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Anxiety and Panic Attacks Self Help Guide

What is Anxiety?

It is normal to feel anxious in some situations, for example, before a job interview or exam. Anxiety is only considered an illness when you feel that way all, or nearly all, of the time. If you worry about nothing in particular, fear the worst most of the time and are unable to control these feelings, you may have what doctors and healthcare professionals call ‘generalised anxiety’.

Generalised anxiety is fairly common and affects more women and men. One in 20 people may experience long lasting or severe anxiety at some point in their life.

Anxiety can be caused by severe or long lasting stress which can in turn, trigger an imbalance in the chemicals in the brain that can make you feel anxious or sad. Some people are born with a greater chance of having this chemical imbalance or it may be caused by a particular stressor such as the loss of a loved one, a relationship break up, pressure at work, serious illness, major life changes, money worries, drug or alcohol misuse.

Anxiety may cause you to feel worried, panicky, nervous, tense, on edge and stressed out.

It may cause your body to physically suffer from;

• Upset stomach
• Heart Palpitations
• Sweating
• Feeling Tired
• Trembling
• Feeling Light-headed
• Feeling Dizzy
• Restlessness
• Shallow, rapid breathing
• Feeling like you can’t catch your breath or panic attacks
• Trouble sleeping
• Dry mouth

Emotionally, anxiety may make you suffer from;

• Irritability
• Feeling Nervous
• Feeling like bad things will happen
• Not able to relax
• Fears that a relative or close friend will become ill or have an accident
• Difficulty concentrating
• Mind going blank
• Feeling low or depressed for a few days
• Feelings of doom and gloom
• Feeling overwhelmed

Some people manage to overcome anxiety on their own although, without treatment some people may feel anxious all the time or every now and again.

There are treatments that work to help overcome or reduce anxiety and there are also many ways that you can help yourself.

• Counselling
• Self-help – Relaxation techniques such as Meditation/ Mindfulness, exercise, learning about what triggers you.
• Prescription medicines (Some anti depressants are also anti-anxiety medicines which target some of the chemicals in your brain that might be causing the anxiety. Other tablets, such as Beta-Blockers, may be prescribed to relieve some of the physical symptoms that anxiety can cause such as rapid heartbeat or sweating).
• Cutting down or avoiding alcohol (alcohol contains depressants and can make you feel worse)
• Cutting down or avoiding cigarettes (The nicotine in cigarettes can make anxiety worse and if your breathing is affected by smoking it increase your anxiety.
• Cutting down or avoiding tea, coffee or cola. (These all contain caffeine which can increase anxiety.)

Please note that cutting down on cigarettes or alcohol may initially make you feel more anxious and if this is the case then it may be best to get your anxiety under control before trying to cut down or stop any of these things.

Self – help techniques
Learning to relax is a way of helping you to overcome your worries. Try a relaxation tape or online meditation. When teaching yourself to relax, remember to be patient – you may have to practise several times before getting the full benefits.

Breathing too quickly can make you feel more anxious – by concentrating on controlling your breathing, it can help control your anxious thoughts and feelings.

Try this exercise:

Start to breathe in slowly and deeply, using your stomach muscles. Imagine your lungs filling completely with air to the count of three, hold your breathe for the count of two and then exhale fully and completely, emptying your lungs for the count of three. As you breathe in, count in your mind, 3 (in)-2 (hold) -3 (out).

Facing up to your worries – Many people find that it is easier to avoid situations that make them anxious rather than deal with them. However, facing your worries can be an important factor in overcoming them. It might seem frightening, but you can practise and learn to deal with them slowly, at a pace which feels comfortable and manageable for you. Practising allows you to gently challenge yourself to gradually build up your confidence and begin to reduce your anxiety.

There are three stages in learning to overcome anxiety;
1) Setting targets – write a list of objects or situations that make you feel anxious and arrange your list in order of difficulty, with the easiest first
2) Grading Tasks – Starting with the easiest task first, write down ways you could achieve this task. This may involve several small steps of increasing difficulty.
3) Practising tasks – Practice each step as often as you need until you can manage the task without difficulty. Be kind to yourself, even if you find it hard at first. Give yourself encouragement and keep a diary to remind yourself of how well you have done.

Stress, makes you feel under threat and makes you feel as though you can’t control things as well as you want to; therefore, safety behaviours are developed in a response to this needing to protect yourself from threats that probably feel very real to you.

However, Safety behaviours feed the sense of threat. They keep your confidence low and keep you believing that the threat is real. (although obviously in cases of ongoing abusive behaviour from another, this is different.)

