Panic attack during stress and burnout: the fight against panic attacks

A panic attack in case of burnout is very common. We almost daily meet people who have to deal with this. We often see people who have multiple panic attacks a day. Reason for us to provide more information about this. Through this article we would like to show you what causes anxiety and panic attacks and what you can do about it. (and put your mind at ease)

More and more people are experiencing stress for whatever reason. Through hustle and bustle, fatigue, going over your limits, your stress system is working and chances are that you will become more and more vigilant…. There must be an annoying colleague lurking around to hand over some more work to you, clients are asking more and more and want answers faster and faster, you feel the hustle and bustle is getting bigger and the feeling that you have ‘everything’ under control is getting smaller and smaller. Because of all this tension your body is on edge, something only has to happen and you just panic: HELP!

Fear and panic

A lot of people suffer from fear. Did you know that 1 in 5 people experience this every day? Fear can control your life enormously, fear can slowly creep into your life and eventually lead to multiple panic attacks every day. Stupid! Fear is actually meant as a natural survival mechanism that saves your life. There is danger, our bodies get a signal that it is time to fight or flee. We manage to react immediately with the help of the hormones cortisol and adrenaline.

Luckily we don’t get into so many acute threatening situations these days, unfortunately we do know threatening situations that last for a long time (job insecurity, 24/7 availability, etc.) and you are not considered as a realistic threat to yourself. It can even get so bad that you get fear or panic for situations you once were not afraid of at all.

As a result, anxiety and panic attacks are becoming more common (in the Netherlands almost 4% of people have had a panic attack before). If you haven’t experienced it yourself, then you certainly know a colleague who suffers from fear or panic.

The onset of a panic attack

A very important cause of an attack is stress. The pressure of daily life causes a continuous stress reaction. A stress reaction that was traditionally meant to help us escape from danger with all your heart. We hardly notice this anymore because of all the small factors that have come to dominate our lives such as your mobile phone, a family, traffic jams, work pressure, a lack of self-control, illness, etc.

Known causes of a panic attack:

• Suddenly you’re scared, you don’t know what to do anymore. You’re nailed to the ground.
• Thinking that a situation is worse than it actually is. The environment would call this exaggeration. But you feel differently
• The direct consequences of a stress reaction (palpitations, muscle tension, sweating) that trigger the fear of becoming very ill, or even dying.
• Fatigue
• Previous panic attacks and feelings similar

What’s a panic attack?

Tension in the body can be so high that you get the feeling that your body or your mind can no longer cope. When this feeling takes control of your thinking, you have a panic attack. You have lost control and are at the mercy of stress hormones such as cortisol and adrenaline. You don’t want to think logically anymore. All you want to do is run away, hide yourself or seek help from someone close to you.

So a panic attack is a fierce flurry of fear, where you quickly feel weird and anxious and that feeling continues to intensify. After a panic attack you are usually exhausted. In a panic attack, you often feel the fear or strange feelings coming, especially after the first time, a bit like a tsunami on its way to you. In many cases you will then start thinking like “oh no, not again, not here, not now, what will everyone think?”

Symptoms of panic attack

Panic attacks are accompanied by excessive sweating, shortness of breath, chest pressure, heart palpitations, nausea, dizziness, muscle tension, fear of fainting, many thoughts going through your head, etc. Because some symptoms resemble a heart attack, many people are afraid that their heart is affected. Doctors regularly get people with heart problems while there are no physical signs.

Because the body is in a ‘top sports state’ for a few minutes, up to a few hours, one often feels tired and extinguished after a panic attack. Often you don’t know how to choose between fighting and fleeing. You’d prefer to run outside, but you can’t do that in the middle of a shop or a party. Then an unbelievable amount of energy is delivered to stay calm and let the outside world know nothing. And during a burnout there is so little energy!

How do you recognize a panic attack?

If you are ambushed by an intense, excessive sense of anxiety, which peaks in a few minutes, there is a panic attack. Such an attack feels very physical.

Complaints that often occur at times when fear prevails:

• heart palpitations, sweating, chills, dizziness, tremors
• rapid breathing
• shortness of breath, an annoying feeling in the chest
• tingling or numbness in hands and/or feet
• dry mouth, nausea, stomach ache, vomiting or diarrhoea
• headaches, redness, feeling of getting away
• Confusion: Not good anymore who or where you are.
• the feeling that you’re losing control of yourself, going crazy or dying

When the panic starts, reasonable thinking stops. Be aware that you can’t think clearly. Experiencing that someone is supportive is often quite reassuring.

Are panic attacks re-occurring?

