Seven Ways To Help Someone Through A Panic Attack

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Educate yourself

According to the Mental Health Foundation (MHF), 13.2% of people have experienced a panic attack. If you know someone who suffers from them frequently, it can be helpful to better understand what they are. Attacks can last between five and 30 minutes, with symptoms including rapid breathing, sweating, a racing heart, shivering and feeling sick. The NHS, MHF, the mental health charities MindTime to Change and No Panic have resources available.

Stay calm

“If you’re having a short, sudden panic attack, it can be helpful to have someone with you reassuring you that it will pass,” Paul Salkovskis, professor of clinical psychology and applied science at the University of Bath, says in official advice from the NHS. It is important to ride out the attack and not look for distractions; just remaining calm yourself can provide comfort.

Be reassuring

Panic attacks can be highly distressing; some people describe feeling as if they are having a heart attack or that they might die. It is important to reassure the person experiencing an attack that they are not in danger. The symptoms, attributable to the body’s fight or flight response, typically peak within 10 minutes.

Encourage deep breaths

Encourage the person to breathe slowly and deeply – Mind advises counting out loud or asking them to watch while you calmly raise your arm up and down. The NHS and No Panic also publish guides to calming breathing exercises.

Be careful not to be dismissive

Your “don’t panic” may be well-intentioned, but try to avoid any potentially dismissive language and phrases. As Matt Haig, author of the best-selling Reasons to Stay Alive, puts it: “Don’t belittle them. They’re among the most intense experiences you can go through.”

Try a grounding exercise

“One of the symptoms of panic attacks can be feeling unreal or detached,” says Martin Antony, a psychology professor at Ryerson University in Toronto, Canada. Grounding techniques, or other ways to feel connected to the present, can be effective – Mind suggests focusing on the texture of a blanket, smelling something with a strong scent – and even stamping your feet.

Ask them what they need

People can often feel exhausted after a panic attack. Gently ask them if you can get them a glass of water or something to eat. (Caffeine, a psychostimulant, is best avoided, as is alcohol.) They may be feeling shivery or too hot. At a later point, when they have recovered, you might like to ask them what they find helpful during or after an attack.

6 Signs It’s Time to Seek Help for Your Anxiety

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Like all emotions, anxiety is healthy, and we’re all prone to feeling it sometimes. Anxiety can become a debilitating problem, though, when the stress you feel is no longer in proportion to the situation. An upcoming test, jobinterview, or first date may make you feel anxious, and that’s healthy. But, if you feel symptoms of anxiety absent any apparent reason, or everyday things make you anxious—leaving your home, for example—it may be time to see a mental health professional. To know if your anxiety is unmanageable, you have to know the symptoms.

1. Physical Symptoms

The physical symptoms of anxiety may include an upset stomach, excessive sweating, headache, rapid heartbeat, and trouble breathing. If you get a stomach ache every time someone invites you to a social function; if you sweat through your shirt whenever you leave the house, even in the middle of winter; or if you feel like your heart is beating so fast it might burst when talking to a stranger on the phone, you may be unhealthily anxious. If your body regularly reacts to everyday stressors the way a caveman would if a lion chased him, your anxiety is no longer healthy.

2. Cognitive Symptoms

Memory issues, trouble concentrating, and insomnia are also symptoms of an anxiety problem. If you can’t fall asleep or wake up repeatedly during the night because you can’t stop thinking about things that stress you out, anxiousness is ruling over you. The same goes for if you can’t focus on work, or sit through a movie, or read a book, or if you seem to be continually forgetting things that happened even recently. When you’re severely anxious about something, even if the thing is “irrational,” it can be hard to function normally.

3. Procrastination and Avoidance

Whether it’s procrastinating about doing the thing that triggers your anxiety—like putting off an errand or not reading an important email until you’re “ready to deal with it”—or avoiding doing just about everything, excessive procrastination and avoidance are both signs of an anxiety issue. We all put off starting unpleasant or difficult tasks sometimes, but when you spend more time avoiding than doing, it may be time to seek outside help.

4. Overthinking and Constant Worrying

If worrying keeps you from functioning or you’re overthinking so much that you can’t focus on important work or sleep at night, you may have an anxiety problem. Your mind races, you lose track of your surroundings, and you’re so caught up in a storm of stressful thoughts that you miss your freeway exit. Anxiety tips over from healthy to unhealthy when it disrupts your life. If a recent health diagnosis has you worried, that’s totally normal. If you’re afraid that you’re dying every time you sneeze, that’s not.

