Living with panic attacks and panic disorder

An anxiety problem like panic often makes people feel generally unwell. They may sleep badly and feel exhausted, have trouble concentrating, and find it hard to relax and enjoy themselves. If attacks continue you are more likely to develop the associated problems of worrying about attacks and avoiding places where attacks might happen.

People who are severely affected find it difficult to go out alone, even to do everyday activities like shopping or collecting children from school. Travel to new places may be impossible. In severe cases this means you cannot work or have a social life outside the home. You may lose touch with your friends.

Some people become preoccupied with their physical symptoms and speak to many different doctors and therapists, convinced they have a serious physical illness. Panic is serious but it is important to recognise it as panic and not some other dreaded disease.

Panic attacks can have a great effect on your family or whanau and friends. They may worry about you being ill, or they may accuse you of worrying too much and get angry when you cannot go out or when you have to leave somewhere because of a panic.

People who have never had a panic attack often dismiss it as worry. They do not realise how severe the anxiety and fear are. Friends may think you are avoiding them if they do not know why you no longer go to see them.

Living with panic attacks is usually one of the most overwhelming, frightening, isolating and debilitating experiences a person can have. People in crisis may feel intense fear and that their world has fallen apart. They often live in fear of their next attack. Worse still, people experiencing panic attacks often lose hope or the belief that they can recover and lead a worthwhile life.

But those people who have come through episodes of mental illness are able to look back and see how fallible their loss of hope was. Everyone with panic attacks can lead a worthwhile life once they learn to deal with them and get the right treatment.

Discrimination and stigma

Many people feel ashamed of their mental illness and can sense other people's misunderstanding and prejudice. Workmates and friends may find it difficult to relate to their panic attacks and respond with either disbelief or rejection.

Even families and mental health workers can be over-anxious or controlling about lives of people with panic attacks or panic disorder. None of this helps. Sometimes the discrimination feels worse than the illness itself.

Support and information

People who have a panic disorder often do better if they seek support people who are caring, non-judgemental and see their potential. Some get their best support from others who have been through the same kind of experience. Other people find a counsellor or another type of mental health worker who is supportive. Or their friends and family or whanau may offer good support.

People with a panic problem can make more informed choices if they educate themselves about their condition and the types of treatment and support that are available. It's also useful to know about your rights.

Using services

 Many people with panic attacks, sooner or later, go to see their GP or a counsellor or are referred to mental health services.

 If you feel depressed and fear you might harm or kill yourself it is essential you seek help immediately.

Sometimes it is hard for people to seek help because they feel ashamed and want to hide their distress. Acknowledging they have a mental health problem and need help can be very scary. People with panic attacks or panic disorder often say the best services are ones where they are listened to, treated as equals and are given support or treatment that works for them. Otherwise, the service is unlikely to meet their needs.

Recovery

Most people with panic attacks or panic disorder make a good recovery. But even if you continue to have panic attacks you can still live a happy and worthwhile life.

Strategies to support recovery

For people who have panic attacks or a panic disorder, the following strategies have been found to be important and useful.

• See your general practitioner. A doctor can help you to recognise panic attacks or panic disorder or make a referral to another health specialist if necessary.
• Have a careful physical check-up to make sure you do not have another physical cause for your symptoms. Ensure your problems are not complicated by other illnesses. If they are severe, your doctor may ask you to see either a psychologist or psychiatrist. Many people who have panic attacks feel that doctors do not understand how bad their attacks are. They often feel that they are being dismissed as just being worried. Write down your symptoms and problems so you will remember them clearly. If you can accept that you do have panic, not some more serious or unknown illness, you may immediately feel quite a bit better.
• Learn about panic disorders.
• Tell family or whanau or friends about your problem. If you find it difficult to let others understand how it feels for you, it may be helpful to find an article or book which explains panic attacks and ask them to read it. You will feel more comfortable if they know you might have to stop to wait out an attack or that you might have to leave a place or situation. Because panic is so common, most people know someone who has had it, even if they have not experienced it themselves.
• Avoid substances that aggravate panic, including caffeine, alcohol and cannabis. You might want to experiment to see if alcohol and caffeine do affect you, but the safest plan is to stop. Do this gradually if you are taking them regularly.
• Have ways of improving your health like eating good food, exercising and having a regular daily routine. These will help you feel better and more in control of your health. But they are not likely to be enough to cure you of panic.
• Try to remember that it is only anxiety which causes the feelings you have during an attack. If you do nothing the attack will do you no harm and it will pass. If you find yourself thinking catastrophic thoughts like: "I am dying," remind yourself that this is not true. Remember that you have survived previous attacks. If you can, you should resist leaving places or situations because of attacks. This is because if you leave or avoid places you will find it increasingly hard to return there.
•  If you have trouble with your breathing during attacks you are probably over-breathing. There are two ways of stopping this. The first is simply to breathe more slowly and deeply. The second is to breathe with the bottom of your lungs rather than the top. This means that when you breathe in your stomach goes out, not your ribs. You can practice this by putting one hand on your stomach, the other on the top of your chest and observe the movement.
• Relax regularly. If you need to, learn a relaxation technique or find something to do with your family or whanau or friends that is relaxing and enjoyable. Sport is good as it helps you relax and helps you feel in control of yourself. Sleep is the most important relaxation, so do not stay up late unnecessarily. If you are in a sexual relationship, remember that sex is a good antidote to anxiety.
• Dealing with stresses in your life is more difficult but you should make sure you have some time to rest and enjoy yourself. If you are working too many hours, or not taking time off at weekends or having holidays, these will all allow stress to build up. If panic has become a major problem, a period of rest and taking it easy can be helpful, if it is possible to arrange this. This does not mean running away from situations that you are anxious about; you do need to face these.

Family and whanau views

Families and whanau often experience real grief, isolation, powerlessness and fear as they witness their loved one struggling with mental illness. Their feelings for their relative can swing from compassion for their pain, to grief at the loss of the person they once knew, to hostility towards their relative for disrupting their lives.

Discrimination and stigma

Families and whanau may feel shame or embarrassment about their relative. They may shut themselves off from their friends and neighbours or feel that these people are avoiding them.

Support and information - family and whanau

Families and whanau often feel drained and stressed and need support to look after themselves as well as their relative with panic problems. There are several ways families and whanau can get support. They can get in touch with other families and whanau who have had similar experiences. Some mental health services provide good support options for families and whanau.

Experiences with services

Ideally, families and whanau who are involved in caring for someone with panic disorder need to be able to communicate freely with professionals about their relative.

Recovery

Most, if not all, families and whanau want to help their relative recover.

Unfortunately, sometimes the person blames their family or whanau and does not want them to be involved in their care. Research shows that if families and whanau can share information, skills and support with their relative and the professionals who look after them, the likelihood of recovery is much greater.

Strategies to support recovery

Family, whanau and friends of someone who has panic attacks have found the following strategies important and useful.

• Learn about panic disorder, its treatment, and what you can do to assist the person.
• Understand the symptoms for what they are. Try not take them personally or see the person as being difficult.
• Help the person to recognise stress and find ways of coping. This may include helping to solve problems that worry them.
• Help remind them not to believe their catastrophic thoughts and not to leave places when they panic. Don't be too forceful or the person may feel trapped.
• If the person has already become quite agoraphobic and finds it hard to go out, gently help them by offering to go with them. Most people with panic disorder find it easier to go out with a companion.

See also: Panic attacks/disorder; Panic attacks/disorder - treatment

Support groups

See the support organisations (which include helplines) under Further information and support below.

Original material provided by the Mental Health Foundation of New Zealand, 2002. Edited by everybody, May 2005.