An anxiety attack (panic attack) is a sudden and intense wave of fear or anxiety that triggers powerful physical and psychological reactions without an obvious reason or danger. These attacks can be very frightening and can occur unexpectedly, often without warning.

Background

An intense anxiety attack (panic attack) can lead to powerful physical symptoms: The patient hyperventilates, experiences a choking sensation, heart palpitations, dizziness, tingling sensations in the hands/lips, and intense fear of death. To an outsider, the attack may seem dramatic, but remember that for the patient, it feels life-threatening even though it is not actually dangerous. Avoid statements like "pull yourself together" or "it will pass, just relax" – if the patient could calm down on command, they would have already done so.

Approach

The most important thing you can do is to create calm and convey a sense of security. Take a moment to make eye contact and show with your body language that you are there to help. Speak calmly and clearly, using concise sentences.

Explanation and Support

Tell the patient what is happening, in a factual but empathetic way. For example: "Your pulse is high and it feels like you can't breathe, but your oxygen saturation is normal – you're getting enough air. What you're experiencing is a severe anxiety attack. It's very uncomfortable, but not dangerous. I will help you through this." Such an explanation can reduce the catastrophic thoughts the patient has about their symptoms.

Breathing Control

Help the patient slow their breathing. You can even lead by example: "Let's breathe together. Breathe in slowly while I count to three, and then out on three. 1-2-3 in… and 1-2-3 out." Count aloud and at a slow pace, repeating until you see that the patient's breathing rhythm calms down. Avoid hyperventilating with the patient; remain calm in your breathing and tone of voice.

Position and Environment

If possible, get the patient to sit down on a chair or on the floor with you. Sitting down can alleviate the acute feeling of panic. If the patient is too restless to sit at first, stand calmly beside them – but avoid walking around or making sudden movements.

Duration and Measures

Most panic attacks peak after a few minutes and subside within 10-30 minutes. Consider whether the patient might benefit from a short stay in a safe setting (emergency room/GP's office) until the attack passes. Use your judgment; avoid unnecessary hospital admission if the patient calms down with simple measures. Afterwards: inform them that help is available for anxiety disorders (GP follow-up, talk therapy) and encourage them to seek further help to manage underlying anxiety.

Written by Live Nordum Hoff