Feeling that the world is going to end, that you may die or you are going “mad”; rapid breathing or being unable to breathe; chest pains; feeling faint or dizzy; sweating; feelings of terror or of unreality, a state called depersonalisation, feeling detached from your body and surroundings…
Unfortunately for the nearly 1% of the UK population – or roughly 600,000 people – that suffers from panic attacks, these are some of the symptoms. Panic attacks can lead people to think they’re having a heart attack or that they’re about to die.
And despite trends around workplace ‘happiness’ and reducing stress for employees, they can happen in the workplace just as easily as anywhere else.
What are panic attacks?
“Panic attacks are more common in people who have a type of anxiety disorder, but anyone can experience them,” says Emma Mamo, head of Workplace Wellbeing at Mind. “Panic attacks can be a really horrible experience, but it’s important to remember that they will pass. They tend to be over in a matter of minutes (usually between five and 20), and are surprisingly common.”
“Panic attacks feel like an alien has taken over your body,” says Dr Perpetua Neo, a psychologist and executive coach. “They are physiologically and psychologically exhausting. They’re often your body screaming at you that something isn’t right in your life. Often, we try to rationalise our fears away – we oscillate between living in our head and escaping our heads – in what I call Cognitive Photostop. We often aren’t aware we might be experiencing High-Functioning Anxiety, because we subscribe to the stereotype that it’s a person unable to function and hiding under the covers everyday, chewing their nails down. And then our body erupts in panic attacks to signal it’s time to stop managing the situation, but rather to start getting to the root and mastering it.”
What can cause panic attacks in the workplace?
“Environment can be a trigger, e.g. if a person feels trapped in their lives (like an abusive relationship) or the lift stalling for 20 seconds to cause their first panic attack, which then cascades to further episodes,” says Neo. “Sometimes panic attacks start in one location, and as we start fearing them and feeling even more helpless and hopeless, they start happening in our workplace. This is especially so if there are situations at work that make us feel trapped or remind us of what is making us highly anxious.”
Likewise, the workplace could be the environment that triggers a panic attack. “Being exposed to unmanageable stress can worsen our physical and mental health, so if you’re going through a particularly stressful period at work that could be a factor,” says Mamo. “Sometimes, however, you won’t necessarily be able to pinpoint the trigger for having a panic attack at work. We often hear from people who’ve experienced panic attacks when returning to a workplace after having time off sick for a mental health problem.”
What you can do in the moment of panic attack?
First and foremost, says Mamo, it’s worth remembering that “everyone’s experience of panic attacks is different and there is no one-size-fits-all approach to managing them – inside or outside work”.
Firstly, excuse yourself from the situation and do something to make yourself feel grounded, safe and comfortable. “Increasingly employers provide quiet rooms for staff who might be struggling, so do make use of these spaces if there is one in your workplace,” says Mamo.
“Grounding yourself is as simple as taking deep long breaths to reset your brain’s fear centre. But make sure you are filling your belly up with air when you breathe in, not the other way round, otherwise you hyperventilate and feel worse,” says Neo.
Neo also advises talking to a manager or your HR and, most importantly, not to feel embarrassed about it. “It’s normal to feel anxious or ashamed, as though there is something wrong with you. Know, it is normal to have panic attacks. It is also normal to have them treated.”
Is it a long-term concern?
“You might have one panic attack and never experience another, or you might find that you have them regularly, or several in a short space of time,” says Mamo. “They often go hand-in-hand with anxiety disorders, but not always. There are many physical health problems associated with long-term levels of stress and anxiety like headaches, problems with jaw and teeth pain resulting from involuntary clenching and grinding, persistent blood pressure spikes and stomach problems. It’s really important that health professionals look at both your physical and mental health, looking to address the underlying root causes of anxiety rather than solely looking at the physical manifestations.”
“The more helpless and hopeless you feel, the more severe it gets,” says Neo. “You start to worry about the trigger situations. For instance, if it’s speaking during a meeting, the thought of your next meeting might terrify you for weeks on end, and that morning itself you’re already primed on high-alert for your next panic attack. And if you look for symptoms, you’ll definitely find them. With time, we learn to feel more helpless— there is a phenomenon called ‘learned helplessness’— and this comes from simply ‘managing’ symptoms.”
As with most mental health problems, panic attacks are treatable, and the sooner you get help, the better. “If you’ve been struggling with your mental health for longer than two weeks, or if symptoms keep returning, and it’s interfering with your life, speak to your GP, who can talk you through options,” says Mamo. “If you have problems with anxiety you might be prescribed beta blockers to help with the physical symptoms such as racing heart or antidepressants if you experience depression alongside anxiety disorder. Medication isn’t for everyone and does have some side effects, so you might want to consider other options as well or instead. Your GP may refer you for talking therapies such as Cognitive Behavioural Therapy (CBT) or counselling. Other people might find things like mindfulness, meditation, yoga, art, music therapy or physical activity beneficial. It’s about finding what works for you.”
To really feel in-control, Neo recommends hiring a professional, “someone who will help you to understand the root and work with you using a practical, structured program, so the situations that used to scare you no longer own you”.
How employers and colleagues can help
It’s valuable to remember that people who experience mental health problems – including panic attacks – can and do make a valuable contribution to the workplace, but may need additional support, says Mamo. “If your mental health problem meets the definition of a disability under the Equality Act 2010 – in that it has a substantial, adverse, and long-term effect on normal day-to-day activities – you need to tell your employer about it. Your employer then has a duty to make reasonable adjustments, which could include anything from changes to working hours, roles and responsibilities to providing quiet rooms and regular breaks, for example.”
Many people find it hard to return to work after a long spell of sickness absence, so employers should think about how they can reduce the anxiety. Things like offering a phased return, meeting the person at the door, developing a plan for their first day back, scheduling a lunch with the team and putting in regular catch-ups can all help with this adjustment.
Mind recommends all employers encourage managers to draw up Wellness Action Plans with those they manage – whether their staff have a mental health problem, or not. “These simple, useful tools help facilitate conversations about mental health including identifying what keeps someone well, what someone’s unique triggers for poor mental health are and what can be done to help. They can be downloaded for free from the new Mental Health at Work employer gateway, curated by Mind, with support from the Royal Foundation, Heads Together and other partners. It can also help to have employees who have been trained in Mental Health Awareness or Mental Health First Aid to be on hand if needed.”
It is also helpful to ensure that all employees know how to support a co-worker who appears to be having a panic attack. “The important thing is to try to stay calm,” says Mamo. “Gently let them know that you think they might be experiencing a panic attack, that it will pass and that in the meantime, you are there for them. Try to take them to a quiet space, encouraging them to breathe slowly and deeply – it can help to count out loud. Once you’re away from colleagues, ask them to keep breathing slowly and deeply (they could watch while you gently raise your arm up and down to help them), encourage them to stamp their feet on the spot and stay with them until they feel better.”
For more information on panic attacks and anxiety, visit mind.org.uk/panic
Useful information for employees and employers is available at mind.org.uk/work
Dr Perpetua Neo
Neil Johnson is a freelance business journalist who contributes regularly to trade publications and member organisations, covering employability, recruitment, business trends and industrial analysis.