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Panic Attacks
Anxiety and panic attacks
Explains anxiety and panic attacks, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.
What is anxiety?
Anxiety is what we feel when we are worried, tense or afraid – particularly about things that are about to happen, or which we think could happen in the future.
Anxiety is a natural human response when we feel that we are under threat. It can be experienced through our thoughts, feelings and physical sensations.
“For me, anxiety feels as if everyone in the world is waiting for me to trip up, so that they can laugh at me. It makes me feel nervous and unsure whether the next step I take is the best way forward.”
Most people feel anxious at times. It’s particularly common to experience some anxiety while coping with stressful events or changes, especially if they could have a big impact on your life. See our pages on how to manage stress for more information about stress.
If you are feeling anxious or experiencing a panic attack right now, see our page on how to manage panic attacks.
What is the ‘fight, flight or freeze’ response?
Like all animals, human beings have evolved ways to help us protect ourselves from danger. When we feel under threat our bodies react by releasing certain hormones, such as adrenaline and cortisol, which can be helpful. These hormones:
- make us feel more alert, so we can act faster
- make our hearts beat faster, quickly sending blood to where it’s needed most.
After we feel the threat has passed, our bodies release other hormones to help our muscles relax. This can sometimes cause us to shake.
This is commonly called the ‘fight, flight or freeze’ response – it’s something that happens automatically in our bodies, and we have no control over it.
“Going out of the house is a challenge because I have a fear of panicking and feel that I’m being watched or judged. It’s just horrible. I want to get help but I’m afraid of being judged.”
When is anxiety a mental health problem?
Anxiety can become a mental health problem if it impacts your ability to live your life as fully as you want to. For example, it may be a problem if:
- your feelings of anxiety are very strong or last for a long time
- your fears or worries are out of proportion to the situation
- you avoid situations that might cause you to feel anxious
- your worries feel very distressing or are hard to control
- you regularly experience symptoms of anxiety, which could include panic attacks
- you find it hard to go about your everyday life or do things you enjoy.
If your symptoms fit a particular set of medical criteria then you might be diagnosed with a particular anxiety disorder. But it’s also possible to experience problems with anxiety without having a specific diagnosis. Our pages on self-care and treatment for anxiety offer suggestions for help and support.
What do anxiety problems feel like?
Watch Lewis, Polly, Faisal, Shelley and Brian talk about what living with anxiety problems feels like for them, and what helps them cope:
Gus’ story
Heart FM DJ Matt Wilkinson talks to Gus Marshall about his experience of anxiety and panic attacks.
Read the transcript of the podcast here. Find out more about our podcasts or subscribe to our podcast on iTunes or Audioboom.
“You know that feeling when you’re rocking on the back legs of your chair and suddenly for a split second you think you’re about to fall; that feeling in your chest? Imagine that split second feeling being frozen in time and lodged in your chest for hours/days, and imagine with it that sense of dread sticking around too, but sometimes you don’t even know why.”
What are anxiety disorders?
Anxiety can be experienced in lots of different ways. If your experiences meet certain criteria your doctor might diagnose you with a specific anxiety disorder.
Some commonly diagnosed anxiety disorders are:
- Generalised anxiety disorder (GAD) – this means having regular or uncontrollable worries about many different things in your everyday life. Because there are lots of possible symptoms of anxiety this can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from another person’s experiences.
- Social anxiety disorder – this diagnosis means you experience extreme fear or anxiety triggered by social situations (such as parties, workplaces, or everyday situations where you have to talk to another person). It is also known as social phobia. See our page on types of phobia for more information.
- Panic disorder – this means having regular or frequent panic attacks without a clear cause or trigger. Experiencing panic disorder can mean that you feel constantly afraid of having another panic attack, to the point that this fear itself can trigger your panic attacks. See our page on panic attacks for more information.
- Phobias – a phobia is an extreme fear or anxiety triggered by a particular situation (such as going outside) or a particular object (such as spiders). See our pages on phobias for more information.
