All of a sudden, your heart starts pounding, your breathing becomes faster and shallower – as if you are running out of air – and your palms are sweaty. You may be shaking or you feel a tingling or numbness. The world around you may be spinning. You can’t think straight and you can’t control your body. You’re scared and you may be convinced you’re dying or going crazy…

Panic attacks can happen to anyone. Described as a rush of overwhelming anxiety, these attacks are so intense that sufferers experience many of the strong physical sensations mentioned above. An attack can also leave us feeling, amongst others:

• paralysed or immobile
• in pain
• out of breath
• dizzy
• nauseous

Some expats, who face all kinds of stressors while adjusting to a new culture, have found themselves experiencing an attack for the first time while abroad. Being in a place that is unfamiliar or feeling alone and isolated can increase anxiety and make some expats more prone to feeling panicky.

What are you afraid of?

A panic attack can be caused by a single stressor or by multiple stressors, though often there is no clear reason. Panic can also sneak up on us without warning and can even occur when we are relaxed or sleeping.

Attacks are often sparked by intense fears that arise in the mind. In other words, the panic doesn’t reflect any immediate danger – though the fear is experienced as very real and immediate.

In some cases, fear of having another attack creates a cycle of anxiety and a panic disorder, where these debilitating symptoms re-occur.

Aside from the disabling feelings and sensations experienced during a panic attack, the fear can lead us to become withdrawn and to experience social phobias or depression. We may also find ourselves avoiding situations or places we associate with previous panic attacks.

So what can you do?

Fortunately there are several steps you can take to empower yourself.

1. Visit your doctor to exclude any medical condition for your symptoms. Something can be considered psychological (or psychosomatic) only after you are sure there is nothing wrong with your physical state.

2. What you tell yourself during the attack matters…
   When you are experiencing a panic attack, it’s quite common to start catastrophising! But replacing a dysfunctional thought with a more functional one will help you enormously during the attack.               For example, a typical thought if you’re struggling to breathe is, “I’m having a heart attack!”
   A more functional thought could be: “I’ve been to the doctor and done the necessary check-ups. I’ve had this before and I was fine. My brain sends me these signals as it responds to a supposed threat. It will soon be over.”This is a simplistic example of a skill that is worth learning. It’s recommended that you learn the specific techniques in counselling so you do it right and in a safe environment.

3. Remember this…
   In 20 minutes or less it will be over! Although even one minute of a panic attack feels like a century, try to remind yourself that your panic won’t last for long. This will help you to calm down, knowing that every minute that passes brings you closer to the end of the attack. If you’ve had an attack before, you can also reassure yourself that this has happened before – and you made it through.

4. Take charge of your stress
   Stress management is a topic of its own and it’s advisable to work with a counsellor to create a step-by-step plan that works for you. Each person’s situation is different but here are some general examples of easy but effective ways to reduce stress: listen to soothing music, try yoga or tai chi, or build up a regular meditation practice. Take lunch breaks and take holidays too. Be sure also to stop stimulants like caffeine and alcohol – this is an important part of any stress management plan.

5. If you can control your breathing, you can control your mind!
   Control and focus on your breathing by using simple techniques to calm your body. Inhale and exhale deeply. Put your hands on your belly or stomach and focus on how the fingers go up and down when you breathe – this helps with shifting the focus away from your panic. (You may like to start with this video meditation.)
   It’s best to practise breathing exercises or meditation regularly so your body ‘remembers’ what to do in times of a panic attack. Your body has a memory and a wisdom… Again, this is something you can develop further in counselling.

6. Remember to stay present
   Remind yourself that you are safe and okay in this very moment – this will help you feel a bit calmer.

7. Out of sight doesn’t mean out of mind
   Avoiding the places or conditions that caused a panic attack may give you some sense of relief but it won’t solve the problem. In the long-term, avoidance behaviours make the issue worse.

8. It doesn’t have to be this way!
   I repeat: you don’t have to feel this way! You may feel afraid to reach out or think you can battle it alone, but there are excellent professionals out there who can support you to overcome your panic attacks. If you are ready to take the next step, we are here to help. With time, self-care and the right kind of support, you can overcome your panic attacks.

9. Add your own tip
   We each experience panic attacks differently. What techniques have helped you? Feel free to add your own tip in the comments below.

It’s quite natural to feel some anxiety if you’ve been through (or are going through) many changes in your life. However, if your panic attacks are affecting your day-to-day life, if you find yourself avoiding people and places in case you have an attack, it’s important to reach out…

If you like this article, subscribe to our newsletter and share these tips with an expat who suffers from panic attacks or knows someone who does.

This information is not intended to treat, diagnose, cure, or prevent any disease. All material in this article is provided for educational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you have regarding a medical condition, and before undertaking any diet, exercise, or other health programme.

© Vivian Chiona

FEEL FREE TO USE THIS ARTICLE IN YOUR BLOG OR NEWSLETTER. We ask only that you attribute Expat Nest and include the following: Expat Nest (www.expatnest.com) is a professional online counselling service for expats.

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