In a fear/panic attack, it is important to know that the attack is self-limiting. Either it’s self-limiting, the fear will always subside. Our body is simply not able to be in the highest state of readiness for long.

Research shows that breathing one’s own exhaled air has no added value compared to a calm approach with careful attention.

A panic attack will often be difficult to understand by someone who does not have these fears. To get rid of panic attacks permanently, it is useful to understand how fear works.

Causes of a panic attack (stress)

Anyone can have a panic attack, but there is evidence of hereditary predisposition. Also, insecure people are more likely to have anxiety and panic attacks than confident people. In addition, factors such as fear of failure, setting the bar high for yourself, high standards and values, an unpleasant private situation and various stress factors play a major role in having panic attacks.

Fear is one of the four basic emotions we have as human beings: we can be afraid, angry, sad or happy. Very normal, very healthy and also necessary. Without fear, we quickly end up in a bad way. On the highway we brake on time, thanks to fear. It is our survival instinct that allows us to react quickly and well when we signal danger. Fear is almost always caused by what we think and not by what really happens. When you think of danger, your body reacts as if you are already in real danger.

In addition, fear is an emotion that we least readily accept. You don’t have to be afraid… You resist it… but resisting a feeling makes the feeling stronger. More tension… more thoughts… Don’t be like that, you don’t have to worry so much… it doesn’t help. What does help is acknowledging the fear, support, understanding.

It could even be that the fear of having a panic attack causes a panic attack. Then you really are in a vicious circle and it is often difficult to get out of it without help (otherwise you would have done it already).

Panic attacks are getting worse

It’s quite understandable that the body reacts to a signal that has caused panic in the past. Think about the time you burned yourself over a fire. From that moment on, most people have a certain awe of fire and they keep their distance. Every fire you see evokes the memory of the pain and the body avoids it. In the case of a fire, a sensible decision has been made and its cause and effect are clear.

But in case of panic, that’s often not the case. An event that evokes fear is linked to something innocent, something that has nothing to do with it. An example: suppose you have a panic attack because you are very tired, you have lived under great pressure for a long time and you hear that you are not yet allowed to go on holiday. If at that moment there happens to be a brass band playing, then playing the band can be linked to the fear. The fanfare is then seen as the cause of the panic attack. And the result is that someone no longer goes to an event where a fanfare is playing.

The fear of a panic attack

And fear grows, so also events where other music is played become unsafe, for example music in a supermarket, a classical concert or a musical. And if the music becomes frightening there, then also places where there is a lot of noise can become ‘scary’ and cause panic.

The explanation is that it is in every human being to avoid things you fear. After all, fear is often justified. When you meet a tiger in a jungle, it is good to be afraid. It sets you in motion and takes care of it before you come looking for a safe haven. But in this case it is neither right nor logical. There is a coincidental relationship between panic and a brass band!

Why a panic attack in case of burnout?

In case of burnout, the hormonal system is completely disturbed due to prolonged overburdening and the intervention of the body as a result. Your stress level is already so high that the last step to a panic attack is taken. A panic attack with burnout is therefore not strange.

Even after a burnout, people can still suffer from a panic attack. Life after a burnout has to be coloured in a different way in order not to have the same stress reaction every time. We have previously written an article for this that you can find here: life after a burnout

The relationship between panic and burnout

Burnout and panic that doesn’t seem to be connected at first. Nevertheless, in practice we often come across people who do. And what is the cause and effect? A burnout makes it more difficult to control your emotions, so a panic attack is quicker. On the other hand, the fatigue that precedes the burnout also makes you susceptible to panic. Sometimes the first panic attack is the start of the burnout. And often the person who has the panic attack finds it very unpleasant and there is a lot of shame.

So it is important to tell a bit more about how a panic attack occurs and what you can do about it. Because it is certainly possible to do something.

Loss of control in case of panic attacks

Many panic attacks are caused by a loss of control. Especially in the case of burnout, in which the body reacts rather strangely because of all the stress hormones, there is a rapid loss of control. You don’t understand why your body reacts this way and you want to get rid of it as soon as possible. However, the frustration causes extra stress and loss of control.

Panic attacks are sometimes part of a burnout and pass after the burnout has recovered. A burnout often manifests itself on the weakest part of the body. For some it is the back, for others the stomach and for others it expresses itself in panic attacks. Usually panic attacks are partly hereditary, although this does not have to be the case.

In order to minimize loss of control, it is a good idea to start describing yourself, or together with a coach, the points you want to keep control over. This will help you because you will be able to deal with your panic attacks in a pro-active way, instead of that annoying feeling that a panic attack just comes on without you having any control over it.