- Post-traumatic stress disorder (PTSD) – this is a diagnosis you may be given if you develop anxiety problems after going through something you found traumatic. PTSD can involve experiencing flashbacks or nightmares which can feel like you’re re-living all the fear and anxiety you experienced at the time of the traumatic events. See our pages on PTSD and complex PTSD for more information.
- Obsessive-compulsive disorder (OCD) – you may be given this diagnosis if your anxiety problems involve having repetitive thoughts, behaviours or urges. See our pages on OCD for more information.
- Health anxiety – this means you experience obsessions and compulsions relating to illness, including researching symptoms or checking to see if you have them. It is related to OCD. You can find out more about health anxiety on the Anxiety UK website.
- Body dysmorphic disorder (BDD) – this means you experience obsessions and compulsions relating to your physical appearance. See our pages on BDD for more information.
- Perinatal anxiety or perinatal OCD – some people develop anxiety problems during pregnancy or in the first year after giving birth. See our pages on perinatal anxiety and perinatal OCD for more information.
You might not have, or want, a diagnosis of a particular anxiety disorder – but it might still be useful to learn more about these different diagnoses to help you think about your own experiences of anxiety, and consider options for support.
“It’s like a swarm of bees just buzzing buzzing buzzing, not stopping, making it impossible to focus and seemingly impossible to slow down and take a breath.”
Anxiety and other mental health problems
It’s very common to experience anxiety alongside other mental health problems, such as depression or suicidal feelings. If you have symptoms of both anxiety and depression but don’t fit one more clearly than the other, you might be given a diagnosis of ‘mixed anxiety and depressive disorder’.
“I have generalised anxiety disorder and depression which seem to come in cycles. It is the unexpected attacks that I find the hardest.”
What are the symptoms of anxiety?
Anxiety feels different for everyone. You might experience some of the physical and mental effects listed on this page, as well as effects in other areas of your life.
You might also have experiences or difficulties with anxiety that aren’t recognised here.
This page covers:
- effects of anxiety on your body
- effects of anxiety on your mind
- other effects of anxiety
Effects of anxiety on your body
These can include:
- a churning feeling in your stomach
- feeling light-headed or dizzy
- pins and needles
- feeling restless or unable to sit still
- headaches, backache or other aches and pains
- faster breathing
- a fast, thumping or irregular heartbeat
- sweating or hot flushes
- sleep problems
- grinding your teeth, especially at night
- nausea (feeling sick)
- needing the toilet more or less often
- changes in your sex drive
- having panic attacks.
The physical effects of anxiety
Watch Alex talk about the physical impact anxiety has on his body in this video:
Effects of anxiety on your mind
These can include:
- feeling tense, nervous or unable to relax
- having a sense of dread, or fearing the worst
- feeling like the world is speeding up or slowing down
- feeling like other people can see you’re anxious and are looking at you
- feeling like you can’t stop worrying, or that bad things will happen if you stop worrying
- worrying about anxiety itself, for example worrying about when panic attacks might happen
- wanting lots of reassurance from other people or worrying that people are angry or upset with you
- worrying that you’re losing touch with reality
- low mood and depression
- rumination – thinking a lot about bad experiences, or thinking over a situation again and again
- depersonalisation – a type of dissociation where you feel disconnected from your mind or body, or like you are a character that you are watching in a film
- derealisation – another type of dissociation where you feel disconnected from the world around you, or like the world isn’t real
- worrying a lot about things that might happen in the future – you can read more about these sorts of worries on the Anxiety UK website.
“I could feel all these physical symptoms building inside me, literally filling every part of my body until I felt completely light-headed and disembodied.”
Anxiety and physical health problems
Some studies suggest that experiencing anxiety could increase the risk of developing certain long-term physical health problems, including diabetes, stomach ulcers and heart problems. But there’s not enough evidence to say for sure exactly what the risks are, or what groups of people are most likely to be affected.
