Why do panic attacks happen?
Panic attacks can happen to anyone, without any obvious cause or warning. They can be extremely alarming both for the person experiencing the attack and anyone trying to help
Exams increase stress – and children and teenagers up and down the country will be sitting in exams halls, waiting to hear the famous words “you can turn your papers over now”. For some, exams cause no problems at all, many just get butterflies, but for some, the fear of exams can result in full blown panic attacks. (For specific information about how to help your child during stressful times, we suggest you read this article).
Certain times of life can make people more prone to panic attacks – often those going through menopause experience them and early Alzheimer’s can also result in a higher incidence. Increased stress and overload can often be a contributory factor. However, there does not need to be any obvious reason – sometimes, they just happen!
What is panic?
Panic is an extreme feeling of fear and dread, and usually the overwhelming desire to escape an uncomfortable situation. Most people have experienced a sense of panic at some time in their life – it is a perfectly normal response. Some people have a history of panic attacks and know what can trigger them. However, for others, they can occur suddenly with no obvious cause. Read on to learn the signs to look out for and what you can do to help.
Physical reactions may be frightening and can include the following:
- A pounding and racing heart or even palpitations (feeling your heart is stopping or missing beats)
- Shortness of breath or a feeling of choking
- Shaking, tingling or numbness in your fingers and toes
- Feeling sick and dizzy
- Sweating
- Needing the loo
- Thinking you might die
- Feeling you are losing control of your mind – even that you are going crazy
- Aggressiveness, sometimes due to the wish to escape
Nevertheless, difficulty breathing due to panic attacks should not be confused with asthma.
Asthma
Asthma is an extremely common chronic and potentially life-threatening condition. When someone has Asthma; their airways go into spasm which causes tightness of the chest; the linings of the airways become inflamed and produce phlegm leading to severe difficulty in breathing.
If someone is having an asthma attack, they need their medication and help quickly, whereas panic attacks are usually short lived, and the casualty quickly makes a full recovery.
During asthma attacks, casualties wheeze and struggle to breathe out, whereas large volumes of air can be heard entering and leaving the lungs when someone is hyperventilating and having a panic attack.
How to help if someone is having a panic attack
- Reassure them; they may be unable to explain what has caused them to panic and do not pressure them to do this, your calm presence should help.
- Speak to them in positive, supportive terms – “You will be okay, this will pass in a minute” etc.
- Remove them from anything obviously causing distress.
- Encourage them to focus on their breathing and breathe calmly and slowly, in and out through their nose and out of their mouth, to reduce the amount of carbon dioxide being lost.
- Small sips of water may help to calm them.
- Stamp on the spot. Some people find this helps control their breathing.
- Try grounding techniques. Grounding techniques can help someone feel more in control. They are especially useful if experiencing dissociation (a feeling of disconnect or flashbacks) during panic attacks.
- Encourage them to concentrate on sounds around them
- Walk barefoot
- Wrap them in a blanket
- Touching something or sniffing something with a strong smell.
- Focus on the sensations right now. Some people keep a box of things with different textures and smells (for example perfume, a blanket and some smooth stones) ready for when they need it.
If symptoms get worse, get medical help.
When the panic attack is over, talk it through with them. Discuss relaxation techniques and other helpful means of coping in case this happens again.
Paper bags
Do not suggest breathing in and out of a paper bag. People used to think breathing in and out of a paper bag was helpful during a panic attack, and the physiology makes sense; breathing out in panic results in the loss of carbon dioxide in the blood and breathing into a bag restores the lost CO2.
However, the danger with a paper bag is that the casualty may become dependent upon it and can panic if they do not have one to hand (my mother suffered from numerous panic attacks in the early stages of her Alzheimers and quickly became obsessed with paper bags after someone had encouraged her to use one).
It is extremely dangerous using a paper bag with someone is having an asthma attack and can make things considerably worse.
If attacks are persistent and severe, the patient can be referred for specialist help.
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Written by Emma Hammett for First Aid for Life
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First Aid for Life is a multi-award-winning, fully regulated first aid training provider. Our trainers are highly experienced medical, health and emergency services professionals. They will tailor the training to your needs. Courses for groups or individuals at our venue or yours.
First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.
The couple of times in my life that I had a panic attack, the ol’ paper bag trick worked wonders. I understand what the article means about someone becoming dependent on paper bags if they have frequent attacks or panic disorder. But for the OCCASIONAL panic attack, there’s nothing wrong with the paper bag quick fix.
Personally, I still wouldn’t recommend them. My mother used to have a lot of panic attacks in the early stages of her Alzheimers and very quickly got reliant on paper bags being the panacea. Caused far more problems than it ever should have done. It can also be dangerous if someone is having an asthma attack rather than a panic attack
Are you a doctor??
When I was 12 I suffered from frequent panic attacks. The brown paper bag always worked for me. Nurses at school even used it on me.
