Do you have panic attacks? Expert advice to help you stop them

One day, I was sitting in front of my computer trying to solve a problem but I couldn\’t think. It was a simple problem but my mind was blank. This was the last straw for me.

Low saw a psychologist, who diagnosed her with depression, anxiety and adjustment disorder. The panic attacks, she learned, were triggered by extreme stress at work and trauma-related incidents experienced early in her life. Not getting enough sleep was another trigger.

She was advised to take it easy and look for a job more suited to her lifestyle. She was also prescribed selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant that increases levels of serotonin, a feel-good chemical that carries signals between nerve cells in the brain and has a positive influence on mood , emotions and sleep. Low chose to take time off and rest.

In 2019, according to the World Health Organization, 301 million people were living with an anxiety disorder. There are many types of anxiety disorder, including panic disorder, which is characterized by panic attacks.


Panic attacks can affect anyone, regardless of age, gender and background, says Singapore-based psychiatrist Dr. Lim Boon Leng. Photo: Dr. Lim Boon Leng

These can affect anyone, regardless of age, gender and background, says Singapore-based psychiatrist Dr. Lim Boon Leng. Factors such as a family history of anxiety disorders, past experiences of physical or sexual abuse, or traumatic events can increase susceptibility.

Women are more prone to anxiety disorders in general and are more likely to have panic attacks.

What does a panic attack feel like? It\’s often experienced as a sudden surge of overwhelming fear or discomfort that usually reaches its peak within minutes, Lim explains.


Symptoms of a panic attack can include a racing heart, trouble breathing, chest discomfort, trembling, dizziness, feelings of impending doom, and loss of control. Photo: Shutterstock

If an individual has recurring panic attacks and anticipatory anxiety, or makes changes in their life to avoid having panic attacks, then Lim says they could be diagnosed with panic disorder.

Panic attacks differ from anxiety attacks, she notes. Panic attack is a formal psychiatric term and has a specific definition. It has to be accompanied by various physical symptoms as well as negative cognitive aspects, he says.

Anxiety attack is a general or umbrella term often used to describe a response to stress or perceived threats, which usually build up more gradually and generally don\’t reach the same intensity as a panic attack.

Panic attacks have no external triggers, unlike phobias, in which an object or situation that one is irrationally afraid of causes anxiety.

There may be internal triggers in panic attacks, Lim adds. Individuals who experience panic attacks tend to be hypervigilant towards physical changes in their body, such as heart rate or breathing rate. For example, when they detect an increase in heart rate, which may be quite normal, their brain sends them a danger signal and they start worrying that they are having a heart attack, which sends them into a panic.

Help is available. Lim says seeking therapy or professional counseling can be helpful. Medications, such as SSRIs or benzodiazepines that calm or celery by increasing the level of the inhibitory neurotransmitter Gaba in the brain, may be prescribed. Common benzodiazepines include diazepam (Valium) and alprazolam (Xanax).

If someone you know suffers from panic attacks, show them support and empathy, Lim says.


Peer groups can be immensely helpful in coping with panic attacks, says Justin Loo, head of programs at mental health charity Resilience Collective in Singapore. Photo: Justin Loo

Justin Loo is the Head of Programs at Resilience Collective (RC), a Singapore-based mental health charity. While getting professional help is immensely helpful for people experiencing panic attacks, he says they can also greatly benefit from peer support groups.

Such groups draw on the shared lived experiences of peers as a resource for you to learn more about your mental health conditions and challenges. They also provide you with community support, she says.

When deciding which support group to go to, consider the severity of your mental health symptoms and which support service would be best for you. And be consistent with getting help.

Understand that having a panic attack isn\’t an indication of emotional or mental weakness, but rather a sign that you need to address your mental health needs, says Loo. This may mean taking better care of yourself, balancing your responsibilities, or asking for support.


A creative outlet like painting often helps people reduce stress and panic attacks. Photo: Jan Kok

When he senses an attack coming, focuses on her breathing. When she feels triggered, she practices mindfulness, asking herself questions like: Is this stressful episode worth ruminating over? and Why am I reacting this way?

Sharing her experience with others also helped. Low volunteers for both RC and Singapore Institute of Mental Health as a mental health advocate, speaking in schools and companies destigmatize mental health problems.

I\’ve read up on coping mechanisms and continue to work on my mindset so that I\’m better able to deal with an impending panic attack and overcome the feeling of losing control, she says.

They are still a work in progress, but recognizing my triggers, being aware of my symptoms, and putting coping strategies into practice has helped me greatly in my recovery.

6 tips for coping with a panic attack

Lim offers these helpful tips for overcoming a panic attack.

1. Focus on taking deep, slow breaths.

2. Ground yourself by touching nearby objects and focusing on their texture.

3. Remind yourself that the panic attack is temporary and will pass.

4. Repeat a phrase that comforts you.

5. Switch your attention to your senses and notice different smells, sights and sounds.

6. This is similar to tip #1. 1, but requires advanced practice. Learn diaphragmatic breathing (also known as abdominal breathing): Inhale slowly and deeply through your nose, feeling your abdomen fill with air and grow like a balloon; then exhale slowly and gently through pursed lips, as if you were blowing bubbles.

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