Having a physical illness or disability can also make you feel stressed and anxious, so it might sometimes feel like your anxiety problems and physical health problems are part of a vicious circle.
Sometimes it might be difficult to work out whether your symptoms are totally related to anxiety, or might be related to a different illness. If you’re experiencing any physical symptoms it’s best to talk to your GP, so they can check out what may be causing them.
“I constantly thought I was dying of undiagnosed illnesses, because I was convinced that the physical symptoms were too bad to be ‘just anxiety’.”
Other effects of anxiety
Anxiety symptoms can last for a long time, or come and go. You might find you have difficulty with day-to-day parts of your life, including:
- looking after yourself
- holding down a job
- forming or maintaining relationships
- trying new things
- simply enjoying your leisure time.
In some cases anxiety can have a serious impact on your ability to work. See our pages on how to be mentally healthy at work for information on how to cope. Our legal pages on discrimination at work can provide information about your rights in the workplace.
If you drive you may have to tell the DVLA if you have an anxiety disorder. For information on your right to drive, including when and how to contact the DVLA, see our legal pages on fitness to drive.
What is a panic attack?
Panic attacks are a type of fear response. They’re an exaggeration of your body’s normal response to danger, stress or excitement. This page covers:
- What do panic attacks feel like?
- When might I have panic attacks?
- What helps to manage panic attacks?
- What is panic disorder?
“My teeth would chatter uncontrollably and my whole body would tremble, I’d hyperventilate and cry with panic as the feeling that I was going to fall unconscious was so convincing.”
What do panic attacks feel like?
During a panic attack, physical symptoms can build up very quickly. These can include:
- a pounding or racing heartbeat
- feeling faint, dizzy or light-headed
- feeling very hot or very cold
- sweating, trembling or shaking
- nausea (feeling sick)
- pain in your chest or abdomen
- struggling to breathe or feeling like you’re choking
- feeling like your legs are shaky or are turning to jelly
- feeling disconnected from your mind, body or surroundings, which are types of dissociation.
During a panic attack you might feel very afraid that you’re:
- losing control
- going to faint
- having a heart attack
- going to die.
You might find that you become scared of going out alone or to public places because you’re worried about having another panic attack. If this fear becomes very intense, it may be called agoraphobia. See our pages on types of phobia for more information.
“I felt like I couldn’t breathe, I just wanted to get out, to go somewhere else, but I couldn’t because I was on a train.”
Panic attacks
Watch Lewis, Polly, Faisal, Shelley and Brian share how panic attacks feel for them, and talk about what helps:
When might I have panic attacks?
Panic attacks happen at different times for everyone. Some people have one panic attack then don’t ever experience another, or you might find that you have them regularly, or several in a short space of time. You might notice that particular places, situations or activities seem to trigger panic attacks. For example, they might happen before a stressful appointment.
Most panic attacks last between 5 to 20 minutes. They can come on very quickly. Your symptoms will usually be at their worst within 10 minutes. You might also experience symptoms of a panic attack over a longer period of time. This could be because you’re having a second panic attack, or you’re experiencing other symptoms of anxiety.
“My panic attacks seem to come out of the blue now. But in fact, they seem to be triggered mainly at night when I want to go to sleep but cannot stop my mind racing, experiencing worry and panic about anything that may be on my mind.”
What helps to manage panic attacks?
Panic attacks can be frightening, but there are things you can do to help yourself cope. It could help to print off these tips, or write them down, and keep them somewhere easy to find.
During a panic attack:
- Focus on your breathing. It can help to concentrate on breathing slowly in and out while counting to five.
- Stamp on the spot. Some people find this helps control their breathing.
- Focus on your senses. For example, taste mint-flavoured sweets or gum, or touch or cuddle something soft.
- Try grounding techniques. Grounding techniques can help you feel more in control. They’re especially useful if you experience dissociation during panic attacks. See our page on self-care for dissociation for more information on grounding techniques.
After a panic attack:
- Think about self-care. It’s important to pay attention to what your body needs after you’ve had a panic attack. For example, you might need to rest somewhere quietly, or eat or drink something.
