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The phrase “panic attack” surely ranks among the most overused and misunderstood in the jargon of modern self-diagnosis.

Most of us will have heard friends, colleagues or family members describe or declare themselves the victim of a “panic attack” – more often than not, the subject is simply describing a state of acute everyday anxiety. Nowadays, the two terms appear to be used almost interchangeably. 

But this is an error which has far more serious implications than merely infuriating passing language pedants.

Panic attacks are often a symptom of pervading panic disorder, a  form of anxiety disorder that inflicts devastating emotional impact on millions globally. While anxiety is universal part of modern life — and can often be resolved by changing the environment or walking away from the source of fear — panic attacks can be unprovoked and unpredictable, yet often correlate with extreme emotional experiences and feelings of loss. 

Studies show roughly one in 40 adults in the US suffer from panic disorder at some stage and, worryingly, panic disorders appear to be on the rise. Figures from the National Health Service in the UK observed outpatient appointments for anxiety disorders, of which panic attacks are a common form, increasing five-fold in the decade up to 2016. 

Women are roughly twice as likely to be diagnosed with panic disorder than men, and the age of onset is normally between 20 and 24.

Its root cause is yet to be established, however there is evidence to suggest that panic disorder runs in families, and therefore may have a genetic basis. Identified risk factors include smoking, psychological stress, and a history of child abuse.

A regional perspective 

Dr Linda Sakr, a UAE-based counselling psychologist formerly based at Dubai Community Health Centre for more than ten years, said roughly 20 per cent of the patients she deals with carry a diagnosis of panic disorder, which is “common and prevalent” in both the expatriate and the local Emirati community.
“Globally,  life has become very fast paced, with high expectations as well as expenses,” she says.

“Young people are under a lot of pressure in terms of finding a suitable partner, finding suitable jobs and meeting living expenses.” 

Mat Schramm, the co-founder of Dubai-based online counselling service Talkcircle.com, said combatting regional stigma is an ongoing challenge, and praised events such as last year’s inaugural Happiness Festival in educating and normalising mental health issues.

“Unfortunately, the region suffers from a general stigma around therapy, including that of addressing panic disorders which are more common than people may think,” said the Australian expat. 

“For many expats, the lack of a regular support structure can add additional pressure – family and friends are natural coping strategies that are often not to hand for someone who has relocated from their home country.

Coupled with a lack of qualified therapists in the region, for both expats and locals, issues are left untreated, which can often lead to problems such as panic attacks.”

The symptoms

Panic attacks can last anything between a minute to more than an hour — depending on when a successful intervention is made— but most typically peak within ten minutes.

Characterised by extreme psychological symptoms, including difficulty breathing, dizziness, palpitations, chest pains, tingling sensations, shaking, sweating, visual difficulty, feelings of unreality and “jelly legs”, it is common for people to believe they are suffering a heart attack.

These unpleasant physiological sensations are accompanied by their own psychological warning signs — thoughts ranging from “I’m going to embarrass myself”, “I’m going mad” to “I’m going to die”.

“Although it is perhaps understandable to experience these thoughts, they are largely mistaken panic disorder-related misinterpretations of what is actually going on,” said Sakr.

“Unfortunately, once you start thinking these thoughts, you become more anxious, keeping the bodily symptoms going.”

The triggers 

The death of a loved one, divorce, job loss and other situations of extreme stress are the most common triggers. However, simply avoiding the problem is not the long-term solution, as bad news remains an inevitability of life. 

“A panic attack is analogous to a burglar alarm which goes off when the window rattles the window panes,” said Sakr. “The key to overcoming panic, therefore, is to reset your alarm system so that it doesn’t go off when there is no real danger. 

“In order to reset your alarm you need to focus on four things: The thoughts that trigger the panic, your breathing, your responses to the attack, and your general level of anxiety.

But even the best set burglar alarm can go off at the wrong moment, so you need to also learn some strategies for coping with the attack itself.” (See panel for more). 

Moreover, many behaviours sufferers may naturally turn to, such as avoidance, emotional masking and aggression, only exacerbate the situation.

New therapy
As with many psychological conditions, treatments typically fall into two distinct camps: medication which treats the symptoms, and therapy which treats the cause, with most clinicians advocating the use of CBT (Cognitive Behavioural Therapy).

Technology is playing an increasingly inventive role in meeting mental health needs.

Digital start-up The Expert Box collaborated with a team of psychologists in The Netherlands to create a free, discreet app to self-monitor and better manage panic and anxiety, called Butterfly Diary.

Meanwhile, as well as offering anonymous one-to-one video therapy, Talkcircle.com recently launched a text therapy service, a new treatment method specifically targeted at anxiety disorders. 

“This allows constant daily text communication with therapists so that issues can be addressed when they arise, often before escalating to what can be a debilitating attack,” added Schramm.

“This allows people to positively and proactively address their feelings with both short and long-term treatment strategies.” 

10 rules of coping with panic

UAE-based counselling psychologist Linda Sakr shares ten steps anyone can use to help deal with panic

1. Remember, panic feelings are only normal reactions that are exaggerated, they are not dangerous.

2. They are not harmful and nothing worse will happen. The feelings will soon pass.

3. Notice what is happening in your body. Stay with the present. Slow down, relax, but keep going.

4. Thinking about what might happen is unhelpful. Only now matters.

5. Accept the feelings. Let them run through you. Do your best not to fight the panic. Float over it.

6. Monitor your level of anxiety: 10 (worst) to 0 (least). Watch the level go down.

7. Stay in the situation. If you run away, avoid or escape, it will be more difficult in the future.

8. Take slow, deep breaths. Breathe from your stomach – say the word “calm” as you breathe out.

9. Consciously relax your tense muscles. Feel yourself relaxing. Drop your shoulders.

10. Now begin to concentrate again on what you were doing before. Slowly move on when ready.