Shame for a panic attack

Another important one we often hear. In a burnout, shame always plays an important role. We sometimes come across people who at the beginning of every morning go out on time so as not to let the neighbours know that they are not at work. People are often ashamed to panic. Nobody wants to be seen as weak and especially when you realise that your fear is not logical, it is difficult to make it clear. This also creates stress, which increases the chance of a panic attack.

You’re never your panic attack!

Remember, you’re not your panic attack. Although it takes away a lot of fun in your life, turns your daily life upside down and hinders you a lot, it is always something inside you. So it’s not you! Compare it to losing a leg: When your leg is amputated, it hampers your daily life considerably, but you are still human with beautiful and less beautiful qualities.

Panic attacks keep coming back

What doesn’t work is thinking that it will go away on its own, at least once you’re in the vicious circle. You’ll have to start changing things in your life, otherwise you’ll get stuck in fear. People feel unhappy when they don’t have a free choice. How annoying it is to have to say no to an outing because you are afraid you will have a panic attack if there is loud music or a lot of noise.

You have to watch the soccer game on TV, because in a stadium it can just go wrong. Or not dare to go out with friends for a day because there are probably shops where music is played all the time.

Helping someone with a panic attack

Can you help as a colleague or manager, friend or partner?

This is how you come to the aid of a colleague who is having a fear/panic attack:

1. Always make sure you’re safe.
2. Recognize the fear of your colleague, he’s there… even if it’s unrealistic and exaggerated. Indicate that you see that your colleague is anxious.
3. Call 112 if your colleague loses consciousness, in case of severe tightness or chest pain.
4. Let your colleague breathe quietly, 3 seconds in, 6 seconds out. The too fast breathing can also be slowed down by keeping one nostril closed and breathing through the other nostril or by breathing through almost closed lips. A slow, deep abdominal breathing is also a good breathing technique to control too fast breathing.
5. Distract your colleague, talk about something other than physical sensations helps, look outside, have knee bends, count backwards from 100 to 1 (causes your colleague to be engaged in something other than fear).
6. Go for a walk with your colleague. Walking is the best way to control fear.

After a panic attack

Your colleague has calmed down by now and will feel very tired. Such an attack is intense, takes a lot of energy and recovery is certainly in order.

1. Make sure that your colleague does not avoid the place or a moment when fear or panic started. If it happens again, it is important to know what the golden rule is: never leave a situation before the fear has subsided…
2. Offer a listening ear.
3. An important question is why certain situations create tensions, perhaps your colleague is not even aware of this. Ask the question, but don’t force yourself. What does your colleague need?

Eight reminders during a panic attack

For people having panic attacks as well as bystanders:

1. The feelings are normal physical reactions.
2. They’re not dangerous.
3. Don’t add scary thoughts (I’m dying, you see my heart is failing).
4. Describe what happens (I am tense and my body reacts to it with palpitations).
5. Wait until the fear subsides and goes away.
6. Notice when the fear subsides.
7. Think about what you can do now (think differently, breathe calmly etc.).
8. Take the first step (bend your knee, breathe through 1 nostril, etc.).

Get rid of panic attacks

In case of burnout, it is often ‘simply’ a matter of recovering. If a burnout is not the cause of panic attacks, there is usually not one solution, but the solution must be found in a holistic approach that leads to a more balanced life. Usually the solution is found in good breathing or in surviving a panic attack. The critical question you can ask here is whether better breathing will prevent panic attacks, when the wrong breathing is a consequence of stress (which is often the case) Wouldn’t it be better to lead a less stressful life?

Dealing with panic attacks is often a lengthy process that requires patience and perseverance. Like a fear of mice, it doesn’t help to just jump in and accept the fear. To be honest, you don’t just jump between mice if that’s what you’re afraid of. It often takes a little push to do just the things you don’t like the most. Because that is the way to overcome fear.

You can only convince yourself that you don’t have to be afraid if you confront your fear. You do this step by step. So to take the example of the brass band again: Together to a performance of a brass band when you are well rested, the pressure of your shoulders is over, the stress is over and you are back in life in a different way. Then you can have a different experience and convince yourself that panic and fanfare are not related.

Training and coaching

Milltain provides training and coaching for private individuals and organisations. Our team consists of 35 coaches and trainers who have now helped thousands of people struggling with stress and burnouts.

Milltain for private individuals:

Are you stuck in life because of stress or a burnout? We developed an effective online programme that is fully focused on the complete recovery from a burnout. More than 2000 people have successfully completed this training!

Movement and nature play prominent roles in this training. Recovery is a process that contains peaks and troughs, and that’s something we know all about. Our highly experienced coaches provide you with active support.

Learn more: Stress and burnout coaching