- Tell someone you trust. If you feel able to, it could help to let someone know you’ve had a panic attack. It could be particularly helpful to mention how they might notice if you’re having another one, and how you’d like them to help you.
See our pages on self-care for anxiety and treatments for anxiety for more information on what could help.
What is panic disorder?
If you’re having lots of panic attacks at unpredictable times and there doesn’t seem to be a particular trigger or cause, you might be given a diagnosis of panic disorder. It’s common to experience panic disorder and certain types of phobia together. People who experience panic disorder may have some periods with few or no panic attacks, but have lots at other times.
Panic disorder and high sensitivity
Some research suggests that people who have panic disorder might be very sensitive to sensory experiences (such as sunlight, smells and changes in the weather), but there’s not enough evidence yet to say for sure.
Also it’s not clear whether having a high level of sensitivity to these sorts of things is something that might cause you to develop panic disorder, or whether it may be an effect of having it.
“Never knowing when I was going to have a panic attack was the worst feeling in the world.”
What causes anxiety?
Everyone’s experience of anxiety is different, so it’s hard to know exactly what causes anxiety problems. There are probably lots of factors involved.
This page covers some things which make anxiety problems more likely to happen:
- past or childhood experiences
- your current life situation
- physical and mental health problems
- drugs and medication
Can anxiety problems be inherited genetically?
Research shows that having a close relative with anxiety problems might increase your chances of experiencing anxiety problems yourself. This is sometimes called ‘anxiety sensitivity’.
At the moment there is not enough evidence to show whether this is because we share some genes that make us more vulnerable to developing anxiety, or because we learn particular ways of thinking and behaving from our parents and other family members as we grow up.
Past or childhood experiences
Difficult experiences in childhood, adolescence or adulthood are a common trigger for anxiety problems. Going through stress and trauma when you’re very young is likely to have a particularly big impact. Experiences which can trigger anxiety problems include things like:
- physical or emotional abuse
- neglect
- losing a parent
- being bullied or being socially excluded
- experiencing racism.
Having parents who don’t treat you warmly or are overprotective can also be a factor.
“I was sent to boarding school and suffered acute separation anxiety, being away from home, and my brother nearly died when I was 12. My mum had an acute breakdown for a period of about a year and had to be home-nursed.”
Your current life situation
Current problems in your life can also trigger anxiety. For example:
- exhaustion or a build-up of stress
- lots of change or uncertainty
- feeling under pressure while studying or in work
- long working hours
- being out of work
- money problems
- housing problems and homelessness
- worrying about the environment or natural disasters (sometimes called climate anxiety or eco-anxiety)
- losing someone close to you (sometimes called bereavement)
- feeling lonely or isolated
- being abuse, bullied or harassed, including experiencing racism.
Big changes to your day-to-day life can be a particular trigger for anxiety, so you may find that you’ve experienced anxiety problems during the coronavirus pandemic. For information on how coronavirus may have affected your mental health and what could help see our coronavirus and mental health pages.
“I have recently realised that I spend money when anxious, which in turn makes me feel anxious about how much I’m spending.”
Physical or mental health problems
Other health problems can sometimes cause anxiety, or might make it worse. For example:
- Physical health problems – living with a serious, ongoing or life-threatening physical health condition can sometimes trigger anxiety.
- Other mental health problems – it’s also common to develop anxiety while living with other mental health problems, such as depression.
“I had cut out alcohol. Many think drinking alcohol helps with anxiety, but it actually makes it worse in the long run.”
How can I help myself?
Living with anxiety can be very difficult, but there are steps you can take that might help. This page has some suggestions for you to consider.
For tips on coping with panic attacks, see our section on what helps to manage panic attacks.
Talk to someone you trust
Talking to someone you trust about what’s making you anxious could be a relief. It may be that just having someone listen to you and show they care can help in itself. If you aren’t able to open up to someone close to you, the Samaritans and Anxiety UK both run helplines that you can call to talk to someone.
