by Car­o­line Rav­el­lo

Every­one ex­pe­ri­ences some mea­sure of pan­ic and anx­i­ety. These are mech­a­nisms built in­to us that al­low us to pro­tect our­selves in many in­stances. Think on it, if you did not have that pan­ic or anx­i­ety “re­flex” you would prob­a­bly have al­ready been knocked down a few times be­cause noth­ing in you cau­tioned you about step­ping off the side­walk in­to the road.

But there is no way to de­scribe an anx­i­ety at­tack to you if you have nev­er ex­pe­ri­enced it. If you have not had a pan­ic at­tack you more than like­ly would dis­count every ex­pe­ri­ence I share to­day, or even dis­re­gard some­one you are wit­ness­ing hav­ing an at­tack be­cause it can all sound and look like dra­mat­ics.

I learned this: “The symp­toms of a pan­ic at­tack are not dan­ger­ous but can be very fright­en­ing. They can make you feel as though you are hav­ing a heart at­tack, or that you are go­ing to col­lapse or even die” (www.nhsin­

Anx­i­ety and pan­ic at­tacks are very new per­son­al ex­pe­ri­ences to me. In re­cent years, I have had at least two emer­gency room vis­its with one end­ing in brief hos­pi­tal­i­sa­tion think­ing that I was ex­pe­ri­enc­ing some car­diac dis­tress. Anx­i­ety episodes have even caused me to ques­tion some in­ci­dence in ear­li­er life which were di­ag­nosed as asth­ma at­tacks. I re­call one oc­ca­sion, in 2016, when I was ag­o­nis­ing about call­ing an am­bu­lance. That day was my first en­counter with what I called an anx­i­ety at­tack. I was sched­uled to at­tend a class and was feel­ing a bit off cen­tre while dress­ing as I had been for about six months or so. When I opened the front door, I froze in deep fear. I can­not tell you what stopped me, but I dared not place one foot out­side.

I went back in­side and called a friend and could not ex­plain what I was ex­pe­ri­enc­ing. My breath­ing was so laboured I thought I would pass out, so I crawled back in­to the bed and as­sumed a fe­tal po­si­tion ex­pect­ing to black out any minute.

Hav­ing al­ways used the terms in­ter­change­ably, af­ter that day, which end­ed with­out too much dra­ma but left me so ex­haust­ed I could hard­ly func­tion, I de­cid­ed to look up the dif­fer­ence be­tween anx­i­ety at­tacks and pan­ic at­tacks.

I am shar­ing some of the in­for­ma­tion to­day along with some in­ter­ven­tions be­cause very of­ten and greater than be­fore these past two-and-a-half years of liv­ing through a pan­dem­ic, I have been hav­ing more con­ver­sa­tions with peo­ple about cop­ing with anx­i­ety.

Ac­cord­ing to the Di­ag­nos­tic and Sta­tis­ti­cal Man­u­al of Men­tal Dis­or­ders (5th edi­tion) a pan­ic at­tack is char­ac­terised by four or more of the fol­low­ing symp­toms:

Men­tal Symp­toms

Feel­ings of un­re­al­i­ty (de­re­al­i­sa­tion)

Feel­ing de­tached from one­self (de­per­son­al­i­sa­tion)

Fear of los­ing con­trol or go­ing crazy

Fear of dy­ing

Heart pal­pi­ta­tions, pound­ing heart, or ac­cel­er­at­ed heart rate

Hot flash­es

Nau­sea or ab­dom­i­nal dis­tress

Phys­i­cal Symp­toms

Chest pain


Ex­ces­sive sweat­ing

Feel­ing of chok­ing

Feel­ing dizzy, un­steady, light­head­ed, or faint

Numb­ness or tin­gling sen­sa­tions

Trem­bling or shak­ing

Sen­sa­tions of short­ness of breath, dif­fi­cul­ty breath­ing (www.very­well­­i­ety-at­tacks-ver­sus-pan­ic-at­tacks-2584396)

In­ten­si­ty of the symp­toms and the length of time are the main dif­fer­ences be­tween pan­ic at­tacks and anx­i­ety. Anx­i­ety can last for months while a pan­ic at­tack may last min­utes. These are ways in which they dif­fer (www.very­well­

Pan­ic At­tack


Lasts for min­utes

Shak­ing or trem­bling

Chest pain

Hot flash­es

Sense of de­tach­ment


Grad­u­al­ly builds

Can last for months



Mus­cle ten­sion


Re­spond­ing to

pan­ic at­tacks

The fol­low­ing rec­om­men­da­tions are from the UK’s Na­tion­al Health Ser­vice:

If you’re breath­ing quick­ly dur­ing a pan­ic at­tack, do­ing a breath­ing ex­er­cise can ease your oth­er symp­toms. Try this:

--breathe in as slow­ly, deeply and gen­tly as you can, through your nose

--breathe out slow­ly, deeply and gen­tly through your mouth

--some peo­ple find it help­ful to count steadi­ly from one to five on each in-breath and each out-breath

--close your eyes and fo­cus on your breath­ing

You should start to feel bet­ter in a few min­utes. You may feel tired af­ter­wards.

Pre­vent­ing pan­ic at­tacks

--Do­ing breath­ing ex­er­cis­es every day will help to pre­vent pan­ic at­tacks and re­lieve them when they are hap­pen­ing

--Reg­u­lar ex­er­cise, es­pe­cial­ly aer­o­bic ex­er­cise, will help you to man­age stress lev­els, re­lease ten­sion, im­prove your mood and boost con­fi­dence

--Eat reg­u­lar meals to sta­bilise your blood sug­ar lev­els

--Avoid caf­feine, al­co­hol, and smok­ing – these can make pan­ic at­tacks worse.

--Cog­ni­tive be­hav­iour­al ther­a­py (CBT) can iden­ti­fy and change the neg­a­tive thought pat­terns that are feed­ing your pan­ic at­tacks

(Cour­tesy: www.nhsin­­ing/men­tal-well­be­ing/anx­i­ety-and-pan­ic/how-to-deal-with-pan­ic-at­tacks)

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