Anxiety, Panic Attacks and How to Manage Them
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.
Read articleAnxiety disorder is persistent, excessive worry and fear that is out of proportion to the situation and interferes with daily life. Its physical symptoms — palpitations, breathlessness, chest tightness — send many patients to the cardiology clinic first.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Constant worry that is difficult to control
- Palpitations, chest tightness and breathlessness with normal cardiac reports
- Restlessness, irritability and being easily startled
- Trembling, sweating, dry mouth and giddiness
- Difficulty falling asleep because the mind will not settle
- Sudden episodes of intense fear with a sense of impending death (panic attacks)
- Avoiding travel, crowds or work situations because of fear
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Anxiety that is interfering with work, study, sleep or relationships
- Repeated panic attacks, or avoidance of ordinary activities
- Chest pain and breathlessness where a cardiac cause has not yet been excluded — get assessed first
- Anxiety with thoughts of self-harm, or with heavy alcohol or sedative use
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Clinical psychiatric assessment
- ECG and cardiac evaluation where physical symptoms dominate
- Thyroid function tests
- Haemoglobin, blood sugar and electrolytes
- Review of caffeine, alcohol, tobacco and stimulant use
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Cognitive behavioural therapy and structured counselling
- Breathing and relaxation techniques practised daily, not only during attacks
- Medication where symptoms are moderate or severe, taken for an adequate duration
- Careful, time-limited use of sedatives, which are habit-forming
- Reducing caffeine, tobacco and alcohol, and correcting sleep timing
- Regular exercise and a graded return to avoided situations
This page is general information, not a diagnosis
Anxiety Disorder can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Psychiatry department. If a symptom is sudden or severe, call 9281862028.
