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Calm down! Daily Mirror   A guide to panic attacks — the symptoms, causes and ways to manage them.   Panic attacks can be pretty terrifying, and are hard to describe to those who haven't experienced them. They can come on suddenly and sometimes for no obvious reason - some of the symptoms can be obvious, whereas others are much more subtle. Ultimately, they are different for everyone. Here's what a panic attack is, how to know one is coming on and some tactics that may help if you're experiencing one.   What is a panic attack? The scientific answer to this is that essentially your body is going into "fight or flight" mode. A panic attack is when you feel a rush of intense anxiety and have a strong sense that something bad is going to happen. What are the symptoms? Symptoms can come on very quickly during a panic attack and vary from person to person. They can include: • A pounding, racing heartbeat that's faster than normal or can even feel irregular • Shortness of breath, or struggling to breath like you're hyper-ventilating or choking • Feeling faint, dizzy or lightheaded • You might feel numbness or tingling in your fingers, toes or other extremities • Sweating, trembling or shaking • Chattering teeth • Ringing in your ears • Feelings of being out of control The symptoms are not dangerous, but can be scary. During a panic attack, you might feel frightened and as if you're: • Having a heart attack because you're heart is going so fast • Going to faint • Or even going to die Panic attacks typically last between five minutes to half an hour symptoms are at their worst within 10 minutes. You might experience symptoms for longer, which could be due to a second attack or because of other symptoms of anxiety.   What causes it? Scientifically, a panic attack occurs when your body tries to take in more oxygen, your breathing quickens. Your body also releases hormones, such as adrenaline, causing your heart to beat faster and your muscles to tense up.   How to stop it? There is no way to simply stop a panic attack, but there are a variety of strategies you can try to help cope with them and make you feel more at ease as the attack passes. People respond differently to different ways of managing panic attacks, so just because a way works for one person, doesn't mean it works for someone else.   Focus on your senses Some people find that listening to soothing music or sounds, touching something soft, or chewing a flavoured sweet can help to ground them.   Focus on your breathing Making sure you breath deeply and steadily can also help to relax you as symptoms pass. Exercises like these can help: • Breathe in as slowly, deeply and gently as you can, through your nose and then out through your mouth.. • Some people find it helpful to count steadily from one to five on each inhale and each exhale. Mindfulness apps such as Calm have some useful exercises on them. • Close your eyes and focus on your breathing. You may start to feel better in a few minutes, but might feel tired afterwards.   Ride it out Professor Paul Salkovskis, Professor of Clinical Psychology and Applied Science at the University of Bath, says to the NHS that it's important not to let your fear of panic attacks control you. He reckons it's important not to look for distractions and instead focus on the feelings of the panic attack, which might sound counterintuitive, but it's to help reassure yourself. "Ride out the attack. Try to keep doing things. If possible, don't leave the situation until the anxiety has subsided," he said. "Confront your fear. If you don't run away from it, you're giving yourself a chance to discover that nothing's going to happen." Indeed, Arash Emamzadeh also wrote forPsychology Today that "leaning into" the symptoms of your anxiety can be healthier than resisting them.   How to prevent it Sometimes particular situations or stresses may make you more susceptible to panic attacks, so it's important to think about what these may be. Looking after yourself mentally and physically can help relieve symptoms, such as: • Doing regular breathing exercises, some people find mindfulness and meditation can help them to relax • Physical exercise can help manage stress, release tension and boost your mood • Eating healthy, regular meals to stabilise your blood sugar and not drinking too much alcohol or caffeine which can worsen anxiety • Psychological therapies like cognitive behavioural therapy (CBT) can help get to the root of negative thought patterns which could worsen panic attacks — if it's something you experience often.

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