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Navigating panic attacks and anxiety in public places

April 1, 2024
Louise Wills

Although anxiety and panic attacks are never easy to manage, most of us would agree that if we had the choice, we’d rather navigate these feelings in our own homes. However, anxiety and panic can creep up on us when we least expect it, which means that we might find ourselves confronted with either or both of these issues in a public space.  

Coping with a panic attack or anxiety in public can add pressure to the situation. Not only do you have to deal with the symptoms (we’ve listed them further down), you may also feel as though you have to ‘act normal’ so that no one around you notices that there’s something wrong. This can make the experience even more unpleasant, and if someone does catch on, you might be left feeling a little embarrassed.

However, if you do find yourself in this position, it’s important to remember that you’re far from alone. 60% of people in the UK have experienced anxiety that’s interfered with their daily lives, while up to 1 in 3 people have a panic attack at some point in their lives. There’s also nothing to be ashamed of; you can’t help your reaction and the experience is far worse for you than it is for anyone else around you.

Learning about how to manage anxiety and panic attacks can help you to feel more prepared, so that if you do run into these issues in a public space, you’ll be equipped with information and tools that can help you to navigate the situation. Don’t let the fear of anxiety or panic attacks stop you from living your life.  

What is a panic attack?

A panic attack is a sudden feeling of intense fear, that’s accompanied by physical and psychological symptoms. Sometimes, a panic attack happens following an obvious trigger, but they can also come seemingly on out of the blue. Panic attacks tend to last between 5 to 20 minutes, with the peak of the attack at around 10 minutes - they don’t go on for days, like anxiety attacks can. More about the difference between panic attacks and anxiety attacks here.

Panic attacks can be a one-off event, so if you’ve experienced one, this doesn’t necessarily mean that it’ll happen again. But for some people, panic attacks can be triggered by certain circumstances, which can lead them to worry that if they’re in the same situation, they’ll have another one. However, by worrying about it, they can actually trigger the panic attack that they’re trying to avoid. Repeated panic attacks could be a sign of panic disorder.  

Physical symptoms:

  • A racing heartbeat
  • Chest pains
  • Struggling to catch your breath
  • Trembling and shaking
  • Feeling very hot, cold and sweating
  • Feeling sick
  • Feeling faint

Psychological symptoms:

  • Feelings of intense terror
  • Feeling like you’re going to die
  • Feeling like you’re losing control
  • Feeling disconnected from your mind, body or surroundings
  • A smothering sensation

What is anxiety?

Feelings of anxiety are a natural response to the perception of a threat. However, sometimes that natural response goes into overdrive and gets the better of us, consuming our thoughts and impacting our behaviour. When this happens, it means that some sort of ‘trigger’ has converted our normal levels of worry into an anxiety disorder, which is a mental health issue. An anxiety attack is when feelings we have peak too high, or go on for too long.  

When we’re out in public, we tend to be less in control of our environment than we are at home, which can mean that it’s more difficult to anticipate and manage our triggers. Perhaps you receive some difficult news while you’re at work, or the underground train that you’re on stops in the tunnel for an unusually long time mid-journey. This could cause you to worry and these worries could spiral out of control.  

Physical symptoms:

  • Pins and needles
  • Shallow breathing, or breathing rapidly (hyperventilation)
  • Feeling nervous, restless or tense
  • Feeling sick or dizzy  
  • Trembling or shaking
  • Experiencing gastrointestinal problems, such as IBS
  • A fast, thumping or irregular heartbeat  
  • Sweating or hot flushes  
  • Feeling weak or tired  
  • Muscle tension

Psychological symptoms:

  • A sense of looming danger, panic or doom
  • Worrying about anxiety itself (worrying that you’re worrying too much)
  • Feeling like you can’t stop worrying, or that bad things will happen if you stop worrying
  • Difficulty concentrating
  • Feeling like you’re losing touch with reality
  • Feeling tense, nervous or unable to relax  
  • Feeling like the world is speeding up or slowing down

How to manage a panic attack or severe anxiety in public:

  1. Talk yourself through it

Panic attacks are scary by nature, but it’s important to remember that how you’re feeling is just your body’s natural response to an adrenaline rush, not an indication that there’s something physically wrong with you. Similarly with anxiety, what you’re worrying about is likely blown out of proportion and not worth the stress it’s causing you.

When going through either of these situations, talk to yourself like you’d talk to a friend; remind yourself that everything is going to be fine and that these feelings won’t last. There might be a little bit of embarrassment to face if someone’s noticed that you’re struggling, but that’s okay too. Be kind to yourself and try not to dwell on it.  

  1. Accept your thoughts and feelings  

During a panic or anxiety attack, it’s normal for your thoughts to spiral, but this can prolong the situation or make it worse. Instead of worrying about the past or the future, try to stay present. Let your thoughts and feelings come and go; notice them but don’t attach meaning to them by engaging or responding to them as if they’re dangerous.

  1. Practice breathing techniques

Breathing techniques are a powerful tool when you’re feeling panicked, fearful or anxious. Focused breathing can help you to calm down and stay in the now, which can ease your symptoms. Breathe in slowly and deeply through your nose, then breathe out slowly and deeply through your mouth. It can be helpful to count from 1-5 on each breath.  

  1. Acts of self-care

If you’ve had a panic attack or your anxiety has been triggered in public, when you get home it’s important to take care of yourself. You’ve been through something difficult and now it’s time to rest and recharge your batteries. Self-care could look like having a hot bath and an early night, watching your favourite tv show with a weighted blanket or speaking to someone you trust about what happened.  

  1. Talking therapy

Panic attacks and anxiety can be debilitating, but the symptoms can be treated and managed. Cognitive behavioural therapy (CBT) can help you to understand what you’re experiencing and why, providing you with strategies, skills and techniques for coping.

At ieso, we offer typed CBT, where a patient and therapist can ‘speak’ to each other by sending messages back and forward via our online platform. Our service is confidential and non-judgemental. Find out more about how to get started here.

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This blog has been written by a member of the clinical team at ieso.
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