Read Amy’s blog about how sharing her experiences of anxiety with others online helps her.
“Getting it off my chest seems to help relieve some of the pressure.”
Manage to your worries
Anxiety can make it really hard to stop worrying. You might have worries you can’t control. Or you might feel like you need to keep worrying because it feels useful – or that bad things might happen if you stop.
It can be helpful to try different ways of addressing these worries. For example, you could:
- Set aside a specific time to focus on your worries – so you can reassure yourself you haven’t forgotten to think about them. Some people find it helps to set a timer.
- Write down your worries and keep them in a particular place – for example, you could write them in a notebook, or on pieces of paper you put in an envelope or jar.
Read Damien’s blog about how being creative helps him manage his anxiety.
“I try to accept that this is how I feel at the moment, but it won’t last forever.”
Look after your physical health
- Try to get enough sleep. Sleep can give you the energy to cope with difficult feelings and experiences. See our page on coping with sleep problems for more information.
- Think about your diet. Eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels. See our page on food and mood for more information.
- Try to do some physical activity. Exercise can be really helpful for your mental wellbeing. See our pages on physical activity for more information.
Read Stephen’s blog about how running helps him feel better.
“I find going for a walk great, even if I can’t go far. I walk around the garden and eat my lunch outside.”
Try breathing exercises
- Breathing exercises can help you cope and feel more in control. You can find some suggestions on our page on relaxation.The NHS also has some tips on breathing exercises for stress.“Breathe… always remember to breathe. Take time to inhale. It’s the simplest thing, but is forgotten in panic attacks.”
Can mindfulness help with anxiety?
Mindfulness is a way of giving your full attention to the present moment. Some people find mindfulness helpful for coping with certain anxiety disorders, but other people say it makes them feel worse.
One of the reasons for this is that some people find noticing their negative thoughts too intense, and it can make them feel worse. If you try mindfulness and still feel unwell, ask your GP or therapist about other things you could try.
The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best-practice in healthcare – says that mindfulness is not recommended for social anxiety. Read more about social anxiety (sometimes called social phobia) in our page on types of phobia.
See our pages on mindfulness for more information.
“Now I look for natural ways to control the panic and anxiety, including meditation, exercise, breathing exercises, mindfulness and diet.”
Keep diary
- It might help to make a note of what happens when you get anxious or have a panic attack. This could help you spot patterns in what triggers these experiences for you, or notice early signs that they are beginning to happen.You could also make a note of what’s going well. Living with anxiety can mean you think a lot about things that worry you or are hard to do. It’s important to be kind to yourself and notice the good things too.“I keep a photo diary of all the things I’ve managed to do! Makes me think ‘I can do this’. So when I go and sit in a café, or go for a walk, I take a pic, and look back when I feel scared… It encourages me that maybe I can do something again if I’ve done it before.”
Try peer support
- Peer support brings together people who’ve had similar experiences to support each other. Many people find it helps them to share ideas about how to stay well, connect with others and feel less alone. You could:
- Contact a specialist organisation. For example, you can find details of support groups, forums and helplines on the Anxiety Care UK, Anxiety UK, No More Panic, No Panic and Triumph Over Phobia UK websites.
- Join Side by Side, Mind’s supportive online community.
- Contact Mind’s Infoline and ask about support groups near you. Alternatively you could find your local Mind and contact them directly.
See our pages on peer support for more information about what it involves and how to find a peer support group to suit you.
If you’re new to online peer support you might also find it helpful to read our information on how to stay safe online.
Complementary and alternative therapies
- You may find that complementary and alternative therapies help you to manage your anxiety.There are many types that you can try, to see what works for you. These include:
- yoga
- meditation
- aromatherapy
- massage
- reflexology
- herbal treatments
- Bach flower remedies
- hypnotherapy.
Some people find that one or more of these methods can help them to relax or sleep better.
Many chemists and health shops stock different remedies and should be able to offer advice.
