  • hot or cold flushes
  • tingling
  • feeling faint
  • trembling
  • nausea or diarrhoea
  • feeling like you’re losing control or you can’t escape.

What causes the attack?

The causes of panic attacks are still being researched. However, there is evidence that different types of stress such as ongoing stress or a one-off stressful event is associated with panic attacks. The stress alters the chemicals in your body that influence the fight or flight response.

There are some illnesses such as diabetes, asthma, or inner ear complaints that have similar symptoms to panic attacks so it is a good idea to check with your doctor to see if the symptoms are due to the illness.

Depression, anxiety and Obsessive Compulsive Disorder (OCD) have also been associated with panic attacks.

How can I manage a panic attack?

Self-talkremind yourself that this is only an uncomfortable feeling and it will pass. To help it do so, try and distract yourself by thinking about something different, like counting backwards in threes from 100 or sing the lines of your favourite song. See if you can concentrate on your breathing, focusing your attention on something else.

Diet- be aware that stimulants, like coffee, coke, anything else with caffeine in it (for example, energy drinks), drugs, alcohol, and smoking can all act as triggers for a panic attack.

Exercise - when you start panicking, a lot of hormones, like adrenaline, start pumping. They keep you feeling panicky. A way to help get rid of those hormones is to exercise, especially doing something that raises your heart rate. Regular exercise uses up naturally produced adrenaline and so can help lessen panic attacks.

Relax – relaxation techniques can be really effective. If you’re having a lot of panic attacks, it can help to get a relaxation CD. Listen to it for however long you like, every day. This can help to reduce your overall stress.Other forms of relaxation are also useful, such as yoga, Tai Chi, pilates, meditation, swimming and even going for a walk.

Breathing – try to practise some slow, controlled breathing while you’re not having an attack and when you get good at it, try to use it while panicking to slow your breathing down:

  • hold your breath and count to ten, then breathe out
  • breathe in through your nose for the count of three, then out through your mouth for the count of three – continue this for one minute
  • hold your breath again for the count of ten
  • do this for about 20 minutes a day (and you could break it up, like doing four five-minute sessions), and any time you’re feeling panicky

Find help – if you are having a lot of attacks, or if they are getting in the way of your life, it’s possible you are suffering from a panic disorder. It can help to see a psychologist, especially one that specialises in anxiety disorders. Check out face-to-face help for loads of information on the different types of help available, how it works and how to get it.

Cognitive behavioural therapy, and in some cases medication, can both help ease panic attacks. Panic attacks can be frightening experiences, but if dealt with properly, can be overcome. The important thing is that you look after yourself and seek help to avoid future panic attacks.


Comments Show all comments

  1. Fenella (Admin) says:

    Hi Orla,

    I know it’s not easy to write your feelings down like this, but I’m really glad you did. I know you’re confused and it's hard to know what's going on, but there’s nothing wrong with you. It sounds like you’re feeling quite anxious and that this anxiety is showing up as a physical need to go to the bathroom. This happens all of us at times, and it’s a normal response to nerves or anxiety. It sounds like this is happening you a lot though and that needing to go to the bathroom a lot causes anxiety in itself because you feel like you can’t relax anywhere where you’re not easily able to get up and go quickly to the bathroom.

    You mention a few things happening at school that make you feel anxious and stressed and that might be the cause of the anxiety you feel. No one deserves to feel sick every morning going into school and I hope I can pass on some information to help. Things will get better Orla, you won’t always feel this way.

    I wonder have you spoken with anyone about how you feel? Sometimes saying things out loud and talking them through with someone you trust can make a huge difference. I know it can be really tough to think about talking so openly and honestly but it really can help. You’re not alone in this and you don’t have to struggle on alone. There are lots of people who can help. Maybe you could talk with one of your parents, or another family member or a close friend? Is there a counsellor at school or a teacher you trust you could chat with? It is ok to talk about these things and the way you feel and to get some support. Read up about the benefits of talking to someone

    Building up our confidence levels and looking after our mental health can really reduce the amount of anxiety we feel and can help us to cope better with stressful times like being asked to read in front of the class.

    As well as talking to someone you trust Orla, lifestyle changes can make a big difference to how we feel and can build up our confidence. Getting exercise, even going for a walk, can help to burn off any extra adrenaline that may build up and cause us to feel anxious. Getting the right amount of sleep can help, as well as eating healthily and taking time out to relax and do the things we enjoy.

