Mental Health First Aid: Panic Attacks 

By Wasim Kakroo

ACCORDING to data released by MSF in 2015, over 1 million adults (26%) in the Kashmir Valley were showing indications of a possible anxiety-related disorder, and the number of cases may have increased since then due to ongoing political upheaval in addition to the distress caused by the ongoing COVID-19 pandemic scenario. Anxiety disorders are diagnosable mental illnesses that create substantial disruptions in a person's daily life due to acute, recurrent symptoms. Anxiety patients may exhibit unpleasant physical, behavioural, and psychological symptoms such as irrational fear, fast heart rate, digestive issues, and distress in everyday situations.

In addition to its core symptoms, anxiety disorders can also lead to an intense spell of anxiety called panic attack. People with this condition may have difficulties in their socio-occupational functioning as a result. Depression, anxiety, and other mental health difficulties, as well as drug abuse disorders, may emerge as a result of these issues.

Mental health first aid can be used to help people who are having panic attacks to help them to keep calm and manage their symptoms until they are taken to a mental health professional. A person who provides mental health first aid can offer encouragement as well as referral information so that longer-term services can be established. A person who provides mental health first aid can offer encouragement as well as referral information so that longer-term services can be established.

What is a Panic Attack?

A panic attack is a brief period of extreme anxiety, fear, or discomfort that begins suddenly and usually ends within 10 minutes. Several of the following symptoms are present during the attack:

  • Palpitations, pounding heart, or rapid heart rate
  • Sweating
  • Trembling and shaking
  • Shortness of breath, sensations of choking or smothering
  • Chest pain or discomfort
  • Abdominal distress or nausea
  • Dizziness, light-headedness, feeling faint or unsteady
  • Feelings of unreality (derealisation), or being detached from oneself
  • Fears of losing control or going crazy
  • Fear of dying
  • Numbness or tingling
  • Chills or hot flushes

Causes of a Panic Attack

Numerous variables such as inheritance and genetics, severe life stressors, and sensitive emotional temperaments can all contribute to causing panic attacks in someone. While the onset of a panic attack may be surprising at first, it is generally caused by particular stimuli over time.

The following factors may increase your chances of having a panic attack:

Family history of anxiety disorders, panic attacks, or panic disorder

Death or illness in the family.

Trauma such as accidents or assaults

A history of physical or sexual abuse during childhood

Significant life changes, such as relocating, getting divorced, or having a child

Tobacco use or excessive caffeine consumption

What to do if someone is seemingly having a Panic attack?

If you feel someone is having a panic attack because they are experiencing the aforementioned symptoms, you should first ask them if they are aware of what is going on and if they have ever experienced a panic attack. If they indicate they've had panic attacks in the past and feel they're having one now, ask if they need any assistance and provide it. Introduce yourself if you are assisting someone you do not know.

How can one tell a panic attack from a heart attack?

Panic attacks might have symptoms that are similar to those of a heart attack or other medical conditions. It's impossible to know for sure whether or not someone is having a  panic attack. If it's something more serious, only a medical professional can tell. If the client has never experienced a panic attack and does not believe they are having one now, you should administer physical first aid.

Apply physical first aid principles if the victim loses consciousness. Check for breathing and pulse before calling an ambulance.

What to do if you are sure someone is having a Panic Attack?

Before assisting someone incase of panic attack, it is critical to assess for suicide or harm. Once you are sure the situation is not dangerous for them, try to have an empathetic listening to their trouble. Empathetic listening is one of the key components of mental health first aid. Listening without passing judgment demonstrates that you care about the person and will not pass judgment on their mental health issues. The capacity to listen to them without passing judgment will encourage them to talk openly and honestly about their situation. Inquire about the person's needs and allow them to tell you what would be most beneficial to them.

Educate the individual that they are having a panic attack. It is critical that you maintain your composure and do not panic yourself. Be patient when speaking to the person in a comforting yet strong manner. Use short, clear words while speaking clearly and gently.

Don’t make assumptions about what the individual requires; instead ask them directly what they believe might help. Don't dismiss the person's experiences. Make them feel that you know that their anxiety and associated discomfort is genuine, but reassure them that, while terrifying, a panic attack is not life threatening. Help them deal with their fears by assuring them that they are safe and that the symptoms will eventually subside.

By doing the following, you may improve your empathetic listening skills:

Maintaining strong eye contact

Maintaining an open and relaxed body language

To demonstrate understanding, reflect back what the other person has said and ask questions.

Being calm and patient while the person is crying, silent, and is trying to discuss difficult issues

Encourage the individual to seek out additional sources of support, such as family, friends, or any communities in which they participate.

You may also encourage the person to practice self-care routines and techniques that will help them develop good coping skills, such as:

Participating in everyday physical activity

Keeping a balanced diet

Mindfulness practices, such as meditation, are beneficial.

Practicing daily gratitude

Using anxiety management techniques at home and at work

Taking a mental health day when necessary as a form of self-care

What to say when the panic attack has subsided?

Ask the person if they know where they can acquire information on panic attacks when the panic episode has passed. If they don't know, give them some ideas.

Tell the person that if the panic attacks continue to bother them, they should seek help from a qualified mental health professional such as a clinical psychologist and/or psychiatrist. You should be aware about the help available in your area so that you are able to guide them to a mental health professional. Assure the sufferer that effective treatment in the form of medicines and therapies for panic attacks and panic disorder are available. Psychiatrists prescribe various medicines that have a calming effect, however their usage can occasionally result in undesirable side effects such as tolerance, dependency, and withdrawal.

Clinical Psychologists are considered one of the core mental health professionals who can help people with panic attacks. They try to understand the various causal factors behind somebody’s panic attack by taking a detailed history, looking into childhood issues such as adverse childhood experiences, family dynamics, and various other psycho-social issues and then accordingly prepare their treatment plan using various therapeutic modalities such as CBT, ACT, DBT, psychodynamic approach etc. in order to make the person competent enough to deal with symptoms, and the underlying issues such as poor self esteem, low frustration tolerance problems in family dynamics, lack of assertiveness and issues with problem solving strategies.

Depending on the severity of the condition, the person may get benefitted either by taking help of a clinical psychologist alone or by seeking combined help from clinical psychologists as well as psychiatrists. Psychiatrists will help them to deal with symptoms while as clinical psychologists can help to deal with issues and thus the patient may eventually feel recovered and be competent enough to live a productive life and realize the potential endowed to them by God almighty.

  • The author is a clinical psychologist and works as a Child and adolescent mental health counselor at IMHANS-K and can be reached at [email protected] 

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