“For me, it’s a hypnotherapy CD. I laughed when my husband brought it home; now I use it myself. Very calming.”
What treatments are available?
There are various evidence-based treatments that have been found to help with anxiety and panic disorder. This page covers:
- Self-help resources
- Talking therapies
- Medication
- How do I access treatment?
- What if I don’t feel better?
Self-help resources
A self-help resource might be the first treatment option your GP offers you. This is because it’s available quite quickly, and there’s a chance it could help you to feel better without needing to try other options.
Self-help could be delivered through:
- Workbooks. For example, your GP might recommend particular titles from a scheme called Reading Well, which offers Books on Prescription. This scheme is supported by most local libraries, so you can go and check the books out for free – you don’t actually need a prescription from a doctor.
- Online cognitive behavioural therapy (CBT) programmes. There are several app-based CBT courses to treat anxiety and panic attacks. You can search the NHS apps library to find an app that may work for you. You might be offered a resource to work through on your own, or on a course with other people who experience similar difficulties.
“I was diagnosed with generalised anxiety disorder, depression and OCD traits. I had CBT for almost a year, which was very helpful.”
Talking therapies
If self-help resources aren’t likely to help with the anxiety problems you’re experiencing, or you’ve already tried them and they haven’t helped, your doctor should offer you a talking treatment. There are two types of talking treatment recommended for anxiety and panic:
- Cognitive behavioural therapy (CBT) – this focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour, and teaches you coping skills for dealing with different problems.
- Applied relaxation therapy – this involves learning how to relax your muscles in situations where you normally experience anxiety.
See our pages on talking therapies and CBT for more information on these and other kinds of therapy.
Medication
Your doctor might offer to prescribe you medication to help manage your symptoms. Some people find it helpful to try talking therapies and medication at the same time, but medication shouldn’t be the only thing you’re offered.
Here are some medications you might be offered:
Antidepressants
Usually this will be a type called a selective serotonin reuptake inhibitor (SSRI). For some people SSRIs can cause side effects, such as sleep problems or feeling more anxious than you did before. If they don’t work, or aren’t right for you, you may be offered a different kind.
See our pages on antidepressants for more information.
Pregabalin
In some cases, such as if you have a diagnosis of generalised anxiety disorder (GAD), your doctor may decide to prescribe you a drug called pregabalin. This is an antiseizure drug which is normally used to treat epilepsy, a neurological disorder that can cause seizures, but is also licensed to treat anxiety.
See our pages on anti-anxiety medication and pregabalin for more information.
Beta-blockers
Beta-blockers are sometimes used to treat the physical symptoms of anxiety, such as a rapid heartbeat, palpitations and tremors (shaking). But they are not psychiatric drugs so they don’t reduce any of the psychological symptoms. They may be helpful in certain situations that trigger your phobia.
See our page on treatment for phobias for more information.
Benzodiazepine tranquillisers
If you experience very severe anxiety that is having a significant impact on your day-to-day life, you may be offered a benzodiazepine tranquilliser. But these drugs can cause unpleasant side effects and can become addictive, so your doctor should only prescribe them at a low dose for a short time, to help you through a crisis period.
See our page on benzodiazepines for more information.
Before deciding to take any drug, it’s important to make sure you have all the facts you need to make an informed choice.
See our pages on things to consider before taking medication and your right to refuse medication for more information.
Our pages on coming off medication give guidance on how to come off medication safely.
“I take medication and this helps, but I have also had online therapy which was invaluable, and cognitive analytic therapy as an outpatient at a psychiatric hospital. Talking cures are fantastic.”
How do I access treatment?
To get treatment on the NHS, the first step is normally to visit your GP. They will do an assessment, which might include asking you to fill in a questionnaire about how often you feel worried, anxious and nervous.
They should then explain your treatment options to you, and you can decide together what might suit you best.
See our pages on seeking help for a mental health problem for more information on how to prepare for an appointment and have your say in treatment.