5. Feeling Agitated and Restless

If you feel on edge, you can’t stop moving, and you’re quick to anger, you may be anxious. I’ve written before about how anger can disguise itself as anxiety, but did you know that anxiety can also disguise itself as anger? Anger can be a way to shield you from stressful thoughts. By raging at someone else, you can blame your anxious feelings on an outside force. And if you’re always moving, you don’t have time to ruminate on anxious thoughts. But neither response is healthy or helpful in the long term. When you feel agitated and restless more often than not, when you can’t stop moving and get easily annoyed or are prone to snap at people, you may have a serious problem with anxiety.

6. Panic Attacks

Often people mistake a panic attack for a heart attack. Tightness in your chest, rapid heartbeat, sweating and shaking, shortness of breath, and an upset stomach can easily be mistaken for a heart attack. It’s important to know the symptoms of a heart attack so that you don’t dismiss one by thinking it’s a panic attack or do the opposite and call 911 when you should call a psychologist. Frequent panic attacks are a sign you may have a panic disorder.

To differentiate between healthy and unhealthy anxiety, ask yourself: Is this manageable? If your anxiety keeps you from sleeping, working, social interactions, or errands, you may want to reach out to a therapist. If you feel anxious more than half the week for six months or longer, it’s probably time to seek help.

12 Signs You Might Have an Anxiety Disorder

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What’s normal?

Everyone gets nervous or anxious from time to time—when speaking in public, for instance, or when going through financial difficulty. For some people, however, anxiety becomes so frequent, or so forceful, that it begins to take over their lives.

How can you tell if your everyday anxiety has crossed the line into a disorder? It’s not easy. Anxiety comes in many different forms—such as panic attacks, phobia, and social anxiety—and the distinction between an official diagnosis and “normal” anxiety isn’t always clear.

Here’s a start: If you experience any of the following symptoms on a regular basis, you may want to talk with your doctor.

Excessive worry

The hallmark of generalized anxiety disorder (GAD)—the broadest type of anxiety—is worrying too much about everyday things, large and small. But what constitutes “too much”?

In the case of GAD, it means having persistent anxious thoughts on most days of the week, for six months. Also, the anxiety must be so bad that it interferes with daily life and is accompanied by noticeable symptoms, such as fatigue.

“The distinction between an anxiety disorder and just having normal anxiety is whether your emotions are causing a lot of suffering and dysfunction,” says Sally Winston, PsyD, co-director of the Anxiety and Stress Disorder Institute of Maryland in Towson.

Sleep problems

Trouble falling asleep or staying asleep is associated with a wide range of health conditions, both physical and psychological. And, of course, it’s not unusual to toss and turn with anticipation on the night before a big speech or job interview.

But if you chronically find yourself lying awake, worried or agitated—about specific problems (like money), or nothing in particular—it might be a sign of an anxiety disorder. By some estimates, fully half of all people with GAD experience sleep problems.

Another tip-off that anxiety might be involved? You wake up feeling wired, your mind is racing, and you’re unable to calm yourself down.

Irrational fears

Some anxiety isn’t generalized at all; on the contrary, it’s attached to a specific situation or thing—like flying, animals, or crowds. If the fear becomes overwhelming, disruptive, and way out of proportion to the actual risk involved, it’s a telltale sign of phobia, a type of anxiety disorder.

Although phobias can be crippling, they’re not obvious at all times. In fact, they may not surface until you confront a specific situation and discover you’re incapable of overcoming your fear. “A person who’s afraid of snakes can go for years without having a problem,” Winston says. “But then suddenly their kid wants to go camping, and they realize they need treatment.”

Muscle tension

Near-constant muscle tension—whether it consists of clenching your jaw, balling your fists, or flexing muscles throughout your body—often accompanies anxiety disorders. This symptom can be so persistent and pervasive that people who have lived with it for a long time may stop noticing it after a while.

Regular exercise can help keep muscle tension under control, but the tension may flare up if an injury or other unforeseen event disrupts a person’s workout habits, Winston says. “Suddenly they’re a wreck, because they can’t handle their anxiety in that way and now they’re incredibly restless and irritable.”

