Anxiety is the body’s way of responding to danger. Adrenaline is produced for us to run away or fight the danger. We need this quick response for survival, but sometimes this alarm system is triggered unnecessarily. The fight/flight response can be triggered by anxious thoughts as well as physical dangers which can lead to panic attacks. People who experience panic attacks may become more sensitive and hyper alert to their surroundings which can lead to this alarm system being set off even more frequently.  

Common symptoms of panic include:

Physical Symptoms:

• Heart racing
• shaking
• dizzy
• breathless
• sweating

Thoughts:

• I am going crazy
• I am having a heart attack
• I will stop breathing and die
• People will realise and make fun of me

Behaviour:

• Avoidance
• Safety behaviours (distraction, taking someone with you etc.)
• Drink/drugs

These symptoms can act in a vicious cycle and although avoidance has short term benefit to escape the anxiety, in the long term it feeds into this cycle and reinforces to the brain that the situation is dangerous. Strategies to help manage panic try to break into this cycle. By targeting one area of the cycle, we can have a positive affect on the entire cycle.  

Moving out of Panic:

It is useful to learn how to manage in the event of a panic attack: breathing is the key. Becoming aware of the pace of your breaths in and out and controlling them is essential. The Square breathing technique is a simple breathing exercise which can help you get control of your breath: 

• Imagine a square 
• Start in one of the corners (e.g. the top left corner)
• Imagine drawing a square while you are breathing or tracing the square with your finger
  • Breathe in for a count of four  
  • Hold for a count of four
  • Breathe out for a count of four
  • Hold for a count of four

Then repeat the same process again until you feel calmer. 

• Remind yourself the panic attack will end and is not actually dangerous. A panic attack is your body going into fight or flight mode and although the physical symptoms feel uncomfortable, they will pass and are safe.  
• Imagine someone offering calm encouragement 
• Focus on the present, become aware of your surroundings. Use your senses to refocus- listen to some music, focus on the smells if you are cooking, look around what you can see around you.  

After an attack it can be useful to log the event in detail to help you notice any patterns (time, place, situation, thoughts, etc) and to help gain mastery over feeling out of control. Ensure you are looking after yourself well (eating healthily and sleeping regularly) and minimising stress levels. 

Getting Support 

It may be helpful to seek medical advice and support if the panic attacks are frequent and severe. If panic is impacting on your capacity to function fully, you may consider using Cognitive Behavioural Therapy (CBT). It may be useful to explore the underlying causes for the panic attacks, perhaps with a Counsellor. 

• The Wellbeing and Student Support are available for students at University of Warwick: https://warwick.ac.uk/services/wss/ 
• Medical support and information can be obtained from GP practices or health centres. 
• You may like to try: http://www.livinglifetothefull.com/ 
• http://www.moodjuice.scot.nhs.uk/mildmoderate/Panic.asp 

For more information: 

• Royal College of Psychiatry: http://www.rcpsych.ac.uk 
• www.getselfhelp.co.uk 
  http://www.mind.org.uk 
  http://mindfulnessforstudents.co.uk/ 
• http://www.cci.health.wa.gov.au/resources/infopax.cfm?Info_ID=44 
• Self-help booklet on panic http://www.ntw.nhs.uk/pic/selfhelp/ 

 Self-help references 

The following references are available from the University Library either in hard copy, CD or ebooks. Most are readily available to buy either in bookshops or over the internet. There are also a limited number of books in the Learning Grid and the Bio-med Grid.

Fear : The Friend of Exceptional People : Techniques in Controlling Fear	Geoff Thompson	Ebook
Overcoming Anxiety, Panic, and Depression : NewWays to Regain Your Confidence	James Gardner, Arthur H Bell	Ebook
Conquering fear	Rowe	MIND
How to cope with panic attacks	Teevan and Gorman	MIND
How to stop worrying	Flory	MIND
The Anxiety and Phobia Workbook	Bourne, Edmund J.	New Harbinger Publications
When panic attacks (book andCD)	Aine tubridy	Newleaf
Overcoming Anxiety (CBT)	Helen Kennerley	Robinson
Overcoming Panic (CBT)	Derrick Silove and V Manicavasagar	Robinson
Coping with anxiety and depression	Trickett	Sheldon Press
Don't Panic	Wilson, Robert R	Harper Perennial
Feel the Fear and Do It Anyway	Susan Jeffers	Vermilion
Panic Attacks	Christine Ingham	Thursons
The worry cure. Stop worrying and start living	Leahy	Pitkus
Understanding Panic Attacks and Overcoming Fear	Baker	Lion

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