In 2013 Oprah Winfrey had a panic attack. "In the beginning, it was just sort of speeding and a kind of numbness and going from one thing to the next thing to the next thing," she told Access Hollywood. Picture: AP

You feel it coming on but you are powerless to stop it. Marchelle Abrahams finds out how to deal with panic attacks.

“Nausea, jelly legs, irritability I didn't know what was happening,” said Peter Matlahaela, a panic sufferer. The triggers for the attacks could be as simple as driving or even while sleeping.

Peter eventually sought help and attended Cognitive Behavioural Therapy (CBT) sessions. “I know that I can feel the fear, but I remember it’s just a panic attack and tell myself that I'm safe.”

Researchers believe that when the brain’s “flight or fight” response for reacting to a threat becomes inappropriately aroused, the result is a panic attack. In other words, it’s your mind’s way of acting irrationally to an otherwise rational situation.

For many people it can be a one-off incident. In fact, some will probably have one or two attacks in their lives and not develop a panic disorder. Believe it or not, it can be a normal response to a stressful situation - it is how you manage it that counts.

Physical symptoms like heart palpitations, dizziness, nausea, tingling and chest pains seem to come out of nowhere. The key is to identify the triggers and find coping mechanisms to deal with them.

In theory, it sounds simple but while in the grip of a panic attack, all logical thoughts go out the window.

"Most people who experience these attacks feel as if they are going crazy or are out of control”, said Johannesburg anxiety expert psychologist Dr Colinda Linde.

“Most people feel anxious about the possibility of having another panic attack and avoid situations in which they believe these attacks are likely to occur.”

But in extreme cases the consequences of this can be far-reaching. Imagine phoning in sick to work because your fear of driving keeps you from getting behind the wheel?

"Some sufferers who experience night-time panic attacks might wake up in a state of terror and fear going back to sleep. The results could be sleep deprivation and exhaustion.

Sufferers are also ashamed and believe it shows their weakness, adds Cassey Chambers, the director of the South African Depression and Anxiety Group (Sadag).

Having a panic attack behind closed doors keeps the secret hidden, but when it happens in plain sight, helpless onlookers might not know how to react.

When someone is having an attack in front of you, the first thing is to stay calm, says Linde. “Keep your voice and movements steady, and remain as a reassuring presence.”

Another strategy is to use distraction, but it’s a quick-fix and not a long-term solution.

“For example, when little ones are about to throw a tantrum, say ‘There’s a monkey in the tree’ and it will immediately shift their thinking.”

Picture: Wikimedia Commons

Triggers

The triggers for panic attacks are often internal, says clinical psychologist David Rosenstein.

“If the person does not have a clear phobia and experiences panic which appears out of the blue, it is often triggered by subtle changes in the body, often due to stress.

"Because it can come on so suddenly, there are thoughts of dying, losing control, embarrassment or even fear of losing one’s mind.

“This is what can make these attacks so worrying as the triggers are often not external,” says Rosenstein, who also specialises in anxiety, depression, panic and phobias.

Secondary effects

“People who develop panic-induced phobias tend to avoid situations they fear will trigger a panic attack, and their lives might be increasingly limited as a result,” says Linde.

She says in severe cases some people develop agoraphobia - a fear of going outdoors.

A recent US study showed that people who suffer from panic disorder are more prone to alcohol and other substance abuse.

They also spend more time in hospital emergency rooms and feel less emotionally and physically healthy.

How to get help

CBT focuses on identifying, confronting and testing negative and automatic thoughts and assumptions with reality.

It brings about a more realistic way of thinking about fearful situations, and challenges anxiety-provoking thoughts and feelings.

Rosenstein says there are physical exercises sufferers can do with a CBT therapist called interoceptive exposures. They include breathing techniques used to reduce and treat attacks.

Yoga has been found to help reduce symptoms.

Mindfulness, breathing, exercise and other lifestyle changes are important in managing your anxiety and panic, he says.

Mental health advocate and Sadag founder Zane Wilson says going for CBT, learning self-help tips, joining a support group and learning more about panic can help you take back control of your life.

* Sadag offers free telephonic counselling, referral to expert resources and support groups nationwide.

For more information visit www.sadag.org.