Panic attacks can be very common in Perimenopause and can be very scary when experienced for the first time, I often see with clients that Panic attacks can happen when they are feeling at their most calmest point and tis creates further confusion as to why they happen.
What is a Panic Attack ?
These are sudden attacks of very intense anxiety or fear during which you feel you are going to die, go crazy or lose control in some way. Panic attacks can happen without any warning, can last for a few minutes or as much as an hour. They are experienced on a very physical level and often start from physical sometimes you may not notice – a clenched jaw, tightness in shoulders, persistent shallow breathing which can lead quickly to a sense of breathlessness. The physical symptoms may have been triggered by anxious thoughts but now the sense of breathing difficulty is causing even more anxiety and panic – a natural response to feeling you can’t breathe.
Other physical triggers for panic attacks can be low blood sugar, extreme dehydration or lack of sleep, which combined or separately can lead to feeling dizzy, light headed, breathlessness and a sudden onset of panic or feeling of loss of control.
While people often describe panic attacks as ‘coming out of the blue’, there will often be an underlying trigger or combination of triggers, which have not been identified. Tracing back and knowing the triggers allows you to put steps in place to avoid them.
What can trigger a Panic Attacks ?
Common triggers would be facing a challenge and feeling overwhelmed by it, for example if fearful of being alone at night, driving on the road alone would seem daunting or if you have a fear of social encounters, making a trip to the supermarket might be an obvious trigger. In some cases, people feel a tightness in their chest or throat or churning stomach, which can lead them to believe they are in the grip of heart attack or a serious life threatening illness, thoughts that quickly escalate the sense of panic.
The panic stems from the confusion you feel and the feeling that you are losing control; the accompanying adrenaline surge affects any rational thinking during a panic attack. It is only when the adrenal gland becomes totally exhausted that the attack subsides as it cannot release any more. This is why, when you start managing panic, that light exercise (walking around the room) is such an effective treatment – it helps exhaust the adrenal gland and dissipates the panic.
Panic attacks are very common: it’s estimated that one in five people will have at least one in their lifetime. After experiencing one panic attack, it’s normal to worry about having another, You might start avoiding situations or activities that you think might trigger an attack, like shopping centres, public transport, airplanes, lifts or being alone. If you can observe that pattern, it’s a good time to have a panic management plan in place.
In some cases panic attacks can be a result of an underlying physical condition like thyroid issues, low iron, and heart and lung imbalances - and so for this reason we would always suggest a checkup with your doctor to rule out any physical causes.
Step by step guide for Panic Attacks
§ Breathe – use any of the techniques outlined for breathing that you like. The clenched fist and progressive muscle relaxation techniques are great ones for panic attacks. Breathing into a paper bag can also really help, you are breathing in the air you have just breathed out which stops you form losing so much carbon dioxide and reduces the symptoms of low oxygen.
§ Try not adding in negative internal dialogue in your head.
§ Remind yourself a panic attack is an excess of adrenaline in the body due to chronic underlying stress
§ Ice cube tip – if you have access to an ice cube try chewing one and also rubbing it on your inside wrist and the back of your neck (some people find relief from this).
§ Exercise: Pace the room, walk during a panic attack. Just try it – it works! You will burn off excess adrenaline which will shorten the attack; physical movement can help the body while it is in fight/flight mode.
§ Write down the thought and images going through your mind
§ Remember: It will pass
Anxiety can be devastating for some women in perimenopause and beyond. Perimenopause and wellness coach Catherine O'Keeffe of wellnesswarrior.ie shows you 5 ways to stop anxiety from taking over.
What is Menopause Anxiety?
One of the biggest issues that raises its head in perimenopause is anxiety, it slowly builds over time until it reaches epic proportions if you have not noticed or started to deal with it…it’s that day when you wake up and have this strange feeling in your body, you feel unsettled and don’t know why, you feel off kilter and anxious when there may not be anything to be anxious about. Then your heart starts to beat faster, your psalms get sweaty, your mouth goes dry etc…. the physical symptoms are endless and differ for everybody. No two women will experience menopause in the same way. One may experience anxiety another may not but may be plagued with hot flushes, no set symptoms for this chapter in our lives.
There are many different forms of anxiety that can exist with Health Anxiety, Panic Attacks and Generalized Anxiety Disorder probably the most common experienced by women in perimenopause. Often women don’t realize this is related to menopause and put it down to other life events but more often than not in your mid-late 40’s the hormonal rollercoaster kicks off an anxiety ride that is far from fun. Personally I see this coming on slowly over time with women, it’s not something that happens in a short space of time but very gradually over a year or more….daily life events that may never have caused you to stop and think now fill you with dread. It is very common to hear women say they get anxious driving on the motorway, they get anxious going out to social events, doing the shopping etc.
As Ulrika Johnsson stated when talking about menopause …’ and then came the most unimaginable anxiety that I’ve not known before. Anxiety, like, proper panic - at one stage I thought my head was going to explode, just anxiety over the tiniest thing, and then you become even more scared because you're anxious."
Thankfully as menopause is now being talked about more openly it’s becoming more obvious the levels of anxiety that women experience at this life stage.
How to Reduce Anxiety at Menopause - 5 Top Tips
Incorporate some form of relaxation into your daily habits which will help you feel calmer and more relaxed, think of it as your daily self-care ritual. To deal with anxiety you need to do the work upfront so that it’s easier when anxious moments strike, you will then be able to calm yourself down easier
Like nutrition is one of the cornerstone of a less anxious life. The benefits of exercise are well documented and numerous ranging from enhanced cardio vascular health, improved sleep, release endorphins which are natural anti-depressants and burns off the stress hormone adrenaline. Consider the various forms of exercise readily available to you and decide on one that you can slowly add into your life and one that brings you joy.
3. Good Food:
Look at your diet and how rich it is in vital nutrients, magnesium , the B’s , vitamin C to name but a few. Try and get as much fresh fruit and vegetables into your diet as you can and where possible opt for organic. It’s not just you are what you eat, it’s also you are what your food eats. So aim for wholesome food little and often.
Look at your caffeine intake: there are numerous studies which show that caffeine increase feelings of anxiety and don’t just think coffee, this extends to tea and chocolate too. Look for alternative drinks ideally herbal teas, water, juices etc
4. Vitamin D:
Essential to ensure optimum brain function and we all need to supplement this into our diet every day. For years we have associated Vitamin D with stronger bones and teeth (due to its ability to help absorb calcium), it is now well known that Vitamin D plays a key role in both sex hormone production (when women are deficient in vitamin D, it reduces estrogen levels) and mood. A lack of Vitamin D diminishes the body's ability to produce feel-good brain chemicals including serotonin and dopamine, as such it is an essential aid to help reduce anxiety. So make sure you have it in your daily food and/or supplement, food sources include fatty fish like mackerel and salmon, egg yolks, shiitake mushrooms, cheese and foods fortified with vitamin D. Getting out in fresh air will also provide some Vitamin D but not enough on a daily basis. It is worthwhile at your next bloods check up to also have your Vitamin D checked (in Ireland this has become a standard addition to blood tests).
5. Keep a Gratitude Journal:
I’m a great believer in the power of being thankful and it only takes a few minutes a day to jot down 3-5 things that you are grateful for, it is just a nice thing to do!
Please note: If you are experiencing panic attacks and palpitations, do get them checked out by your GP or other health professional, low iron can be a cause of both.
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