Breathing Principles Series - Managing Panic Attacks and Anxiety

---

For those who experience regular panic attacks then, what can you do to safely start getting them back under control? There are a few different options available to you, but the aim is to a) get yourself to safety and b) start to address the symptoms. Here we will look at how best to manage a situation where you find yourself beginning to suffer from an attack… Panic Attack Symptoms Before you can begin to treat a panic attack, you first need to be able to identify the symptoms of one. This will give you ‘early warning’ so you can begin to put a plan into action that will help you to calm yourself down and return to normal function. The symptoms of a panic attack then include: • Rapid heart rate • Shallow breathing • Racing, negative thoughts • Sweating • Muscle tension • Dizziness

• Chest pain • Pacing Often the heart rate can reach the point where it is so intense that it feels like you are having a heart attack. In fact, this is one of the big problems many people face when suffering from panic attacks: they become convinced that they are suffering from a heart attack which causes them to panic even more! The symptom stake about 10-20 minutes to reach their peak and will often then subside but sometimes take several hours. Of course, it is very important to get yourself checked if you think there is any chance that you might be suffering from a heart attack. Note however that in cases of heart attack the feeling of dread will tend to precede the elevated heart rate or the stress. Panic attacks also cause shaking, restlessness, rapid and shallow breathing, nausea, and butterflies in the stomach. The best way to describe a panic attack is as being very similar to a fight or flight response but turned up to 11. If you have ever had to give a speech in public which you've been scared to give, if you have ever had a confrontation with someone in the street, or if you've ever gotten into a serious argument with someone in a shop, then you will likely have experienced these symptoms. This is what a panic attack feels like but a little worse and with the added breathing issues and dizziness. If that's what you're experiencing, then you're probably suffering with a panic attack and not a heart attack. You can be sure of this in fact – but if you are ever uncertain then it's always worth speaking with your GP to be on the safe side. Consider the aspect of demographics and risk factors as well. Heart attacks are very unlikely unless you’re someone who is in an ‘at risk’ bracket. The next way to tell the difference between panic attack or heart attack is to examine the precise nature of the chest pain. Often, it's the chest pain that makes us suspect we are having a heart attack when in fact it is 'just' a panic attack. However, the chest pain associated with each is quite different. In a heart attack for instance, the pain is normally described as a 'crushing' pain and a dull ache, as though someone is sitting on your chest causing a shortness of breath. This is then often experienced alongside pain in one arm, in the jaw and in the neck. In a panic attack meanwhile, the difficulty breathing is caused by hyperventilation rather than heart problems and this will be experienced as low CO2 and dizziness as opposed to a feeling as though you're about to suffocate. Any 'tightness' in the chest will be caused by muscle contractions that are the result of stress.

What is a Normal Heart Rate During a Panic Attack? Seeing as anxiety increases your heart rate (via adrenaline) and panic at- tacks are essentially extreme anxiety episodes, it makes sense that your heart rate should increase at this time. But what is a normal panic attack heart rate?

Unfortunately, the answer is not that straight forward. For starters, every- one has a different resting heart rate to begin with meaning they start from different baselines. An athlete may have a resting heart rate as low as 40bpm or less, whereas someone unhealthy could have a heart rate as high as 120bpm when they're not doing anything.

Fitness dictates heart rate to a large extent because exercise strengthens the heart. The stronger the heart becomes as a muscle, the more it will be able to drive blood around the body with each beat. Ultimately, this means that a very strong heart won't need to beat as rapidly to circulate as much blood.

Other factors also affect heart rate, however, include blood viscosity and vasodilation, height, metabolism and more. Even the air temperature can affect your heart rate. Some perfectly healthy people have high heart rates for seemingly no reason.

A panic attack heart rate then is likely to result in a marked and sudden spike for that individual, though it might still be beating slower than some people not having a panic attack.

As a general rule though, you can likely expect a panic attack heart rate to be anything from 100 to 170bpm – equivalent to an intensive bout of exercise. What's also important to keep in mind though, is that everyone experiences panic attacks differently and every case of a panic attack is different.