Talking To A Health Care Provider About Your Mental Health
Communicating well with a health care provider can improve your care and help you both make good choices about your health. Find tips to help prepare for and get the most out of your visit at Taking Control of Your Mental Health: Tips for Talking With Your Health Care Provider. For additional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality website.
If you or someone you know is in immediate distress or is thinking about hurting themselves,call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK . You also can text the Crisis Text Line or use the Lifeline Chat on the National Suicide Prevention Lifeline website.
The Effects Both Mental And Physical
Reiki practitioner Jane Elizabeth, left, and psychotherapist Carolyn Yaffe stress the importance of breathing techniques to combat panic attacks. Courtesy Jane Elizabeth and Carolyn Yaffe
Panic attacks can be triggered by myriad external experiences, such as crowded or enclosed places or, alternatively, wide-open spaces. Work, family and relationship issues, trauma, major illness or an accident can also play a part.
Stimulants such as caffeine and nicotine can contribute, while anxiety-prone people are more likely to be affected. Women are twice more likely to experience them than men and, if panic attacks continue, they are classed as a panic disorder.
Often, people develop specific fears and phobias, such as leaving their home, travelling, attending work or school, says Carolyn Yaffe, a psychotherapist at Medcare Camali Mental Health Clinic. They may also avoid social situations. Social interactions can easily trigger a panic attack when a person is experiencing social anxiety or panic disorder. They can also contribute to increased anxiety and depression and, often, people will most fear the anticipation of a panic attack rather than the panic attack itself.
Many celebrities have spoken about their experiences of having panic attacks, including Oprah Winfrey, pop star Ellie Goulding and Oscar-winning actress Emma Stone.
Ways To Prevent Panic Attacks
âYou need to try to work out what particular stress you might be under that could make your symptoms worse,â says Professor Salkovskis. âItâs important not to restrict your movements and daily activities.â
- 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. Panic support groups have useful advice about how you can effectively manage your attacks. Knowing that other people are experiencing the same feelings can be reassuring. Your GP can put you in touch with groups in your area
- Cognitive behavioural therapy can identify and change the negative thought patterns that are feeding your panic attacks
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Who Does It Affect
While panic disorder can affect anyone, there are certain groups of people that it affects more often than others.
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Women: Like most other anxiety disorders, women are twice as likely as men to experience panic disorder.
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Young adults: Panic disorder usually appears in your mid-twenties, although it can happen at any age. Three quarters of people with panic disorder experienced the onset before the age of 33. Although it can exist in kids, it’s often not diagnosed until they’re older.
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People with a chronic illness: Three quarters of people with panic disorder report having at least one other diagnosed chronic physical or mental illness like diabetes or depression.
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Family history: People with a family history of anxiety or depression are at greater risk for developing panic disorder.
How Do You Know Youre Having A Panic Attack
An anxiety or panic attack often comes on suddenly, with symptoms peaking within 10 minutes. For doctors to diagnose a panic attack, they look for at least four of the following signs: sweating, trembling, shortness of breath, a choking sensation, chest pain, nausea, dizziness, fear of losing your mind, fear of dying, feeling hot or cold, numbness or tingling, a racing heart , and feeling unusually detached from yourself.
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People On Taking Adhd Meds
Anxiety can be helpful when it causes us to pay attention to dangerous situations. It evolved originally to keep us safe. Anxiety might manifest as racing thoughts, a rapid pulse or even an upset stomach. Typically, however, it doesnt prevent you from consistently and successfully carrying on with your everyday activities.
Diagnosis
People who worry occasionally about regular situations or specific events have run-of-the-mill anxiety, which almost everyone experiences. If you live with a general, persistent feeling of dread, however, you might have an anxiety disorder, and there are several types. People with generalized anxiety disorder, for example, may feel constantly on edge, irritable and unable to sleep.
Treatment
For basic, occasional anxiety tied to life events or situations, techniques like deep breathing, acupuncture, meditation and yoga are a good place to start for relief.
For people with more severe anxiety or an anxiety disorder, doctors often recommend psychotherapy, such as cognitive behavioral therapy, which can train you to respond differently to stressful situations.
Another option for treating an anxiety disorder is medication. SSRIs, or selective serotonin reuptake inhibitors, like Zoloft or Prozac, can help people feel less anxious.
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The Difference Between An Anxiety Attack And A Panic Attack
Once again, anxiety attack is not a clinical term. It’s a term used to describe periods of more intense anxiety that go beyond traditional anxiety experiences.
That differs from the term panic attack. Panic attacks are severe anxiety attacks like what is described above – attacks that are often so disabling that many people struggle to cope with them and develop panic disorder, health anxiety, and possibly agoraphobia.
Traditionally, the term “anxiety attack” is used to discuss weaker versions of panic attacks. If you have multiple panic attacks, you have panic disorder. Anxiety attacks can affect anyone – even those without panic disorder or an anxiety disorder – and so the term is used to encompass all of these types of attacks.
For the purposes of this article, we’ll discuss these types of anxiety attacks as the weaker version of a panic attack. But in life, people do use the two terms somewhat interchangeably, and both are related to the same feelings of doom, along with relevant symptoms.
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Stress Anxiety And Then Panic: Neal’s Story
As Sideman says, his attack occurred in the early 1990s, and few people seriously considered the possibility of a panic attack in a 39-year-old man. So he went home thinking all would be fine, only to have another, more severe attack one week later.
Now, looking back, the situation seems clearer.
I was under a lot of stress starting a new business, working 16-hour days, a close friend was ill and dying, and on top of all that, I was doing a super heavy workout regimen at the gym with a trainer,” Sideman says. “So it was a lot of physical stress, emotional stress, and a lot of financial stresses.” He says he also can see roots of anxiety in his childhood and teen years as well as in other family members.
In the moment, he didnt know what to think because it can be tough to know what a panic attack is like until you have one. His second panic attack was really a full-blown panic attack, where I thought I was going to die,” Sideman says. “I thought I was going to pass out, not wake up, go crazy, have a heart attack.”
He recalled being terrified, and the response he chose was one that can actually make panic disorder worse: He started to avoid the situations where he had attacks.
How To Get Through A Panic Attack
Panic attacks can make you feel like youve lost control, but with the right tips, you can get back in the drivers seat.
Unsettled. Scared. Anxious. Physically ill. The way you feel during a panic attack can be frightening and overwhelming.
With everything going on in the world, panic attacks might be new to you or have made a reappearance or maybe this isnt your first rodeo.
Whether youve had many panic attacks or just one, many strategies exist that can help you get through an attack.
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Choose The Right Time
Choosing the wrong time or place to have such a sensitive discussion can amplify problems and damage your relationship even further, says Nick.
Try to avoid speaking to a sufferer about their addiction if they are under the influence there and then, as its unlikely they will be as reasonable as you want.
Its preferable to do it in a private space and somewhere the sufferer feels comfortable being open and honest.
What You Can Do
To get through a panic attack, try to take control of your breathing first. Find a place where you can sit or be comfortable. Concentrate on making your breath slow and even. Try to inhale through your nose for 4 seconds, hold it for 2 seconds, then exhale through your mouth for 6 seconds. Tell yourself that youâre not in danger and that the attack will pass.
If youâre not sure if youâre having a panic attack, itâs a good idea to go to the hospital to rule out any other health problems.
Panic disorder is one of the most treatable types of anxiety disorders. Medication and a type of talk therapy called cognitive behavioral therapy can help. See your doctor if you have panic attacks often.
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Concentrate On Your Breathing
Focus on breathing in slowly, then breathing out slowly. It can be helpful to count when youre breathing to focus your mind. You can start small at first, like counting to three as you breathe in and counting to three as you breathe out. When you begin to calm down, you can increase how long you hold each breath to five seconds or seven seconds.
There are lots of different breathing techniques that you can try. You can use apps like Headspace and Calm to practise breathing exercises, or have a look online and see what works best for you.
Panic Disorder In Children
Panic disorder is more common in teenagers than in younger children.
Panic attacks can be particularly hard for children and young people to deal with. Severe panic disorder may affect their development and learning.
If your child has the signs and symptoms of panic disorder, they should see a GP.
After taking a detailed medical history the GP will carry out a thorough physical examination to rule out any physical causes for the symptoms.
They may refer your child to a specialist for further assessment and treatment. The specialist may recommend a course of CBT for your child.
Screening for other anxiety disorders may also be needed to help find the cause of your child’s panic attacks.
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I Knew Something Terribly Wrong Was Happening
J.T. Lewis, 58, Charlottesville, Va.
Courtesy J.T. Lewis
One morning almost 20 years ago, J.T. Lewis hailed a cab because she was late to work. As she settled into the back seat, Lewis noticed the car seemed unusually hot, dirty and cramped. The driver’s seat was so far back it seemed to be crushing her. She felt sweaty and light-headed.
“Suddenly, I couldn’t breathe, Lewis recalls. There was this crushing chest pain. I knew something was terribly wrong. Was I dying?”
The attack subsided after a few minutes, but Lewis was so shaken she had the driver drop her at her physician’s office. After a battery of tests, the doctor told her there was nothing physically wrong with her.
A few weeks later, Lewis, who frequently traveled for her job as a lawyer, had just buckled into first class on a plane when it happened again. The pressure in her chest. The feeling that she couldn’t breathe. Sweaty and pallid, she asked the flight attendant for some water.
