Menopause and panic attacks
Panic attacks can feel terrifying – you can’t breathe, feel sick, shake and lose control. They can last for just seconds at a time or up to an hour. You may have had one or several and there are many individual factors that contribute to why you’re experiencing them. Read on for information to spot and manage them.
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PANIC ATTACK DEFINITION
A panic attack is generally defined as a sudden episode of intense fear that triggers severe physiological reactions when there is no real danger or apparent cause.
Panic attacks can feel extremely frightening and can feel like you’re having a heart attack or even dying. Although panic attacks aren’t life-threatening, they can significantly affect your quality of life. They can make you feel anxious, fatigued and low.
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SIGNS OF A PANIC ATTACK
During a panic attack, you get an intense rush of mental and physical symptoms. It can come on very quickly without warning and, sometimes, for no immediately apparent reason, which can be very distressing. Symptoms can include:
- A racing heartbeat
- Feeling faint
- Chest pain
- Shortness of breath
- Hot flushes
- Shaky limbs
- A choking sensation
- Numbness or pins and needles
- Dry mouth
- A need to go to the loo
- Ringing in your ears
- A feeling of dread/doom/dying
- A churning stomach
- A tingling in your fingers
- Feeling like you’re not connected to your body
WHAT DOES A PANIC ATTACK FEEL LIKE?
Panic attacks are intense, overwhelming and terrifying. It can start with a total loss of control of breathing and crying. You might desperately gasp for air, sob and feel like you are choking. You may experience waves of churning nausea with a desire to be violently sick. Your heart can pound so quickly you may worry you are having a heart attack or die.
It is scary when you feel you are not in control, hear yourself making weird noises or feel your heart hammering. Getting yourself back under control is a real challenge while you are in a heightened state of anxiety and fear. Most panic attacks last between five and 20 minutes, although some have been reported to last up to an hour.
Afterwards, you can feel vulnerable and fragile, as well as embarrassed if it has happened in a public place or in front of people. It takes a while afterwards to return to your pre-panic state.
Be aware that most of these symptoms can relate to other conditions or problems, so may not always be experiencing a panic attack. For example, a racing heartbeat can mean you have low blood pressure.
WHAT TO DO DURING A PANIC ATTACK
Try not to fight it and remember it's not life threatening
Stay where you are and focus on breathing slowly and deeply
Remember that the attack will pass
Focus on positive, peaceful and relaxing images
HOW TO STOP A PANIC ATTACK
There are several techniques that can help manage and prevent panic attacks:
1. Breathing. If you start to feel one coming on, focus hard on slow breathing. Try counting to four as you breathe in and then to four as you breathe out
2. Acceptance. If you’ve had one before, you know what’s happening to you and you can comfort yourself that it will pass
3. Relaxation. Try mindfulness every day to manage stress and anxiety. Stella has many guided meditations and soundscapes to help you
4. Focus. You could try closing your eyes and imagining a place with happy memories or smelling a strong scent (such as a lavender spray)
5. Lifestyle choices:
- It may seem obvious but reducing your stress levels is important, even if it is not easy. Try and identify specific stress sources, such as your job or relationships
- What you eat and drink can also add to your stress levels – reducing caffeine, alcohol and food low in nutrients will help
- Get some exercise, even if it is a brisk walk
6. Therapy. Talk to your doctor about cognitive behaviour therapy and if that is right for you
PANIC ATTACKS AND MENOPAUSE
Overall, it is thought that hormonal changes associated with menopause make panic attacks during midlife more prevalent.
Oestrogen and progesterone usually work together to regulate mood. As these hormones drop off in midlife, women are more at risk of developing anxiety. If this is overwhelming or left untreated it can ramp up into panic attacks.
Menopausal hot flushes may also bring on panic attacks, as women can worry and feel self-conscious about sweating in public.
Although panic attacks are frightening, they’re not dangerous.
An attack will not cause you any physical harm, and it’s unlikely you’ll be admitted to hospital if you have one.
However, you may feel unsafe, especially if a panic attack happens in a public place and you’re feeling unprepared to navigate through it.
Long-term anxiety and panic attacks can cause your brain to release stress and “fight or flight” hormones cortisol and adrenaline on a regular basis.
This can increase the frequency of symptoms such as headaches, dizziness and depression.
If you feel that you might have symptoms of panic attacks that make day-to-day living feel tough, it might be a good time to book an appointment with your doctor or speak to someone you trust about getting help.
Repeated or regular panic attack episodes may also indicate a panic disorder, which can be characterised as having feelings of anxiety, stress and panic regularly and at any time, often for no apparent reason.
When an attack happens, my body feels light and I can see myself from above. I feel like I am disintegrating and physically gone”
- Siegel AM, Mathews SB. Diagnosis and treatment of anxiety in the aging woman. Curr Psychiatry Rep. 2015 Dec;17(12):93.
- Smoller JW, Pollack MH, Wassertheil-Smoller S, et al. Prevalence and correlates of panic attacks in postmenopausal women: results from an ancillary study to the Women’s Health Initiative. Arch Intern Med. 2003;163(17):2041-2050. doi:10.1001/archinte.163.17.2041
- Freeman EW, Sammel MD, Liu L, Gracia CR, Nelson DB, Hollander L. Hormones and Menopausal Status as Predictors of Depression in Women in Transition to Menopause. Arch Gen Psychiatry. 2004;61(1):62–70. doi:10.1001/archpsyc.61.1.62
- Freeman EW, Sammel MD. Anxiety as a risk factor for menopausal hot flashes: evidence from the Penn Ovarian Aging cohort. Menopause. 2016;23(9):942-949. doi:10.1097/GME.0000000000000662