Depression Is a Medical Condition, Not a Weakness
Depression affects a large number of Indian adults, and most never seek treatment. It responds well to treatment — often better than many chronic physical conditions do.
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A panic attack feels exactly like a heart attack, which is why so many arrive in emergency departments. Both need to be taken seriously — and both are treatable.
What a panic attack is
A panic attack is a sudden surge of intense fear accompanied by powerful physical symptoms: pounding heart, chest tightness, breathlessness, sweating, trembling, dizziness, tingling in the hands or around the mouth, nausea, and a strong sense of impending doom or of losing control.
It typically peaks within ten minutes and subsides over twenty to thirty. It is not dangerous and does not cause a heart attack — but it is genuinely terrifying, and dismissing it as 'just tension' is neither accurate nor helpful.
Worth knowing
A first episode of chest pain and breathlessness should always be medically assessed. Once cardiac causes are excluded, the diagnosis of panic can be made with confidence — and treated.
During an attack
- Remind yourself: this is a panic attack, it will pass, it will not harm me
- Slow your breathing — in through the nose for four counts, hold for four, out through the mouth for six. The longer out-breath is the part that calms the nervous system
- Use grounding: name five things you can see, four you can touch, three you can hear, two you can smell, one you can taste
- Place a hand on your abdomen and breathe so that the hand moves, rather than the chest
- Do not leave the situation if you can stay safely — escaping teaches the brain that the situation was dangerous
- Do not breathe into a paper bag; it is unsafe if the cause is actually cardiac or respiratory
Generalised anxiety
Persistent, excessive worry about multiple areas of life, occurring on most days for six months or more, with restlessness, fatigue, difficulty concentrating, irritability, muscle tension and disturbed sleep, is generalised anxiety disorder.
Unlike ordinary worry, it is difficult to control, out of proportion to the actual situation, and interferes with functioning. It commonly coexists with depression and responds to the same treatments.
What helps in the long term
- Cognitive behavioural therapy — the best-evidenced treatment for anxiety disorders
- Medication, usually SSRIs, for moderate to severe anxiety
- Regular aerobic exercise, which has a strong and reliable anti-anxiety effect
- Reducing caffeine, which directly mimics and worsens anxiety symptoms
- Consistent sleep timing
- Limiting alcohol, which reduces anxiety for hours and then rebounds it higher
- Structured relaxation practice — progressive muscle relaxation, yoga nidra or meditation
- Reducing news and social media consumption when it is driving the worry
Worth knowing
Benzodiazepines calm anxiety quickly but cause dependence within weeks. They have a place for short-term crisis use only, never as ongoing treatment.
Physical conditions that mimic anxiety
Before settling on an anxiety diagnosis, it is worth excluding an overactive thyroid, cardiac arrhythmias, low blood sugar, asthma, anaemia and the effects of certain medications and stimulants. A basic set of blood tests and an ECG usually settles the question.
This is not overcaution. Thyrotoxicosis in particular presents almost identically to anxiety and is easy to miss without a test.
Key takeaways
- Panic attacks peak within ten minutes and are not physically dangerous, though they feel dangerous.
- Slow breathing with a longer out-breath is the most effective immediate technique.
- A first episode of chest pain should always be assessed before being attributed to panic.
- Benzodiazepines are for short-term crisis use only — they cause dependence quickly.
A note on medical advice
This article is general health education written and reviewed by the Department of Psychiatry at SIMS. It is not a substitute for an examination, a diagnosis or the advice of your own treating doctor, and it cannot account for your history, medicines or reports. If a symptom is sudden or severe — chest pain, stroke symptoms, breathing difficulty, serious injury, seizures or heavy bleeding — call 9281862028 or come straight to the emergency department instead of reading further.
AnxietyPanic attackMental healthBreathing