    5th year can be a stressful year in school as you move into the senior cycle and try to cope with the extra pressures and demands from teachers. It’s important to take time out for you and to relax. Learning some relaxation techniques might be really worthwhile. There’s a breathing exercise on the relaxation page on ReachOut.com and you could start with learning that and practising it whenever you feel anxious or stressed.

    Keeping a journal and writing down how you feel can help you to identify how things that happen during your day make you feel. Lots of people find this quite helpful.

    If you ever want to talk to someone, but don’t want to talk to someone you know, you can contact Childline 24 hours a day by calling 1800 66 66 66. You can text Talk to 50101 between 10am and 4pm every day and they also have an online chat service at www.childline.ie available 10am to 4am every day.

    Having the right support from trusted family, friends and your school counsellor or another teacher at school can make a huge difference, so please do talk with someone you trust Ciara and have a think about making some small lifestyle changes and learning some relaxation techniques. You’re not alone in this and things can get better.

    Take care,

  2. Orla says:

    I'm not sure if I suffer from anxiety or not but everything I have read online fits in perfectly with how I am feeling.
    I am 17 and I am currently in 5th year in secondary school, recently in classes I've felt the urge to pee constantly, I've got checked and there is no infection but I seem to have that feeling when ever I know I can't get up and go to the bathroom for example on a bus or in class. This is really effecting my school life because I can't concentrate at all in classes because I'm worried I might pee myself even though when I go to the bathroom the feeling has passed until I sit down in my next class and the cycle repeats it's self.
    I also struggle in a certain class where my teacher always picks me to read the whole chapter of a book or my whole essay to the class. I struggle with this because I'm quite shy and as soon as I begin to speak I loose my breath and it feels like I'm not getting enough air, I also am very shakes for about 15 minutes after. My teacher knows I struggle with reading out loud in class but he constantly picks me to read every day, every time I tell someone they say he's only trying to help and I wish that was the case but I truly believe he does it on purpose because since I started in my school he never liked me at all.
    I'm just really confused as to what is wrong with me and is there anything to help because I feel sick going into school every morning knowing I'll have to read and knowing I'll have to go to the bathroom every 10 minutes.
    I'm not sure if I'm evening writing under the right topic but I'm just desperate for an answer and someone to help me.

  3. ReachOut.com says:

    Hi Jessica,

    We can hear that anxiety and panic are really affecting your college life. There are definitely things your college can do to help you and we hope you give these things a try before thinking too much about leaving college. Most colleges in Ireland have health centres and counsellors available for students. They are usually free to access and help students with a huge range of personal and college related concerns, worries and anxieties.

    Your college should have a student union welfare officer and we would suggest talking to your welfare officer and letting them know how you are feeling. Your welfare officer is there to help with things like this and there may be a few things they can do for you, as well as helping to liaise with your lecturers to let them know of what you’re going through and what they can do to help you, i.e letting you take breaks when you need to or making sure you get any notes you might miss.

    I wonder if you are getting any ongoing support from a counsellor or your local doctor to help with the panic and anxiety you experience? If not, it would be worth talking to your local doctor to get some information and advice and talking with a counsellor to help you deal with the panic and anxiety and hopefully reduce it. To find a counsellor, you could ask your local doctor for a recommendation, or you could look up www.counsellingdirectory.ie.

    There’s lots of information on the page above about panic attacks and ways of dealing with them and we also have information on generalised anxiety.

    There may also be some useful information in our Minding our mental health section. In terms of helping to reduce panic and feelings of anxiety, exercise, diet, sleep and relaxation can play a big part.

    Please do look up and contact your college health centre, talk with your student union welfare officer and if you’re not already getting support from a health professional, do talk with your local doctor and contact a local counsellor.

    I hope this is helpful Jessica.

    Take care,

  4. Jessica says:

    Hi, Ive suffered with GAD and panic disorder for a few years now. When I was in school I had a really supportive group of people (friends and teachers) around me who knew when I was finding things tough and understood when I needed to take a break. Now that Im in college I feel really lost and that Im falling through the cracks. Although I love my course and worked really hard to get into it, the hours are intense and I cant afford to miss any time. Because of the type of anxiety disorder that I have, If Ive had a panic attack in a certain place before, and I go there again it triggers my attacks. Lecture halls really stress me out as I feel I cant just leave if I have a panic attack. I am wondering if there is anything universities do to help students with issues like this? I am considering dropping out of college not because I don't like my course (I actually love it) but because I feel like I am falling behind and the stress of that is only worsening my anxiety. Thanks!

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