Suddenly you are terrified. Deep down in-the-bones terrified.
You’re shaking. You can’t breathe. Your heart is racing. Oh god – are you having a heart attack?
No, you’re not actually in any danger or dying. You are ‘just’ having a panic attack; a sudden episode of extreme fear that sets off an intense physical reaction.
Panic attacks in the menopause can be very frightening. People say it can also make you feel like you’ve lost control or you’re going crazy.
But it’s neither of those things. It’s not you – it’s your changing or imbalanced hormones that are to blame.
Oestrogen and progesterone usually work together to regulate mood. As these hormones drop off in midlife women are more at risk of developing anxiety, and if this is overwhelming or left untreated it can ramp up into panic attacks.
These scary episodes can be over in seconds or last for up to 40 minutes.
Menopausal hot flushes may also bring on panic attacks, as women can worry and feel self-conscious about sweating in public.
Big lifestyle shifts like children leaving home or parents becoming older can also be distressing at this stage of life and bring on an episode.
Our advice and guidance
One of the worst things about panic attacks is the fear that you’ll have another one. Set yourself free from this vicious cycle by following these hints and tips.
Cut back on coffee
Coffee, and all beverages rammed with caffeine like energy drinks and sodas, will stimulate activity in your brain. This is not helpful if you’re prone to panic attacks.
Swap your soft drinks to caffeine-free alternatives like squash, herbal teas and good old wonderful water. While you’re at it, consider cutting down or eliminating alcohol from your day as this winds up your brain cells too.
Whatever you decide to drink, stay well hydrated. Getting a dry mouth may feel like the start of a panic attack, and then trigger a real one.
Sort out your sleep routine
If you’re having difficulty sleeping or suffering from night sweats, like many women in the menopause, then you may be more likely to feel anxious and get panic attacks. This can then become a vicious circle.
Look at what you do leading up to bedtime. Do you give yourself breathing space after work and before your head hits the pillow? Do you put your phone away a couple of hours before you head upstairs? (Avoid screens before shuteye as they pump out blue light and trick your brain into thinking it’s daytime).
You can also set yourself up for quality sleep by not eating too much too late or having a warm bath – the drop in body temperature when you get out will help you snooze. Find out what helps you to relax in the evening and keep doing it.
Try a natural remedy
Many menopausal women swear by supplements to help them with their symptoms.
It’s always a good idea to check with your doctor that supplements won’t interfere with your other medicines before you try them out.
Calm down dear
There’s nothing more annoying or upsetting than someone telling you to chill out when you feel like you’re wound up like a clock spring.
But the best thing you can do to calm down during an attack is breathe. You don’t have to blow into a paper bag, anything that will structure and slow your breathing will help. Breathe in for five and out for 10. Simple but incredibly effective.
Hypnotherapy, yoga and meditation will all help you relax and focus on breathing deeply and slowly too.
Burn it off
You may not feel like pulling on your cycling shorts when anxiety strikes – but it could help you enormously.
Exercise uses up nervous energy, helps you sleep, helps regulate your hormones and encourages the beneficial breathing techniques we’ve just talked about. All these things can equal fewer panic attacks.
See your doctor
If you’ve tried all of the above and you’re still having regular or severe panic attacks, or you’ve started avoiding certain situations in case you have one, then you may have a panic disorder and need to see your GP.
Your doctor may encourage you to see a mental health therapist or prescribe antidepressants or sedatives. They can also check you over and rule out any heart problems or other physical symptoms worrying you.
Our advice to them
We’ve recommended that they avoid stimulants like caffeine, stays hydrated and practices good bedtime habits as a bad night’s sleep can lead to a more anxious day.
Create breathing space
No, we’re not saying leave them alone. We mean actually breathe together.
Slow, deep breaths initiate the parasympathetic nervous system, which is designed to calm us down. It helps a lot during an attack but taking time together to practice this when they are calm means she’s more likely to naturally practice deep and beneficial breathing.
Yoga and meditation are both great, and there are loads of ‘how to’ videos online and mindfulness apps which mean you can practice from the comfort of your living room.
Regular exercise can help them manage panic attacks during the perimenopause and menopause.
Exercise uses up nervous energy, helps them sleep, regulates their hormones and encourages the beneficial breathing techniques we’ve just talked about. All these things can equal fewer panic attacks.
Partnering up to go for a walk, swim or to the gym is also more likely to help them make exercise a healthy habit.
Ask her to explain
You may have felt scared before – but have you had a panic attack?
Don’t assume you know what it feels like for them. Gently ask them to explain the effect it is having on her physically and emotionally.
Ask them exactly what you could do to help them generally de-stress but be aware you may not be able to do anything to make them feel better. But they may not want answers, they may just need to talk – and be properly heard. Switch your listening ears on and give them your full attention.
Go with the flow
You might notice their panic attacks strike at times when you’ve got plans. Going to social events may feel more stressful than usual, as the pressure of keeping up appearances when you’re not feeling super-anxious is hard work. They may also be scared of having a panic attack – which brings one on.
Be prepared for plans to change at short notice and try not to put them under any pressure, even if it means you are missing out as well.
Suggest a supplement
Some people find natural remedies useful for managing this symptom.
Why not gently ask if they have tried anything like that?
If you’re worried about panic disorders, you should see your GP who can discuss your symptoms in the context of the menopause.
If you’d like more information, we have put some further references below for you: