DR MICHAEL MOSLEY: How I’ve learned to manage my panic attacks

A couple of nights ago I woke up suddenly, around 3am, feeling panicky. My heart was racing, stomach churning, and I was convinced that something bad was about to happen.

I soon realised that I was having a full-blown panic attack, but knowing what was happening didn’t really help.

I tried to do some slow, deep breaths and focus on other, more pleasant, thoughts — but the feelings of dread just got stronger.

After a couple of minutes I put my clothes on and went outside for a walk (I’m currently filming in Australia, so it wasn’t cold).

And in 20 minutes or so, the fear had passed and I got back into bed and almost immediately fell deeply asleep.

A couple of nights ago I woke up suddenly, around 3am, feeling panicky. My heart was racing, stomach churning, and I was convinced that something bad was about to happen. Pictured: Dr Michael Mosley 

I tried to do some slow, deep breaths and focus on other, more pleasant, thoughts — but the feelings of dread just got stronger

Panic attacks are common, with around a third of us experiencing at least one at some point.

If you’ve previously had a panic attack it increases the chances you’ll have another, and some unfortunate souls have them almost daily.

The main symptom is the onset of intense fear in a situation where there is no obvious danger, and it’s often accompanied by feeling faint, chest pain, shortness of breath and trembling.

Some people report ringing in the ears, while others describe it as like an ‘out-of-body’ experience. Many of those having a panic attack for the first time think they’re having a heart attack or stroke.

There seems to be a genetic basis, with panic attacks often running in families, and they can be triggered by a major life event, such as divorce — but otherwise, they’re a bit of a mystery, as often there’s no obvious cause.

N ext week I am embarking on a tour across the main Australian cities. And while I enjoy appearing in front of a live audience, I find the build-up to the first show very stressful. So I am under a lot of pressure at the moment, which could explain why the panic attack happened.

It’s also possible that the groundwork for this recent attack was laid many years ago when I made a documentary about fear.

It involved going caving and I got stuck deep underground while trying to squeeze through a narrow fissure. I was only trapped for a few minutes, but I can still remember the intense feelings of fear, and I’ve had nightmares about it since.

READ MORE: How to stop a panic attack before it starts: Expert reveals 5 ways to manage anxiety to prevent it from spiralling out of control

 

So perhaps I had a nightmare, which I can’t remember, but which flooded my body with adrenaline, triggering an attack.

One of the things that adrenaline does is make you breathe faster, and one of the most striking things about panic attacks is that people who experience them often start hyperventilating some time before the attack itself.

In a 2011 study by the Southern Methodist University in Texas, 43 people who were prone to daily panic attacks were fitted with sensors to measure their heart rate, breathing rate and level of carbon dioxide in their breath (when you hyperventilate you breathe out more carbon dioxide than normal).

The sensors were attached to a monitoring pack that had a panic button, which the participants pressed if they felt an attack.

The main finding from this study was that carbon dioxide levels were abnormally low in the hour before the volunteers experienced a panic attack — suggesting that they had begun hyperventilating long before they felt panic — but those levels then suddenly shot up just before the attack.

As levels of carbon dioxide rose, patients began to experience anxiety, fear of dying and chest pain.

So are the rapidly changing levels of carbon dioxide what’s really triggering these attacks?

In 2012, researchers at Maastricht University in the Netherlands asked a group of healthy volunteers to inhale carbon dioxide at increasing concentrations — they found the higher the concentration of carbon dioxide in their blood, the greater the feelings of panic and fear, accompanied by surges in blood pressure.

The link between carbon dioxide and fear could help explain why one of the best ways to cope with a panic attack is to try to control your breathing — focusing on taking long, slow, deep breaths.

Follow a pattern of 4:6 — breathing in deeply through your nose to a count of four, then out through your mouth to a count of six.

Doing this for a couple of minutes should stabilise your carbon dioxide levels and the feelings of panic should subside.

This is obviously easier said than done, particularly when you’re feeling terrified and finding it hard to focus. But if you practise doing slow, deep breathing at times when you’re not panicked, this will help.

You could also try hugging a cushion — or at least a cushion like the one being developed by engineers at the University of Bristol.

It has an inflatable chamber that’s linked to a pump which makes it ‘breathe’ in and out at a slow and steady rate.

When they tested it on students about to take a gruelling exam, hugging the cushion helped reduce their anxiety, mainly because the students began unconsciously to adjust their own breathing rate to that of the cushion.

There are other ways to cope with panic attacks.

You can, for example, try reasoning with yourself, along the line of, ‘I know this will soon pass and I am not going to die.’

Or try distracting yourself by counting as many brightly coloured objects around you as you can. Or grab something really cold from the fridge, as this will help you focus on the feelings of cold, rather than the fear.

If you have persistent attacks see your GP, who may prescribe medication or cognitive behavioural therapy, which can help by encouraging you to challenge your negative thoughts. And do, of course, practise slow, deep breathing.