How to Handle a Panic Attack at Work

Thoroughly unpleasant and hard to deal with at the best of times, panic attacks at work are even worse.

The sense of obligation to an employer can magnify and multiply the sensation, causing the attack to get more and more intense.

Anxiety about work is a common cause of panic attacks. Communicating openly and tackling problems head-on is key.

Here’s some guidance on what to do when having a panic attack at work, how to deal with them, and the warning signs to look out for.

What is a panic attack?

It’s a sudden, unexpected wave of debilitating fear. It often strikes with no warning and doesn’t always have a clear reason for doing so.

In the middle of an unexpected panic attack, you can feel like you’re choking, your heart is stopping and you’re going to die. But they’re usually harmless and there are coping strategies and medication practices available to help with these panic attack symptoms.

Panic attacks are normally had by those with panic disorder. There are also similar issues such as anxiety attacks, normally suffered by those with general anxiety disorder. Let’s look at the difference between the two disorders and how to cope with this health problem.

The difference between panic or anxiety disorder

While panic and anxiety disorders share some similar symptoms, there are key differences. Knowing the difference will help you know how to manage anxiety attacks in employees.

Panic disorder

This disorder is characterised by more sudden and intense attacks, with no presence of danger.

It's not unusual for a person with panic disorder to become so consumed with worry and fear they develop behavioural changes, such as agoraphobia, to avoid environments or situations where they fear a panic attack may arise.

Some common symptoms are:

• Recurring panic attacks
• Fear of going insane or losing control
• Detachment from reality and oneself
• Excessive worry about a future attack
• Chest pain, trembling and shaking
• Accelerated heart rate and shortness of breath

Anxiety disorder

This is less to do with sudden outbursts of panic with no trigger but a more pervasive worry about everyday life events.

This worry will be present for extended periods of time (6 months and longer) and will affect day to day life and functions, such as job performance and maintaining relationships. Some common symptoms are:

• Excessive worry over everyday life events
• Anxious thoughts disrupting daily functioning
• Insomnia, fatigue and muscle tension
• Short temper and irritability
• Periods of blank mindedness or difficulty concentrating
• Issues with digestion

The difference between anxiety and panic attacks

There’s often some crossover when referring to anxiety and panic attacks. This is because the symptoms are very similar and it’s hard to tell the difference between the emotional and physical symptoms.

One of the main differences is that a panic attack usually occurs without any specific trigger, whereas an anxiety attack has a stimulus or stressor. There are then differences in the symptoms and causes.

• Panic attacks are always intense. Anxiety attacks vary in severity, from mild to severe
• As panic attacks have no trigger, they appear suddenly. Anxiety attacks become more intense over minutes, hours or even days
• Panic attacks are intense but are often over after a few minutes. Anxiety attacks and their symptoms can last for long periods of time

While the terms are often used loosely together, how you deal with anxiety attacks will be different from a panic attack.

What causes an attack?

It could be a one-off, and never happen again—but it’s common to experience them recurrently.

They’re often triggered by a certain situation. A fear of heights, anxiety about important deadlines, social situations—anything which makes you feel unable to escape.

This is because a panic attack is a triggering of the body’s fight-or-flight response.

The triggers are different for everyone. And for some, they don’t have triggers at all—they can happen anywhere, at any time. Your body decides it needs oxygen and releases lots of adrenaline—this causes your breathing to quicken, your muscles to tense and your heart rate to skyrocket.

What are the signs of a panic attack?

It comes on swiftly, usually lasts under 20 minutes and ends abruptly. It’s not always easy to spot when someone is in the grip of a panic attack.

But if you feel any of the following—or see someone in your workplace suffering from these signs—then it’s likely an attack is happening:

• Fast, shallow breathing that’s difficult to control
• A rapid heartbeat, tight chest and the sense that your heart could burst
• Shaking, trembling hands
• Tightness in the throat, difficulty swallowing and a sensation of choking
• Dissociation, a feeling of ‘unreality’ and lightness
• Excessive sweating
• Nausea
• Hot or cold flashes, sometimes both at once
• A fear of dying, loss of control or a sense that you’re losing your mind

How to stop a panic attack

It’s not easy, but panic attacks can be brought under control. If someone you know is having a panic attack, help them by:

• Staying by them, and remaining calm
• Offering medication—only if it’s theirs, and you know why they take it
• Speaking in short, clear sentences
• Helping them to breathe slowly—count to 10 with them as they breathe in, and again as they breathe out

How to deal with a panic attack at work

Prevention and treatment is the best way to deal with panic attacks or anxiety attacks at work.

Rather than looking to control the attacks, having a support network in place for employees can help relieve the pressure.

With an employee assistance programme (EAP), you can provide your employees with expert support and counselling. These professionals can help them with these measures below.

Therapy

There are several therapies that can be used to treat symptoms of panic disorder.

A professional counsellor can walk you through these talking therapies and explore what comes up from them. These include:

• Cognitive behavioural therapy (CBT): A talking therapy which addresses negative thoughts, your beliefs and attitudes towards life and uses them to deal with coping skills
• Applied relaxation therapy: Focuses on the physical symptoms and aims to teach you how to relax musicals which are tense when experiencing anxiety
• Exposure therapy: Calculated exposure to the anxiety-inducing stressor/triggers in a safe environment to help overcome the stressor

Grounding techniques

While therapy and medical professionals can help, It’s hard to avoid situations where you become anxious or panicked in life or at work.

This is where grounding techniques come in, if you can identify the beginning of an attack, grounding techniques can help you manage the attack. Some techniques are:

• 5-4-3-2-1 Technique: taking in the details of a surroundings with detail, using the 5 senses.
• 5 things you can see
• 4 things you can feel
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste
• Breathing exercises
• Placing your hands in cold water
• If sat in a chair, press your body weight into your feet and the ground

Having workplace trainings and sessions on grounding techniques and other tools to manage your mental health at work can be an invaluable investment of your time.

Panic attack at work: I’m embarrassed

People find if they experience an attack at work, they become embarrassed or ashamed. This further hampers their mental health.

It’s understandable, many would feel embarrassed to show to their peers their personal issues.

This stems from mental health stigmas. It’s more difficult for an employee to admit they’re struggling with mental health issues than with illnesses such as the flu. Both are a form of illness yet only one is acknowledged without judgment.

Encouraging a positive attitude towards mental health in the workplace will help employees feel like they can ask for support or time off when dealing with health issues or major life events.

A perfect way to do this is by having a clear support structure such as an EAP in place.

This gives clear pathways to help that are there for them to approach by themselves or for you to suggest.

By having a solution, it makes addressing the problem a less painful process.

How to handle anxiety attacks with employees

Regardless of the industry you work in, there’s a possibility your employees will experience anxiety attacks at work.

People with a panic disorder can work in a less stressful job than you would expect and still feel anxious and develop panic attacks at work.

How will this affect an employee’s job?

If they are experiencing panic attacks regularly, they may be suffering from panic disorder. It is recommended they speak to their GP about this.

They’ll make a diagnosis, and recommend therapy, counselling or medication as appropriate.

They should talk to you about any adjustments they may need, though if you are aware of the issue, you can initiate the conversation and give them the chance to tell you then. This allows you to make reasonable adjustments to combat triggers.

Flexible working, a different seating arrangement or headphones to avoid sensory overload are good examples of this.