Unfortunately NHS waiting lists for talking treatments can be very long. If you’re finding it hard to access talking therapies you could consider:
- Charities and specialist organisations. See useful contacts for a list of organisations that may offer therapy or be able to put you in touch with local services. Mind’s Infoline could also help you find services near you.
- Private therapy. Finding a private therapist is another option some people choose to explore, but it’s not suitable for everyone because it can be expensive. See our page on private therapy for more information.
What if my anxiety stops me from seeking help?
It can be especially hard to get treatment if making or attending an appointment with your doctor involves doing something that causes lots of anxiety for you. For example, you might not feel able to talk on the phone or leave the house.
Here are some things you could try:
- Ask your doctor if they offer home visits or telephone assessments. If not, they might be able to book you an appointment at a time when the surgery tends to be quiet.
- Some GP practices will allow someone else to ring up and book appointments for you (with your consent). It could also help to have someone come with you to the appointment for support.
- Depending on what’s available in your area, you may be able to refer yourself for talking therapy at a local Improving Access to Psychological Therapies (IAPT) service. Some IAPT services are delivered online or over the phone. You can search for IAPT services on the NHS website.
See the National Institute for Health and Care Excellence (NICE)’s guidelines for treating anxiety disorders for more detailed information.
“If you don’t know what’s wrong with you, how do you know how to fix it? For me, being diagnosed with anxiety and panic disorder came as a relief! It meant I wasn’t imagining the awful symptoms I’d been experiencing.”
What if I don’t feel better?
Your doctor should offer you regular appointments to check how you’re doing, and see how well any treatment is working for you.
Different things work for different people, so if a particular medication, type of talking therapy or particular therapist doesn’t work for you, your doctor should offer an alternative.
If you’ve tried a range of treatments and none of them have helped, your doctor might refer you to a community mental health team (CMHT). This is made up of a number of different healthcare professionals, such as psychiatrists and clinical psychologists. Your CMHT can assess you separately and offer you a personalised treatment plan.
This is particularly recommended if:
- your symptoms are making it very difficult to carry out everyday activities
- you have a serious physical health problem or another mental health problem
- you’re having thoughts of self-harm or suicide.
It’s important to remember that recovery is a journey, and it won’t always be straightforward. For example, you might find it more helpful to focus on learning more about yourself and developing ways to cope, rather than trying to get rid of all your symptoms.
See our pages on recovery and facing and overcoming barriers for more information.
How can other people help?
This page is for friends and family wanting to support someone who experiences anxiety or panic attacks.
It can be really difficult when someone you care about is experiencing anxiety or panic attacks, but there are things you can do to help. Here are some tips:
Don’t pressure them
Try not to put pressure on your friend or family member to do more than they feel comfortable with. It’s really important to be patient, listen to their wishes and take things at a pace that feels okay for them.
It’s understandable to want to help them face their fears or find practical solutions, but it can be very distressing for someone to feel they’re being forced into situations before they feel ready. This could even make their anxiety worse.
Try to remember that being unable to control their worries is part of having anxiety, and they aren’t choosing how they feel.
“What helps me is calmness, acceptance – not trying to dispel it with ‘rational’ or ‘logical’ argument.”
Helping someone who is having a panic attack
It’s understandable to feel frightened if someone you care about experiences a panic attack – especially if it seems to happen without warning. But it can help if you:
- try to stay calm
- gently let them know that you think they might be having a panic attack and that you are there for them
- encourage them to breathe slowly and deeply – it can help to do something structured or repetitive they can focus on, such as counting out loud, or asking them to watch while you gently raise your arm up and down
- encourage them to stamp their feet on the spot
- encourage them to sit somewhere quietly where they can focus on their breath until they feel better.
You should never encourage someone to breathe into a paper bag during a panic attack. This isn’t recommended and it might not be safe.
See our page on panic attacks for more information and tips on how to cope.
Try to understand
- Find out as much as you can about anxiety. This will help you understand what they are going through. Reading personal stories of anxiety can help too.