To break this cycle, consider;

• What are your safety behaviours?
• Consider how much they help or hinder you (in the short- term and the long-term)
• Predict what would happen if you got rid of the safety behaviours? (What is the worst thing that could happen?)
• Work out a plan how to tackle one of your safety behaviours.
• Review it – (how did it go? Was it worse or better than you had expected?)

Panic Attacks

“Panic” means being in a state of terror”

Although they cause great stress and discomfort, panic attacks themselves, are not dangerous.

When you have your first panic attack, you may fear you are having a heart attack or stroke or fear you are going mad. Panics can last for a few seconds to a few hours and may leave you feeling shaken and exhausted. If you suffer another attack, you may begin to change your behaviours to try and avoid another attack.

Panic can affect your thoughts – There is a rush of fear and you may feel like you are losing control. You may feel that something awful is about to happen, even if you can’t identify what it is that you fear. These thoughts can cause you even more stress and the more stress you feel, the more it affects your thoughts, creating a vicious circle.

Panic can affect your actions – You may begin to avoid certain places or situations or avoid doing things in an attempt to prevent a panic attack. You may begin to restrict your life, affecting your self-confidence.

Panic can affect your body – Your heart rate may almost double in a few minutes of panic and this has such an impact upon the rest of the body, it can create a feeling of utter terror. As your thoughts connect to your bodily responses i.e. My stomach is heaving – “I’m going to be sick”, a vicious circle of anxiety begins.

Breathing – When you breathe in, you breathe in Oxygen, When you breathe out, you breathe out Carbon Dioxide.

When someone is calm, there is a balance between the oxygen going in and the carbon dioxide going out.

When someone panics, breathing quickens up and becomes much too fast for what your body needs. This is called Hyperventilation. The fight/flight response has been triggered and your body is primed with energy to tackle a threat.

This can be helpful in situations where you have to run from a danger – you can successfully use up this extra energy whilst protecting yourself. However, one of the problems with panic attacks is that the threats you are worrying about are often not those that you can run from or fight. So you are left with lots of excess energy and oxygen that you can’t use up. It remains in your bloodstream longer as your cells do not need to use it up and therefore you have an imbalance of too much oxygen which may make you feel dizzy, faint, confused, disorientated, breathless, have a choking sensation, blurred vision, raised heart rate, numbness or tingling in fingers, feet or mouth, stiff muscles or clammy hands.

All these symptoms may cause you to panic even more, as you may interpret them as dangerous or scary.

How to tackle a panic attack

• If you feel a panic coming on, don’t let it make you run away – stand your ground
• Try to slow your breathing down, keeping it under control. Try a breathing technique such as counting in as you inhale for the count of three, holding the breath for the count of two and then exhaling, letting go of your breath to the count of three.
• Each time you breathe in, say to yourself “I’m in control”
• Each time your breathe out, say to yourself “relax”
• Try to relax your body, letting your shoulders drop a little and your muscles loosen.
• Breathe into a paper bag or cup your hands around your mouth and nose. This can help to re-balance your oxygen and carbon dioxide levels.
• Remind yourself, that these are just symptoms of the hyperventilation and they will pass.
• Imagine the panic travelling down through your body and flowing out through the soles of your feet.
• Keep your blood sugar levels balanced with food, make sure you get enough rest, avoid excessive alcohol or caffeine
• Try to keep your thoughts under control. Focusing on an object nearby can also help, really noticing its shape, colour, texture etc. or counting all the blue or red things you can see around you.
• Recognise and be kind to yourself that you are having a panic attack. Remind yourself that “it is only panic, that nothing bad will happen, that you can control it, that it will pass, just as it always does.“
• Fight the panic – you are in control – don’t let the panic win and rule you.

Useful Books

Butler G and Hope T. Manage your mind: the mental fitness guide. Oxford university Press, 1995
Fennell M. Overcoming low self – esteem: a self help guide using cognitive behavioural techniques, London: Constable and Robinson, 1999
Kennerly H. Overcoming anxiety: a self- help guide using cognitive behavioural techniques. London: Constable and Robinson, 1997

Useful Websites

www.bbc.co.uk/health/mental (BBCi Mental Health Section)
www.connects.org.uk (Connects Mental Health Portal)
www.mentalhealth.org.uk (The mental health Foundation)
www.nimhe.org.uk (National Institute for Mental Health in England
www.netdoctor.co.uk (Netdoctor.co.uk)
www.self-help.org.uk (Self Help UK)

Useful Organisations

No Panic Helpline 0808 8080545 (10am-10pm daily)
Sane Helpline 0845 767 8000 (12 noon to 2am daily)
National Phobics Society Helpline 0870 7700456
Mind Helpline 0845 7660163
Neurolink 0845 7023070