The theme of this year’s Mental Health Awareness Week (15th – 21st May) is Anxiety. Mental Health First Aid Trainer, Andy Elwood, talks about panic attacks, something people living with anxiety may experience. Here he outlines the importance of MHAW and makes some suggestions as to how to help someone experiencing a panic attack.
Poor mental health is common. One in four people experience poor mental health each year and 72 million working days are lost each year due to it. So, there are good reasons why it’s important to get involved with Mental Health Awareness Week (MHAW).
Despite so many people living with poor mental health, there is still a stigma associated with mental health and talking about mental health, which can deter people from getting help to find relief from the distress and feelings of low mood they have. Sadly, professional support isn’t always available immediately, so it’s important to increase awareness and knowledge of how to help someone experiencing poor mental health.
By increasing the public’s general awareness, knowledge, and understanding, we can have helpful, supportive conversations, and have some ideas about how we could encourage them at least to talk to someone else who might have more knowledge and offer them help.
To help start that sort of conversation with someone who may be experiencing a panic attack, here are four examples of helpful ways to show we have a little more knowledge and understanding of poor mental health.
Helping someone experiencing a panic attack
An important thing to realise is that this person feels like their life is under threat and they may die. That’s how serious and how strong these feelings are. Sometimes the person doesn’t know what terrible thing is going to happen or what threat they’re under, but they still have what some people describe as a ‘feeling of impending doom’.
The physical signs and symptoms of a panic attack can look very like someone having a heart attack or an asthma attack. That would be difficulty breathing, maybe even choking, and pain in the chest. The person may be sweating, and they may talk about how fast their heart is pounding, that they can feel the palpitations.
If there’s any doubt at all about what’s going on, then call 999 and get an ambulance on the way. Someone may die from a heart attack or an asthma attack, they won’t die from a panic attack. But if there’s any doubt, then there’s no doubt.
What should we do if we know or think someone is having a panic attack? I’ve already mentioned, if you’re unsure, call for an ambulance. So, what we want to do is a little bit like an asthma attack in physical first aid, we want to break the chain of events.
Change the environment
If someone’s inside, get them outside. We want to remove them from that trigger, get them in a different environment. If we can appear to be cool, calm, and confident, that will really help. Telling someone in a loud voice, “You need to calm down” and using ‘calm down gestures’ will not help at all. Slowing down your speech and using a soothing, softer voice can be really calming and reassuring, and really helps. Try to channel your soothing late-night DJ voice.
Getting the person outside, especially if there’s any nature or greenery around, is great because you can deflect their attention to flowers, plants, trees and birds if you’re in nature. However, there are still plenty of things to notice if you’re out in an urban environment. We need to use the person’s senses to try and ground them in the moment and tell them that they are safe.
So, focus on things they can see, things they can hear, things they can touch, smell and maybe even taste as well. Using their senses will ground them in the moment and distract them, give them a different focus rather than, “It is so difficult to breathe. I don’t know where my next breath is coming from. I’ve got this pain in my chest.”
Another technique, other than grounding, focus or distraction techniques, is to focus on breathing. However, it is difficult to coach someone’s breathing, especially if it’s their first panic attack and they have no experience of how to use their breath as a helpful coping strategy. There are lots of techniques out there and it can be difficult to coach someone in that moment of crisis. So, I would always opt for the focus technique first using the senses.
But if we are focusing on breathing, the one thing I’d recommend is trying to lengthen the out breath. If we can get someone to breathe out slower and longer, everything else will follow from there. As we’re slowing down the out breath, the body and the mind starts to realise, “I’m not actually under threat because I can breathe out slowly. I don’t need to take another deep breath in quickly because my life is not under threat, and I don’t need to stay here and fight or run away.” However, don’t expect the person to have a conversation with you, they’ll be focusing on their breathing and slowing things down. It may take around 10 to 15 minutes for this to pass.
Let them know you’re there to support them
It’s really helpful to let them know they have your support. Tell them, “You’re safe. I’m going to stay with you now. This will pass. You will get through this,” and be confident in your delivery. That is really reassuring. And when the person gets through that, and the attack is over, they may talk to you a little bit more, but it may not be a two-way conversation. In these circumstances it’s more about coaching this person through the panic by using these focused, grounded techniques. And if that’s not working too well use the breathing technique outlined.
So, speak calmly, change the environment, use the grounding or distraction techniques (or breathing) and let them know they’re safe and that you’re going to support them.
Andy Elwood is a Mental Health First Aid instructor and an ambassador for Movember. He creates safety and trust by sharing his own vulnerability and gives a unique ‘behind the scenes’ insight into life and death situations from his 20 years’ experience working in the emergency services as a paramedic on search and rescue helicopters.