Thank you for this. A paper bag can work for the reasons I have mentioned. However it can lead to a reliance on these and cause further problems. Hence they are no longer recommended. Best wishes Emma
I have been hyperventilating often for the last few days and it is very scary as I keep looking for deep breaths and end up hyperventilating and my chest seems like its burning from over trying to breathe deep. Its frightening and scary.i never suffered from asthma but do have anxiety symptoms. What can I do or take to alleviate this situation.i dnt want to keep over breathing all day.its tiring and my chest and lungs feel strained.
Dear Georgina, So sorry you are experiencing these issues. The best way forward it to do breathing exercises. However, if this doesn’t work, I would suggest you contact your doctor and get further medical advice. Best wishes Emma
I think the reasons are valid for rendering the paper bag method obsolete. But I also think there is a case for its educated, informed, hopefully directly observed usage like, say, in people with confirmed hyperventilation syndrome who suffer from post-hyperventilation apnea, which can potentially be lethal.
Personally, I think the way to go ideally is not cutting down options, but disseminating more health teachings.
Thanks for this very comprehensive facts about panic attacks.
Glad you fount useful
i had a panic attack in an airplane (there was a little bit of turbulence) even the pilot told us that it was going to be bumpy, i been on flights so many times and this turbulence was just another regular call. But all of a sudden ( never in my life experience a panic attack) it just happens. Thank God there was a nurse in from of us and she quickly passed me a paper bag and told me to breath slowly and that help so much, my body was all cramp up even my finger locked, i was so afraid after that they gave me oxygen and i calmed down.
That sounds scary Ronald. Glad you were helped by a professional – that’s lucky – and that you’re alright now. Look after yourself
Your advice about a paper bag is wrong when it has helped so many people including patients I had to take care of. I mean if we don’t give them a paper bag and calming doesn’t work now what? That’s a medical emergency so anything you can do helps. PERIOD
Dear Kasey, really glad you have been able to help so many people. Controlled breathing is just as effective and does not carry the risks of reliance or on making things worse if they are having an asthma attack, rather than a panic attack.
you should not be advising your a fool. in an emergency on a flight do what works i have been to emergency rooms in hospitals they don’t care about long term if their is an emergency they deal with the situation as a matter affect all doctors don’t care about long term they treat the symptom in front of them and ignore the long terms effect for example over prescribing ct scans and mris with gadalidium ignoring the effect on the body of gadilinium and that the cumilitive ct causes cancer to spread.
I don’t have asthma so a bag would help me as I get severe attacks while driving
Dear Dee, please don’t use a paper bag when driving. If you have a panic attack whilst at the wheel, please pull over and calm yourself with breathing exercises before continuing. Many thanks Emma
I have begun to have what my daughters and I think are panic attacks and possibly have developed a panic disorder. I am in the process of being diagnosed with IIH. These attacks happen when I get emotionally upset. I start crying and it becomes so severe I quit breathing, and then cannot think how to breathe again. They have taken me by ambulance to the ER once, and called paramedics to my home once. I have had a total of 4 since January. It is very scary for them bc I lose consciousness sometimes. Does this sound like a panic attack?
Incredibly frightening for you. You should visit your doctor. There are some really helpful resources for this on the MIND website, including some great grounding techniques that may help. It does sound like you could do with some additional help and support. Best wishes Emma
Breathing becomes even more difficult because the person is trying too hard. Rather, try softening the muscles of the chest/rib cage, the diaphragm, the stomach. and the belly. Relax the tension in the face and the back of the neck. As the muscles relax, the lungs are not constricted and they can move more easily. Helpful with anxiety and with panic. Yes, Look into grounding techniques as well.
If i sleep evening frequently i wakeup with panic attack.I feel like i am going to die and my heart rate rapidly increased.At this time i drink suger diluted water ,regularaly breething and try to remember i have panic attack..i have no idea why it doesnt happen when i go to bed at night and wakeup in the morning.
Yeah I had a bad panic attack a few years ago. My muscles went into spasm, I couldn’t straighten my arms or legs, my jaw locked and I was biting on my tongue. The nurse at A+E gave me a paper bag so it’s still used in the NHS, within a minute I felt better. I would definitely say if it’s an isolated incident then paper bag is the best way to go but I can see how people with reoccurring attacks may become dependant on it
recurring attacks should be medicated
I have a question.
Can panic attacks make you lose your bladder?
You can lose control of your bladder a little due to muscle spasms, yes. A little wee is quite normal, especially in more mature ladies ?
you can ask if the person has asma if they can’t communicate then don’t use the bag or minimum usage. in the beginning of an attack the person might be able to communicate. most people don’t have asma. if you let the attack continue they could have a stoke or heart attack.
