UAE: Pandemic leads to spike in panic attacks; psychiatrist offers advice

As the world comes to terms with the Covid-19 pandemic, people are increasingly reporting that they suffer from panic attacks that leave them both physically and mentally exhausted.

Priory Wellbeing Centres Dubai and Abu Dhabi say they have seen a 20 per cent increase in enquiries about treatments for anxiety since the start of the pandemic.

Mental health organisations also noted that there has been a significant increase in the number of people seeking help after experiencing panic attacks. The attacks may be due to a wide range of reasons, including money problems, relationship issues, and changes related to work or children’s education.

Dr Waleed Ahmed, Consultant Psychiatrist from the Priory Wellbeing Centre in Abu Dhabi, has witnessed an increase in panic attack cases among children and adolescents particularly. “A recent study showed increased levels of anxiety and depression in the UAE compared to pre-pandemic times, and from my own team’s clinical experience, there has been an increase in the reporting of anxiety disorders in otherwise well or low-risk people,” he told Khaleej Times.

“We have seen a rise in cases, both during and after the pandemic, especially among children and adolescents. There is a common thread among the majority of patients – they were fine until the pandemic started and schools went online. Young people have definitely felt the full force of pandemic-related restrictions, such as limited social and physical interaction, excessive digital consumption and, of course, online schooling. For many, this has had an immense impact on their mental health, particularly in relation to anxiety and stress levels.”

He added: “For many people, panic attacks can be short-lived - stopping when a stressful situation is resolved or treatment is sought. For others, however, these attacks can happen more frequently and may develop into a long-term panic disorder.”

What are panic attacks?

Dr Ahmed explains that panic attacks are abrupt, brief episodes of intense anxiety that reach a peak within minutes, and usually last between five and twenty minutes. However, in some cases, they can last up to an hour. They can come on very quickly and without an apparent reason. Panic attacks are usually very frightening and distressing. While anxiety is a feeling of unease and can include feelings of worry and fear, panic is more severe.

Intense psychological and physical symptoms are common with panic attacks, including a strong feeling of dread, danger, foreboding, losing control, or dying; feeling like one is not connected to the body or feelings of unreality; breathlessness and feelings of choking; racing or pounding heartbeat; feeling sick, faint or dizzy; chest pain; sweating; trembling; numbness, pins and needles sensation in fingers; ringing in the ears and abdominal symptoms like the need to go to the toilet.

Approximately one in four people will have a panic attack at some point and two per cent of those will go on to develop a panic disorder. Women are two to three times more likely to experience panic attacks than men, and the highest incidence of panic disorders can be found in people aged 15-24 years, with a second peak later in life between 45-55 years.

“There are many theories regarding the causes of panic attacks or panic disorder. When we feel under threat, our body activates what is popularly called the ‘fight or flight’ response,” said Dr Ahmed.

“Certain hormones and parts of the brain are activated that make the heart beat faster and prepare the body to either fight the threat or escape from the situation. In a panic attack, the fight or flight response is activated despite there not being any apparent danger. The body is then flooded with chemicals like adrenaline that cause many of the physical symptoms.”

According to Dr Ahmed, attacks can be extremely frightening and distressing. “They mimic heart related symptoms – palpitations, sudden chest tightness or pain, and breathlessness. They can also cause psychological symptoms of dizziness, fear of losing control and fear of dying. This combination, with a negative cognitive appraisal of the situation, can lead many to believe they are experiencing a life threatening episode like a heart attack,” explained psychiatrist.

“However, panic attacks are harmless and do not physically cause damage. Patients with panic attacks usually do not require hospital admission. However, they can be quite debilitating if people start avoiding situations that they think are associated with the attacks.”

Tips to manage panic attacks

Dr Ahmed says that if you know what to expect, there are things you can do to help make further attacks easier to manage. During a panic attack, he advises:

>>Recognise that this is a panic attack; its temporary and will soon pass; it is not life threatening. To realise this effectively, some familiarity may be required and so this is for subsequent panic attacks.

>>Don’t try and avoid the situation – try and ‘stay with the feeling’ without fighting it.

>>Some people find it helpful to find an object to focus on and notice everything possible about it – they will verbally describe it in detail to themselves as a means of distraction and grounding.

>>Our thoughts, feelings, and bodily responses are interconnected, so think about a happy place, memory or positive experience.

>>Another grounding technique is to look at your surroundings and think about five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.

In terms of lifestyle changes, Dr Ahmed adds: “Anything that reduces stress and anxiety levels can potentially limit the occurrence of panic attacks. Effectively managing stress by taking breaks, managing time and tasks, getting enough sleep, eating wholesome foods, regular exercise, mindfulness practice, self-soothing activities like taking a massage and journaling all go a long way to help calm the mind and body. Reducing one’s caffeine intake will also help.”

While panic attacks can be distressing and difficult to cope with, if you can access effective treatment they can be reduced and resolved. Without expert support, your panic attacks may become worse and more frequent over time. Help from a mental health professional is advised.

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