Chronic indigestion

Anxiety may start in the mind, but it often manifests itself in the body through physical symptoms, like chronic digestive problems. Irritable bowel syndrome(IBS), a condition characterized by stomachaches, cramping, bloating, gas, constipation, and/or diarrhea, “is basically an anxiety in the digestive tract,” Winston says.

IBS isn’t always related to anxiety, but the two often occur together and can make each other worse. The gut is very sensitive to psychological stress—and, vice versa, the physical and social discomfort of chronic digestive problems can make a person feel more anxious.

Stage fright

Most people get at least a few butterflies before addressing a group of people or otherwise being in the spotlight. But if the fear is so strong that no amount of coaching or practice will alleviate it, or if you spend a lot of time thinking and worrying about it, you may have a form of social anxiety disorder (also known as social phobia).

People with social anxiety tend to worry for days or weeks leading up to a particular event or situation. And if they do manage to go through with it, they tend to be deeply uncomfortable and may dwell on it for a long time afterward, wondering how they were judged.

Self-consciousness

Social anxiety disorder doesn’t always involve speaking to a crowd or being the center of attention. In most cases, the anxiety is provoked by everyday situations such as making one-on-one conversation at a party, or eating and drinking in front of even a small number of people.

In these situations, people with social anxiety disorder tend to feel like all eyes are on them, and they often experience blushing, trembling, nausea, profuse sweating, or difficulty talking. These symptoms can be so disruptive that they make it hard to meet new people, maintain relationships, and advance at work or in school.

Panic

Panic attacks can be terrifying: Picture a sudden, gripping feeling of fear and helplessness that can last for several minutes, accompanied by scary physical symptoms such as breathing problems, a pounding or racing heart, tingling or numb hands, sweating, weakness or dizziness, chest pain, stomach pain, and feeling hot or cold.

Not everyone who has a panic attack has an anxiety disorder, but people who experience them repeatedly may be diagnosed with panic disorder. People with panic disorder live in fear about when, where, and why their next attack might happen, and they tend to avoid places where attacks have occurred in the past.

Flashbacks

Reliving a disturbing or traumatic event—a violent encounter, the sudden death of a loved one—is a hallmark of post-traumatic stress disorder (PTSD), which shares some features with anxiety disorders. (Until very recently, in fact, PTSD was seen as a type of anxiety disorder rather than a stand-alone condition.)

But flashbacks may occur with other types of anxiety as well. Some research, including a 2006 study in theJournal of Anxiety Disorders, suggests that some people with social anxiety have PTSD-like flashbacks of experiences that might not seem obviously traumatic, such as being publicly ridiculed. These people may even avoid reminders of the experience—another symptom reminiscent of PTSD.

Perfectionism

The finicky and obsessive mind-set known as perfectionism “goes hand in hand with anxiety disorders,” Winston says. “If you are constantly judging yourself or you have a lot of anticipatory anxiety about making mistakes or falling short of your standards, then you probably have an anxiety disorder.”

Perfectionism is especially common in obsessive-compulsive disorder (OCD), which, like PTSD, has long been viewed as an anxiety disorder. “OCD can happen subtly, like in the case of somebody who can’t get out of the house for three hours because their makeup has to be absolutely just right and they have to keep starting over,” Winston says.

Compulsive behaviors

In order to be diagnosed with obsessive-compulsive disorder, a person’s obsessiveness and intrusive thoughts must be accompanied by compulsive behavior, whether it’s mental (telling yourself It’ll be all right over and over again) or physical (hand-washing, straightening items).

Obsessive thinking and compulsive behavior become a full-blown disorder when the need to complete the behaviors—also known as “rituals”—begins to drive your life, Winston says. “If you like your radio at volume level 3, for example, and it breaks and gets stuck on 4, would you be in a total panic until you could get it fixed?”

Self-doubt

Persistent self-doubt and second-guessing is a common feature of anxiety disorders, including generalized anxiety disorder and OCD. In some cases, the doubt may revolve around a question that’s central to a person’s identity, like “What if I’m gay?” or “Do I love my husband as much as he loves me?”

In OCD, Winston says, these “doubt attacks” are especially common when a question is unanswerable. People with OCD “think, ‘If only I would know 100% for sure whether I was gay or straight, either one would be fine,’ but they have this intolerance for uncertainty that turns the question into an obsession,” she says.

This article originally appeared on Health.com