Dear Kirsten

I was unwell recently, suffering from chest pains, dizziness and couldn’t catch my breath.  I had pins and needles in my hands and they were numb too.  I felt quite confused which made me a bit panicky.  The ‘episodes’ have happened more than once, and were so intense on one occasion my wife called an ambulance. I was given an appointment with my GP who checked my heart, blood pressure etc, and put it down to anxiety. The surgery have offered me some support, and I’ve been  put on a waiting list.  I cannot afford private healthcare. Is there anything I can do to help myself in the meantime?

Kirsten says: It sounds like you are describing an anxiety or panic attack, these attacks are absolutely awful for the sufferer and very common. Thankfully there are lots of things you can do - the first being to get a good understanding of what is happening in your body when you feel anxious.

Our brains are an absolute marvel, however some areas are millions of  years old and were designed to cope with a very different environment; our stress system is one such area.

Our stress response system refers to a number of different areas of the brain including something called the amygdala. It’s a survival mechanism that activates when we are are threatened. This stress system stood us in excellent stead when we needed to scan our environment for immediate threat and react quickly (think of your hunter gatherer ancestors scanning the woodlands for predators).

Our threat detection system scans both our inner world (thoughts, feelings, memories, body sensations etc) and  the external world (vision, proprioception, sounds, experiences) and assesses them as they present. It’s a clever bit of kit that can assess information like facial expressions for trust worthiness and lets us know the risks before our conscious thoughts have caught up.

We actually need anxiety, it keeps us out of danger. In low levels it can creates motivation to change situations, to improve, to move forwards, to keep ourselves safe. 

The problem we have as modern humans is our threat system is old, it struggles to keep up with our modern lives, the pressures and expectations that come with it. 

When our threat system picks up an alert or trigger it prepares our body for action. In a flash signals from our brain tell our heart to get ready for action, in response it pumps faster, breathing increases out of step with our environment. We can begin to feel as though we are not breathing properly, in a bid to protect us our conscious brain tries to take up control over the breathing which ironically can make matters worse. 

Research shows what many of us do is forget to fully exhale, we try to pull air into our lungs without realising that they are already full and this makes us panic more. 

We can start to have chest pains - in fact some panic attack suffers can feel like they having a heart attack. Our stomach churns, hands shake, we feel numbness, pins and needles, dizziness - the list of unpleasant symptoms goes on. It’s really understandable that so many of us believe that something so physical has a physical or medical cause. The answer lies in our lifestyle, our histories and our mental and emotional health.

Why am I having them?

The demands of our modern lives often ask us to stay in a state of chronic stress - rather than the assess, prepare for action and reset pattern that our brains are designed to do.

In order to operate we very often have to shut down or ignore our stress signals. We often don’t realise that we are already a few rungs up our “stress ladder”, without realising it we are already overwhelmed, we have become used to living with this level of stress. 

As more piles onto our plates we can experience additional threat system activation and  out of nowhere we experience an intense period known as a panic attack.

What can I do?

Firstly, know that panic attacks are very common, in 2018, 165,000 bed days were given over to acute anxiety costing the economy £71.1 million. Mental report that in 2018 13.2 per cent of people had experienced at least one panic attack.

Try to get to know how anxiety feels in your body and use this as a prompt to reduce your anxiety before it gets to a higher level of intensity. 

If you start to have an anxiety attack remember to exhale, use distraction methods such as counting objects you can see. Try to reassure yourself - these attacks are common, they will pass, they are not physically harmful, you are going to be ok.

Take a moment to do a 360 degree scan of your life, check out any areas of potential stress - look at home life, work, relationships, responsibilities - try to notice your body sensations as you think about each area. If you feel there are areas of obvious difficulty, develop an action plan that helps you take small manageable steps to reduce some of the stress.

Get back to  basics - a lack of sleep can increase production of stress hormones and make anxiety attacks more likely. Make sure you maintain good dietary habits - trying to eat something every three hours to maintain stable blood sugars. Make room for rest days and make those rest days count, taking yourself out of your environment (Covid permitting) and away from potential stressors.

Investigate mindfulness, using guided meditation and breathing exercises can help strengthen a relaxation response to anxiety. The more you practise, the easier it gets. Use techniques like yoga, progressive muscle relaxation and trauma release exercises (YouTube has some great resources) to keep your body in a calmer state.

Fear of having another attack can actually provoke another anxiety attack and cause  us to change our behaviour, sometimes avoiding things that seem to trigger us. Try not to do this - anxiety can make your world smaller and smaller. Panic attacks are transient, they will pass, they can feel as though everyone can see you are having one but this isn’t the case, very often people don’t notice.

Get to know your triggers and check out your thinking patterns to see if you are letting your thoughts run to worst case scenarios - if you do notice your thoughts are triggering anxiety there are some really great CBT resources online to help you challenge these thoughts.

Finally, if it isn’t enough, reach out for support: has some excellent resources and support.

All best wishes


Kirsten Antoncich is a UKCP accredited Psychotherapist, neurofeedback practitioner and a fellow of the Royal Society. She works with children, young people and adults from her base in York. To ask her a question in complete confidence, please contact her via