DR MICHAEL MOSLEY: How I learned to manage my panic attacks

A couple of nights ago I woke up suddenly, around 3 am, feeling a panic. My heart was racing, my stomach was churning, and I was convinced that something bad was about to happen.

I soon realized I was having a full blown panic attack but knowing what was going on didn’t really help.

I tried to take a few slow, deep breaths and focus on other, more pleasant thoughts, but the feelings of fear grew stronger.

After a couple of minutes I put on my clothes and went for a walk (I’m currently shooting in Australia so it wasn’t cold).

And in 20 minutes or so, the fear had passed and I went back to bed and almost immediately fell fast asleep.

Panic attacks are common, with around a third of us experiencing at least one at some point.

If you’ve previously had a panic attack, it increases the chances that you’ll have another, and some unlucky souls have them almost daily.

The main symptom is the appearance of intense fear in a situation where there is no obvious danger, and is usually accompanied by a feeling of fainting, chest pain, shortness of breath and tremors.

Some people report ringing in their ears, while others describe it as an “out of body” experience. Many who have a first-time panic attack think they are having a heart attack or stroke.

There appears to be a genetic basis, with panic attacks often running in families, and can be triggered by a major life event such as divorce, but otherwise they are a bit of a mystery as there is often no single cause. obvious.

Next week I embark on a tour of the main Australian cities. And while I enjoy appearing in front of a live audience, I find the preparation for the first show very stressful. So I’m under a lot of pressure right now, which might explain why the panic attack happened.

It is also possible that the foundations for this recent attack were laid many years ago when I made a documentary on fear.

It involved going caving and I got stuck underground while trying to get through a narrow fissure. I was only trapped for a few minutes, but I can still remember the intense feelings of fear, and I’ve had nightmares about it ever since.

So maybe I had a nightmare, which I can’t remember, but it flooded my body with adrenaline, triggering a seizure.

One of the things that adrenaline does is make you breathe faster, and one of the most amazing things about panic attacks is that people who experience them often begin to hyperventilate some time before the attack itself.

In a 2011 study conducted by Southern Methodist University in Texas, 43 people who were prone to daily panic attacks were fitted with sensors to measure their heart rate, respiratory rate, and level of carbon dioxide in their breath (when you hyperventilate). you exhale more carbon dioxide than normal).

The sensors were connected to a monitoring kit that had a panic button, which the participants pressed if they felt an attack.

The main finding of this study was that carbon dioxide levels were abnormally low in the hour before the volunteers experienced a panic attack, suggesting that they had started hyperventilating long before they panicked, but those levels spiked. suddenly just before the attack.

As carbon dioxide levels rose, patients began to experience anxiety, fear of dying, and chest pain.

So is it the rapidly changing levels of carbon dioxide that really triggers these attacks?

In 2012, researchers at Maastricht University in the Netherlands asked a group of healthy volunteers to inhale carbon dioxide in increasing concentrations; found that the higher the concentration of carbon dioxide in the blood, the greater the feelings of panic and fear, accompanied by blood surges. blood pressure.

The link between carbon dioxide and fear could help explain why one of the best ways to cope with a panic attack is to try to control your breathing, focusing on taking long, slow, and deep breaths.

Follow a 4:6 pattern: Inhale deeply through your nose for a count of four, then exhale through your mouth for a count of six.

Doing this for a couple of minutes should stabilize your carbon dioxide levels and the feeling of panic should subside.

Obviously, this is easier said than done, especially when you’re feeling terrified and finding it hard to concentrate. But if you practice slow, deep breathing at times when you don’t panic, it will help.

You could also try hugging a cushion, or at least a cushion like the one engineers at the University of Bristol are developing.

It has an inflatable chamber that is connected to a pump that makes it ‘inhale’ and exhale at a slow, steady pace.

When tested on students who were about to take a grueling exam, hugging the cushion helped reduce their anxiety, mainly because the students began to unconsciously adjust their own breathing rate to that of the cushion.

There are other ways to deal with panic attacks.

You can, for example, try to reason with yourself, along the lines of, ‘I know this will pass soon and I’m not going to die.’

Or try to distract yourself by counting as many brightly colored objects around you as you can. Or grab something very cold from the fridge, as this will help you focus on the feeling of cold, rather than the fear.

If you have persistent attacks, see your GP, who can prescribe medication or cognitive behavioral therapy, which can help encourage you to challenge your negative thoughts. And of course, practice slow, deep breathing.