- Ask about their experience. You could ask them how anxiety affects their day-to-day life, and what makes it better or worse. Listening to how they experience things could help you to empathise with how they feel.
“Be kind, be non-judgemental. Let us know it will pass, let us know you are there.”
Ask how you can help
Your friend or family member may already know how you can support them – for example, helping them with difficult situations, talking to them calmly or doing breathing exercises with them.
By asking them what they need or how you can help, you can support them to feel more in control themselves.
Knowing that there is someone around who knows what to do if they start to feel frightened or panicked could help them feel safer and calmer.
“Reminding me to breathe, asking me what I need.”
Support them to seek help
If you think your friend or family member’s anxiety is becoming a problem for them, you could encourage them to seek treatment by talking to a GP or therapist. You could:
- Offer to help them arrange a doctor’s appointment. If they are scared of leaving the house, you could suggest they ring their GP to find out if they will do home visits and telephone appointments.
- Offer support when they attend appointments. You could offer to go with them to their appointments and wait in the waiting room. You can also help them plan what they’d like to talk about with the doctor. See our page on talking to your GP for more information.
- Help them seek help from a therapist. See our page on how to find a therapist for more information.
- Help them research different options for support, such as community services or peer support groups such as those run by Anxiety UK and No Panic. See our useful contacts page for more information. You could also call Mind’s Infoline to find out more about local services.
See our page on helping someone else seek help for more information.
Look after yourself
It can sometimes be really challenging to support someone with a mental health problem – you are not alone if you feel overwhelmed at times. It is important to remember to look after your own mental health too, so you have the energy, time and space you need to be able to help.
For example:
- Set boundaries and don’t take on too much. If you become unwell yourself you won’t be able to support them or yourself in the same way. It is also important to decide what your limits are and how much you feel able to help.
- Share your caring role with others, if you can. It’s often easier to support someone if you’re not doing it alone.
- Talk to others about how you’re feeling. You may want to be careful about how much information you share about the person you’re supporting, but talking about your own feelings with someone you trust can help you feel supported too.
- Find support for yourself. The organisations in useful contacts are there to support you as well. You may find peer support or therapies are a good outlet for your feelings.
For more suggestions see our pages on how to cope when supporting someone else, dealing with pressure and how to improve your mental wellbeing.
Useful contacts
Mind’s services
- Mind’s helplines provide information and support by phone and email.
- Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.
- Side by Side is our supportive online community for anyone experiencing a mental health problem.
Other organisations
Anxiety Care UK
anxietycare.org.uk
Helps people with anxiety disorders.
Anxiety UK
03444 775 774 (helpline)
07537 416 905 (text)
anxietyuk.org.uk
Advice and support for people living with anxiety.
British Association for Counselling and Psychotherapy (BACP)
bacp.co.uk
Professional body for talking therapy and counselling. Provides information and a list of accredited therapists.
Improving Access to Psychological Therapies (IAPT)
nhs.uk/service-search/find-a-psychological-therapies-service
Information about local NHS therapy and counselling services, which you can often self-refer to (England only).
National Institute for Health and Care Excellence (NICE)
nice.org.uk
Produces guidelines on best practice in healthcare.
NHS Service Finder
nhs.uk/service-search
Searchable database of NHS services in England.
No More Panic
nomorepanic.co.uk
Provides information, support and advice for those with panic disorder, anxiety, phobias or OCD, including a forum and chat room.
No Panic
0300 7729844
nopanic.org.uk
Provides a helpline, step-by-step programmes, and support for people with anxiety disorders.
Samaritans
116 123 (freephone)
jo@samaritans.org
Freepost SAMARITANS LETTERS
samaritans.org
Samaritans are open 24/7 for anyone who needs to talk. You can visit some Samaritans branches in person. Samaritans also have a Welsh Language Line on 0808 164 0123 (7pm–11pm every day).
Triumph Over Phobia (TOP UK)
topuk.org
Provides self-help therapy groups and support for those with OCD, phobias and related anxiety disorders.