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Why do so many people have panic attacks?

Published Sep 5, 2012

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London - Veronique Hadley was chatting on the phone to her mother when she had her first panic attack. ”Quite suddenly, I had the feeling I couldn’t breathe,” says the 34-year-old nurse.

“I felt overwhelmed with worry and it escalated to the point where I felt I was going to die. I had to hang up. Luckily, I was with a friend who helped me lie down in bed and stayed with me. It was frightening – I didn’t know what was wrong.”

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Veronique, from Oxford, hoped the attack was just a one-off. But they continued until she was having one almost every day for over a year.

“I was constantly having negative thoughts and worrying. I started having trouble getting to sleep, too.”

Recent statistics suggest growing numbers of Britons are gripped by anxiety and panic attacks.

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Hospital appointments for anxiety quadrupled between 2007 and 2011. In Sussex, children as young as five are reportedly being referred for anxiety management.

New figures show prescriptions for anti-depressants have risen by 9.1 percent in just 12 months, a significant proportion of which were given for anxiety.

Experts offer a number of reasons for this worrying trend, including the recession, pressures of social networking and the 24-hour society in which cellphones and technology encourage us to be available at all hours. It’s also been suggested more people are seeking help as depression and anxiety lose their stigma.

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But some campaigners warn anxiety is rooted in everyday stress, and we are overmedicating the problem by reaching for “happy pills” to manage it.

Anxiety shares some symptoms with depression and, indeed, one often precedes the other.

But the key difference in anxiety is the presence of physical symptoms, or panic attacks, says Beth Murphy, head of information at mental healthy charity Mind,which has seen calls about the condition double.

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“Not everyone who has anxiety experiences panic attacks, but a lot of people will. The symptoms include increased heart rate, a dizzy feeling, sweating, shaking, and feeling you’re going to be sick or faint. It’s also emotional – feeling you can’t cope and people are staring at you.”

We’ve all felt anxious at some point. The problem starts when we feel like this even in normal everyday situations, says Dr Gillian Butler, a leading clinical psychologist and co-author of the book, Manage Your Mind.

“We are all susceptible to anxiety. We feel anxious from the ordinary stresses and strains of life – and when these stresses accumulate they can feel overwhelming and undermine your confidence. While depression is rooted in a sense of failure and loss, anxiety is a feeling that everything will go wrong.”

While experts agree antidepressants and benzodiazepines (a form of tranquilliser) can be effective for short-term bouts of anxiety – for example, following a bereavement or trauma – a large body of research shows the condition is most successfully treated with cognitive behavioural therapy (CBT), a type of talking therapy that encourages you to change your negative thoughts and behaviour.

“We help people with anxiety to realise that, in fact, the worst thing to do is think you must be happy all the time,” says Dr Paul Blenkiron, a consultant in adult psychiatry at Bootham Park Hospital, York, who offers CBT.

“It’s better to say to yourself: ‘I’m worrying, it’s normal and it’s not going to kill me.’ “

Yet despite government investment to train more therapists in cognitive behavioural therapy, research by Mind shows availability is still patchy, with a 2010 study showing one in five people waits more than a year to get CBT.

Experts warn too many people are being given drugs instead. “There is clear evidence that talking therapies, such as cognitive behavioural therapy, are the most effective treatment for anxiety disorders,” says Paul Farmer, chief executive of Mind.

“We are concerned that the long wait for talking therapies may mean some doctors are left with little choice but to prescribe medication, even when they think an alternative treatment would be more effective.”

There are also some concerns that anxiety has become fashionable – Alexandra Shulman, editor of UK Vogue, recently revealed she suffered from panic attacks and took Xanax, a type of benzodiazepine, describing it as her “lucky charm”.

Dr Joanna Moncrieff, a consultant psychiatrist and senior lecturer at University College London, warns we are in danger of overmedicalising the problem – and treating it with drugs may even make it worse.

“It’s easy – and fashionable – to stick a label on the difficulties people have with modern life, partly because it sells drugs and partly because that way politicians and society don’t have to think about what’s actually causing these problems. Anxiety can be a chronic problem – but these drugs work at first and then wear off.”

Moncrieff is concerned GPs, discouraged from prescribing benzodiazepines long-term because of concerns about addiction, may be giving anxiety patients antipsychotics in low doses instead.

“These have lots of dangerous side-effects – they are toxic to the heart because they cause arrhythmia and sudden cardiac death, increase the risk of ischaemic heart disease, and make people put on weight.”

However, Dr Cosmo Hallstrom, a private psychiatrist based in London, says medication can be a valuable solution for what can be “a very severe and enduring” illness.

“In my clinic I do allow people to be on long-term benzodiazepines for anxiety, as it’s sometimes the most effective treatment.

“I monitor them carefully and make them aware of the risk of addiction. I’m aware not everyone would agree with me. While it is not ideal, it’s better than the alternative.”

He says a new drug has recently been licensed for anxiety in the UK – Lyrica or pregabalin, an anticonvulsant that is also used to treat epilepsy and nerve pain.

For Veronique at least, medication was not the answer. After a year of panic attacks, she saw her GP, who diagnosed anxiety and gave her a prescription for a type of tranquilliser called lorazepam.

But she was hesitant. “I knew from my job what this medication was. I knew it was a short-term solution and there were side-effects. And it knocks you out. I decided not to take it.”

She was told the waiting list for counselling was years long. Then in 2010 her employer provided some free counselling, and she took a course of CBT, too, which helped her to get to grips with the source of her attacks.

“I realised a lot of my negative thoughts were about death and this may have come from the fact I lost my dad and my grandparents before I was 10.

“We learnt everyone is scared of death and it’s important to enjoy the present moment.

“I still have anxious moments, but where before I would try to avoid thinking about it, now I don’t avoid it. I know it’s just my thoughts and it’s nothing I should worry about.” – Daily Mail

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