Panic Attacks: Know Your Triggeres

Many of us have had first-hand experience of a panic attack. There’s that overwhelming sense of anxiety and rising panic that starts to take over every inch of your body, and then the sudden rush of breathlessness and spread of overbearing heat that you just can’t ignore.

Once someone has a panic attack, they become very anxious about having another one. This can cause a vicious cycle

They’re certainly not pleasant, but why exactly do they happen? And could understanding this in greater depth help people manage their anxiety in practical ways? The problem is that everyone is different, and there’s no one answer that fits every situation. “Almost anything can be a trigger for a panic attack,” explains Dr Elena Touroni, a consultant psychologist and co-founder of The Chelsea Psychology Clinic and My Online Therapy. “It may be a social situation where you feel exposed, the thought of an important meeting at work, or symptomsearching on the internet.

Anything that causes anxiety can act as the initial trigger, and it really depends on the person, and what kinds of situations provoke their anxiety, as to what this is.” It’s thought up to a third of the population will experience from a panic attack or anxiety disorder at some point in their life, but researchers are still trying to understand more about their causes. Often they seem to come out of nowhere, and this can be confusing for those who feel they are usually in control of their emotions. Saying that, there are some common triggers to be aware of, such as crowds, the feeling of being trapped, and other situations which cause fear, as well as certain things that make you vulnerable to an attack, such as stress and alcohol.

The very thought of a panic attack can also initiate a downward spiral of worry. “What tends to happen is once someone has a panic attack, they become very anxious about having another one. This can cause a vicious cycle whereby the fear of having a panic attack becomes the trigger for the panic attack itself,” explains Dr Touroni.

The important thing is to be kind and compassionate to yourself, and not to ignore what’s going on in your body or mind

UNEXPLAINED PANIC

Feeling overwhelmed certainly seemed to be a key trigger for Sarah Lloyd, a 42-year-old mother-of-two, who began having panic attacks in her 20s when an ever-increasing workload became too much. “My first panic attack was in my office; I felt a huge wave of overwhelming emotion and warmth in my face, and I couldn’t breathe. I took myself off to a meeting room and sat there feeling helpless,” she says. “I always had trouble saying no, and was far too eager to please, so I’d find myself taking on more and more work, which exacerbated my stress.”

Things remained the same for Sarah for many years, even after a change of job, and the birth of her children brought postnatal depression, which created more anxiety-fuelled situations. Despite realising the impact stress had on her wellbeing, Sarah wasn’t able to put her finger on the specific circumstances that caused her panic attacks.

UNDERSTANDING MORE

Sarah’s situation isn’t unique, and in her case a particularly bad panic attack made her reassess her lifestyle, and look to make significant changes. Taking the time to learn more about her triggers helped her do this, and create a happier, more relaxed environment at home and work.

“I can now recognise my personal triggers,” she says. “It starts when I forget to breathe, or if I feel like I’m being pushed into something I don’t want to do. “I also realised the attacks used to come in cycles – it was often the week before my period that I found myself unable to cope with situations,” she adds. “When I understood that played a part, I made a special effort not to book too much in the diary around that time, gave myself days to relax, and made an effort to be mindful about it. I also took the natural supplement ashwagandha to help stabilise my moods.”

For Dr Touroni, recognising your body’s reaction to certain situations and dispelling the fear around a panic attack is key. “It’s about starting to interrupt the anticipatory anxiety, which is usually what maintains panic attacks,” she explains. “Remind yourself that while a panic attack can feel scary, it can’t harm you.”

RECOGNISE YOUR TRIGGERS

So, how can you identify what causes your panic to build? “You need to start observing what happens in your mind and body as your anxiety levels rise,” Dr Touroni advises. “What thoughts are you having? What sensations can you feel? It’s also necessary to explore what about the situation makes you feel so vulnerable. What are you frightened of?”

Most experts say the best way to do this is to keep a physical log. Write down anything that may be important (including your sleep routine, what you’ve eaten, and how you’re feeling), and over time you may start to see a pattern. Sarah agrees. “Keeping a diary was really useful for me. Try to notice when you start to feel out of control, and pay attention to your breathing. We hold our breath far too much, and this can lead to us blocking the oxygen to the brain, which then triggers anxiety.”

Speak to family and friends too – they may have insight into your behaviour that even you haven’t realised. “My husband could always tell when I was heading for a break – I’d start to do this thing with my fingers,” Sarah says. “Asking loved ones to help figure out when you’re about to spiral can be useful, especially if you don’t know where they come from.” Once you can recognise this, you can start to put coping mechanisms in place.

“If I feel something coming, I now try to respond in a positive way by taking time to ground myself using a combination of cognitive therapies and breathing exercises,” Sarah says. “I find breathing is the key; I try to recognise what my breath is doing, and get it back under control before anything happens.”

The important thing is to be kind and compassionate to yourself, and not to ignore what’s going on in your body or mind. Don’t be tempted to push your feelings under the rug, or fight against your panic – sometimes this can make things worse. As many experts advise, learning to live with your anxiety and understanding your panic attacks is the first step to helping overcome them.

COPING STRATEGIES:

Feel a panic attack on its way? Try these tips…

USE BREATHING TECHNIQUES:

Practices like the 4-4-4 technique (where you inhale for four counts, hold your breath for four counts, and exhale for four counts) that encourage you to focus on your breathing, can help to stop a panic attack in its tracks.

FOCUS ON YOUR SENSES:

By paying attention to what you can feel, hear, see, smell and taste, you can help take your mind off your rising panic, and instead ground your body and mind in the here and now.

LEARN TO SILENCE NEGATIVE VOICES:

Our inner voices have a lot to answer for, and can contribute to anxiety spiraling out of control. Try to reframe the negative thoughts in your head, and understand when they’re impacting your emotional wellbeing.

STEP OUT OF THE SITUATION:

If you’re in a specific situation that is making you feel like a panic attack is imminent, try to step away. Even just getting some fresh air for two minutes can make a big difference.