How can I overcome panic attacks?

The Observer Magazine 12.02.2006

A student is struggling to cope with anxiety attacks, but doesn’t want to take medication. Are there any effective alternatives? Our experts offer some suggestions.

Question

I am a 20-year-old female student, and I have been suffering from terrible anxiety and panic attacks for the past few months. They began when I started a new degree course at a new university, after dropping out of my old one. I often wake up panicking that I have made completely the wrong choice with my life. The panic worsened significantly when pretty awful money problems began to emerge. I have tried KALMS, but they had no effect. I don’t wish to take up drugs of any kind if they are hard to stop taking or have unpleasant side effects. Can you suggest any effective natural remedies, or is medication the only way? I feel like I’m losing it and my short-term memory has become terrible too. I haven’t yet seen a doctor.

THE YOGA EXPERT

Simon Low

Yoga is the universe’s great preventative and curative medicine, and for you I’d recommend a Hatha class at least once a week for gentle, breath-led movement and plenty of time for being still. As soon as you feel panic coming on, sit down, feel flat on the ground, with posture upright but relaxed. Release any tension in your jaws. Close your eyes, place your hands on your belly and concentrate on your breath. As you slowly inhale, draw the breath down into your belly, pause and count ‘1,000, 2,000’, before repeating. The pauses prevent hyperventilation. Now add ‘inner’ words to the process. ‘I breathe in calm as I inhale,’ and ‘I breathe away all fear as I exhale.’ Continue to breathe this way for a minute after the symptoms have gone. It may take time before the panic attacks go, but it makes a difference immediately. Let me know how you get on.Yoga@simonlow.com

Simon Low is co-founder of the Triyoga centre

THE PSYCHOLOGIST

Jacquie Hetherton

I see many patients with problems like you, so please don’t feel alone or that your only option is medication. Cognitive behavioural therapy (CBT) can certainly help you, as CBT has been proven to be very effective at treating anxiety and panic attacks. The theory is that it’s not the situations themselves but our interpretations of them that create anxiety. A CBT psychologist will ask you to describe an attack to see if these thoughts are realistic or simply unpleasant and frightening. The aim is that you learn to keep yourself from falling back into anxiety and panic. Knowledge is power, so I suggest you read as much as possible – Mind over Mood by Greenberger & Padesky (Guildford Press) is particularly useful. CBT can be effective quickly – five or six sessions may be enough – but it may be a good idea also to contact a psychiatrist who has specialist knowledge of medication that can help you.

Dr Jacquie Hetherton is a lecturer in clinical psychology

At Royal Holloway, University of London, and an

Accredited cognitive behavioural therapist

THE  PATIENT

Lucy Hebditch

As someone whose panic and anxiety attacks started at 19, during my second term at university, I know how you feel. I thought I was dying. I couldn’t breathe, started hyperventilating and an ambulance was called. I was convinced I’d never get better, but I’m well now, and you’ll get better, too. I recommend seeing your GP to find out your options – I went down the medication route, but there are other ways to help yourself. My GP referred me for counselling, which really helped, and gave me leaflets so I could understand panic and anxiety attacks. Read as much as you can to help you feel in control (www.nopanic.co.uk). If you feel yourself getting anxious, try the ‘seven 11’ rule – breathe in for seven counts, and out for 11 to stop you hyperventilating. Also know your triggers – I’m more anxious when over tired. Finally, consider telling your friends, I felt so much better knowing others understood and were there to support me.

Lucy Hebditch is a council worker on the Isle of Wight

Ways to help yourself

Relaxation exercises can help you to reduce stress levels. Although I have never seen it mentioned in terms of a de-stressant, love-making has always been highly successful.

Engage in physically draining activities. Do not simply sit around feeling agitated or lost in self pity: Get up and go swimming, jogging, dancing, trekking, cycling, climbing , juggling,  gliding , sailing, skiing, surfing, etc

Engage in simple repetitive activity. Focus attention upon 'countables' . Depending where you are there should always be some form of countables. In a library for example, the countables could be books, bookcases, people, desks, chairs, red headed people wearing glasses. windows. doors. public posters: There is usually something countable wherever you are.

Many people find it helpful to carry some cards containing coping statements around with them. Whenever one feels the start of an attack coming on, you simply take them out, read them and repeat the statements over to yourself.

De-stress by expressing your anger by pounding on pillows and cushions. Throw soft things around, dance to loud music, or dig the garden and flatten the earth by hammering it with a spade.

Do things that require your concentration to be focused. Crosswords are well suited to this activity, as is knitting or playing cards.

Learn and practice deep abdominal breathing.

Cuddles are always highly effective at making us feel good about ourselves