The flight attendant took one look at her and instead had the pilot return the plane to the gate, so Lewis could get off. I was frustrated, confused and humiliated, Lewis said. I began avoiding business travel.”
After that, the panic attacks started happening more often. In the short run, medicine quelled her symptoms: Her doctor prescribed daily beta blockers plus Xanax for the moments when she felt an attack coming on .
Now retired from law practice, she hasn’t had a full-blown panic attack in years.
How To Help Others Cope With A Panic Attack
For some people, panic attacks are a daily occurrence, and for others, they are more infrequent. Regardless of the frequency, people who experience panic attacks can benefit from having support and knowing you are there.
Sitting with the person and helping them access skills they might be familiar with, like paced breathing and sensory grounding techniques, and doing them together with them can be helpful when helping a friend or loved one cope with a panic attack, says Gingrich.
Additionally, you can be the voice of the reason in the situation and remind them that they are safe and these feelings will pass. Sometimes hearing it from someone else can help provide a sense of reassurance.
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How Is Panic Disorder Treated
First, talk to your doctor about your symptoms. Your doctor should do an exam and ask you about your health history to make sure that an unrelated physical problem is not causing your symptoms. Your doctor may refer to you a mental health specialist, such as a psychiatrist or psychologist.
Panic disorder is generally treated with psychotherapy, medication, or both. Talk with your doctor about the best treatment for you.
Psychotherapy. A type of psychotherapy called cognitive behavioral therapy is especially useful as a first-line treatment for panic disorder. CBT teaches you different ways of thinking, behaving, and reacting to the feelings that come on with a panic attack. The attacks can begin to disappear once you learn to react differently to the physical sensations of anxiety and fear that occur during panic attacks.
For more information on psychotherapy, see .
Medication. Doctors also may prescribe different types of medications to help treat panic disorder:
- Selective serotonin reuptake inhibitors
- Benzodiazepines
Another type of medication called beta-blockers can help control some of the physical symptoms of panic disorder, such as rapid heart rate. Although doctors do not commonly prescribe beta-blockers for panic disorder, they may be helpful in certain situations that precede a panic attack.
Managing A Panic Attack At Work
A panic attack, defined by the American Psychological Association as, a sudden surge of overwhelming fear that comes without warning and without any obvious reason can strike anyone at any timeeven at work. The feelings and physical symptoms are very real and can be very scary. Panic attacks wont kill you, but depending on how severe and frequent they are, they can have a significant impact on your quality of life in every realm, including work. Often triggered by stressful situations, the symptoms of panic attacks usually recede when the stress ends. Common triggers at work include public speaking, conflict, an important meeting, a major transition such as a promotion or a big project, or a work-related social event such as a meeting with a key client or after-work drinks. The author provides tips for managing your symptoms and keeping them from taking over your workday and how to support a colleague who may be experiencing one.
Youre at work when you suddenly feel a deep sense of dread. Heart pounding, hands trembling, lightheaded, and drenched in sweat, you cant breathe. You think youre having a heart attack and feel like youre about to die. Youre about to call for an ambulance when the symptoms start to fade. You just had a panic attack.
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What Causes Panic Disorder
Panic disorder sometimes runs in families, but no one knows for sure why some family members have it while others dont. Researchers have found that several parts of the brain and certain biological processes may play a crucial role in fear and anxiety. Some researchers think panic attacks are like false alarms where our bodys typical survival instincts are active either too often, too strongly, or some combination of the two. For example, someone with panic disorder might feel their heart pounding and assume theyre having a heart attack. This may lead to a vicious cycle, causing a person to experience panic attacks seemingly out of the blue, the central feature of panic disorder. Researchers are studying how the brain and body interact in people with panic disorder to create more specialized treatments. In addition, researchers are looking at the ways stress and environmental factors play a role in the disorder.
What You Need To Know About Panic Disorders
Unlike anxiety, which often has clear triggers, panic attacks occur suddenly and unexpectedly and typically only last for a few minutes.
Those who experience panic attacks have reported lightheadedness, chest pain, hot flashes, chills, and stomach discomfort. Some say they feel like they were being choked or suffocated. Others say an attack made them feel detached from reality.
Occasional panic attacks can happen to anyone, although for some individuals, they occur more frequently and cause significant distress and impairment.
Evidence-based treatments for panic disorder are similar to those for anxiety and involve exposure-based treatment. Mindfulness and meditation can also be useful to curb stress and promote increased psychological flexibility.
Sometimes medications are used to augment behavioral treatments for panic disorder and include beta-blockers, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors.
If you have had continued panic attacks, you may need to seek professional help. Your doctor will ask about your symptoms, other mental health and medical conditions, and whether you are experiencing abnormal stress or anxiety. Blood tests and a heart examination may also be required.
Both panic and anxiety are treatable and manageableeven when they may feel as if they are out of your control.
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