I have been having panic attacks for the past 6 years for no reason it’s comes very often and always think I was going to die my blood pressure goes up, my chest and arm tightening but I sometimes use the paper bag and it’s work please else can I do to ride of this from my life I’m not comfortable at all. Please your advice help me. Thank you
I have been having panic attacks for the past 6 years for no reason it’s comes very often and always think I was going to die my blood pressure goes up, my chest and arms tightening but I sometimes use the paper bag and it’s works for me please what else can I do to get ride of this from my life I’m not comfortable at all. Please I need your advice.
Thank you
I had panic attacks for years. They are very scary, and I always thought I was dying. It didn’t matter what was going on they just came out of left field. I always got heat from my face down, making it hard to breathe, instant palpations, throw up. use of bathroom. For about a year I would wake up in the middle of the night, Scared and hard time breathing. Then they started all over again. I went to my Primary Physician and a specialist. I had a MRI, had a brain scan, an echogram on my heart. Nothing was found wrong and Dr couldn’t do any thing for me. Eventuallly I recognized the signs coming on and got busy. Get your thoughts off of yourself. The more you accept the panic attack the more it consumes you. I would start saying aloud, This too shall pass.
I read a question, how do people end up with anxiety? I reflected on my own experience. At 12 yo I was diagnosed with a breathing/lung disease. I was active and athletic and would try to maintain that life, for a few more years. I’d never be a professional athlete, I wouldn’t earn an athletic scholarship either. Those were my only goals I had by that age. Six to 7 years later I started having extreme anxiety issues. It was severe enough at times, I wouldn’t be able to walk. Blah blah blah. Turns out, in studies that had been conducted of people who were prescribed the same medication as I was for the acquired lung disease, a small number of those subjects developed long term debilitating anxiety. Peachy. I have no need to bs about any of it. Truth is, even if I hadn’t ran away to my dads Bc my brother was beating me on a daily basis, he was going to kill me. His mother never disciplined him, he was her pride and joy,. TBH I would get punished/disciplined for him beating me up. Anywhere from 8 – 12 years old and I was truly suffering. For all intents and purposes, I suppose I was screwed either way. It was an awful environment for me with momster and her son, it was just a different kind of abuse at my dads. Him and my stepmomster were alcoholics. They hit it every single day (after work, they “functioned”) they never did stop smoking tobacco. Thirty-nine years later, I’ve battled this breathing disease, the debilitating anxiety, then obviously depression and a laundry list of other syndromes/illnesses/ disorders over these decades and it’s been more difficult than anyone can imagine. When I start thinking of what my life could’ve been versus the reality of the situation, uhh. There’s just no word that can adequately describe any of it. I would be diagnosed at 12 having an acquired lifelong (now) overlapping lung disease which was exacerbated by my parents second hand cigarette tobacco smoke. And by the time I was 18, I would have another acquired lifelong debilitating issue of extreme anxiety that I got from long term side effects of the medication I was put on daily fir 6 + years for my lungs.
The biggest events in my life have been absolutely overshadowed by these “extras” that I didn’t need. We would spend our honeymoon in a hospital Bc I couldn’t breathe, two pregnancies that almost weren’t, the second one was bad, but God gave me healthy babies Thank God! At no time in those formative years early adolescence, would I have understood the concept of lung disease and cigarettes. I didn’t have the mentality nor intelligence to comprehend it. But I knew I was going to get beat to death. So I was screwed either way. I salvaged my childhood as best anyone could but the traumas never stopped long enough for me to even catch my breath.
So anyway, I’ve been isolated for 22 months, trying to stay Covid free. So much for that. I’ve no idea how I could’ve caught it, I’ve been around no one since New Year’s Eve. At all. So yes, this covid positive test result last week was shocking. But If I can beat this Covid- which I am beating it- then when I’m better, I can go around people again! I need that. I miss people. I miss me.
I had so many goals and dreams for something called “my future.” Right here and now is that future. Frankly, this wouldn’t have been my “worst case scenario” plan for a future though. Lol. I’m a reasonable person. I know things could have been so much worse. I just wish I could have had a chance, just a tiny opportunity to make it better. I know I would’ve.
I guess the point to my story was lost in translation. You can get severe anxiety from a side effect of certain medications.
I haven’t even said anything yet about MY ordeal of the anti anxiety medicine that I was put on for 15 years, and
I am not trying to turn that page!
ive had panic attacks for the past 3 years now, its ruined my life, i cant go anywhere without having one, when i have one my muscles would spasm out and my body will have a tingly feeling and i would get paralyzed and my mouth would be really dry. i had to call the ambulance a few times, im only 14, the nurse first gave me a vomit bag and told me to breathe in and out, then she told me paper bags also helped. Its such a life saver, whenever i have a panic attack at school i would go to sick bay and get my paper bag out and breathe in it, my paralysis goes away in about 4 minutes and my breathing calms down.