Claire Eastham has had 371 panic attacks in seven years, which means she knows only too well what they feel like, what brings them about, which drugs help and why ice lollies calm her down. Here, the 34 year-old mental health blogger from Manchester, whose new book, F**ck I Think I’m Dying, is out now, shares her story.
When and where did you have your first panic attack?
I was 24 years old, sitting in a meeting room, with two of my then team managers. I worked for a major publishing house at the time and was interviewing for a potential promotion. I’d been working myself into the ground for months, but I convinced myself that it would all be worth it once I progressed to the next stage of my career. That morning, before the meeting, I knew that something was ‘wrong’ before I even stepped in the room. I felt dizzy, on edge, and my mouth was dry.
I hoped that I was just experiencing standard nerves. I tried to shake it off, but the feelings, (or warning signs) wouldn’t budge. Unknown to me, I’d been living with undiagnosed social anxiety for ten years by this point and my brain had finally reached its limit. Little did I know that I was mere minutes away from a complete mental breakdown. One that would take almost a year to fully recover from.
Describe what it feels like to have one?
A panic attack feels as though pure, liquid terror has been injected into the veins. Before the main physical symptoms occurred, I experienced a sudden, falling sensation and my stomach flipped, as though I were on a roller coaster. A warm and not unpleasant sensation seeped down my neck and arms, (I now understand that this was a huge dose of adrenaline). When this surge reached my heart it exploded, punching violently against my ribcage.
I couldn’t take a deep breath no matter how hard I tried. My vision became blurry, I was sweating, my stomach cramped, and my limbs felt numb. I had an overwhelming feeling that something was very wrong. I thought I was having a heart attack or losing control of my sanity. My brain screamed at me to run, so I did. I stood up, apologised to my colleagues and ran out of the meeting. I’ve never been so frightened or felt so completely out of control. The whole thing felt like a never-ending cycle of fear.
What do you believe are the root causes for having them?
A panic attack occurs when the amygdala in the brain activates the ‘fight or flight response’ in error. The ‘fight or flight response’ is a primitive and innate reaction to danger. Once danger has been identified, it floods the body with extra adrenaline to help the person escape or fend off the threat.
However, the world arguably changed faster than the brain could evolve. In the past, humans were threatened by predators, whereas now it could be heavy workloads, deadlines, money, health or relationship concerns. We have neglected our mental health and overstressed our amygdalas so much, that it can no longer differentiate between physical and mental threats. I experienced panic attacks when I’ve been neglecting my mental wellbeing, by taking on too much work and not prioritising rest and self-care.
What are your triggers?
The most common triggers for panic attacks include stress at work, going to restaurants, supermarkets or being on public transport, and public speaking. All of which can overload the amygdala from a sensory perspective.
Specific triggers for me include being in meeting rooms or small offices especially if they’re too hot or the doors are closed. This makes sense, as I experienced my first ever attack in a meeting room, so my brain is always on high alert for danger. Another is when people say my name when I’m not expecting it. I think this links back to school since hearing your name in my school at least out of the blue, usually indicated that something was wrong. in some way. So I automatically presume that I’m in trouble!
I’m more prone to panic attacks when I’ve been overworking myself and not making adequate time for rest. Unfortunately my amygdala associates ‘work’ with danger and doesn’t trust me to know when to stop. This is not surprising seeing how I consistently worked myself to the bone over the years, first at university and then during my first ‘proper job.’ I struggled to recognise when ‘enough was enough’ & that I needed to rest.
What techniques do you recommend to manage one when it comes?
First of all, a person should accept that the attack is happening. Don’t try to fight or ignore it, as this will only prolong the experience. As unpleasant as it is, let the sensation wash over you like a wave. Remind yourself that although you feel threatened and that the symptoms are uncomfortable, nothing bad is going to happen. You won’t die, or lose control.
It sounds simple, but your only job is to let time pass and make yourself as comfortable as possibly while it does, the attack will end, because they always do. If possible, go for a walk to help the adrenalin dissipate.
Breathing techniques such as ‘belly breathing’ can also be very effective. As psychologist Dr Soph highlights “a deep breathe communicates to the brain that everything is ok.” (Basically, it can turn the fight or flight response off).
How have other people reacted to you in a way that is helpful?
It’s important that people don’t fuss or overreact. My emotions are already heightened, so I need others to be patient and calm, and not attempt to take control. The best way to soothe me is to sympathise but also remind me that I’ve dealt with panic before, so I can do it again now. My husband, Dan, tends to suggest that we go for a walk, even if it’s 10pm! The fresh air helps to clear my head and the gentle exercise burns off some of the adrenaline.
What are the unhelpful responses?
Asking me lots of questions or arguing with me is the worst! E.g.What are you talking about? Don’t be stupid, of course, you’re not dying! Why is this happening right now? If a person does this, I’ll most likely snap at them, which causes even more upset. In the past, unknowing friends & colleagues have reacted with shock, followed by annoyance, shouting at me to; pull it together, or stop being dramatic! Strange, because if I had been vomiting, or felt faint then I would’ve been treated with kindness and concern. Invisible health conditions are often harder for people to comprehend.
What role have therapy and medication played for you?
I’ve been taking Setraline for several years which increases the amount of serotonin in my brain. Exposure therapy has been the game changer though, as it has allowed me to communicate with my amygdala and to re-train it to some extent.
Exposure therapy encourages patients to deliberately put themselves in situations that will trigger an attack. The idea is to do this in small steps and work your way slowly over a series of weeks. The purpose is to allow a panic attack and all the unpleasant symptoms to run their course without reacting. This communicates to the amygdala that there is no threat and the fight or flight response has been triggered in error. This will prevent similar errors in the future. Exposure therapy is a challenge, but very effective.
What are your daily routines for self-care?
I stopped expecting my ‘self-care’ urges to kick in naturally. Left to me own devices, self-care is never a priority. Even the basics, such eating enough food can be overlooked if I’m working on a big project. I now schedule this in my calendar. I have strict breaks, make sure I drink enough water, eat well and exercise.
Napping has also become very important, something that I’ve been ashamed of in the past, due to the connotations with laziness. However, I burn through my energy reserves faster than most people and a nap is a great way to switch off and re-charge. I have a thirty-minute nap most days after lunch, or after important meetings.
Ice lollies! I discovered this one recently and it’s absolutely cracking! The change in temperature is a gentle distraction for the brain and draws focus away from the attack. It also soothes a dry mouth, helps with sweating and regulates breathing, (if you’re sucking on a lolly, then you can’t ‘over breathe’ and hyperventilate).
Panic attacks, as distressing as they might feel, are actually a sign that your brain is functioning well. You have an astute reaction to danger, which is good! Rather than trying to ‘cure’ them, what we need to do is learn how to manage them, when they’re triggered in error, e.g. on public transport, or in a supermarket. I learned how to do this the long and hard way, (over 371 attacks to be precise).
Yet despite everything, panic has never prevented me from living my life and I can help all those who buy my new book to do the same.
F**k I Think I’m Dying by Claire Eastham (Square Peg, £12.99)