Tab Ahmad

What does a panic attack feel like? No two people would give exactly the same answer, and the intensity of attacks can vary. But for me, the simple answer is ‘terrifying’. It is being convinced I am about to have a heart attack, or drop dead from a brain haemorrhage or that the symptoms of a minor physical illness are the signs of terminal cancer. It is hyperventilating and being immobilised by fear as darkness descends and eclipses me, sending my brain and body into turmoil. During my worst phase, I thought I’d actually gone mad.

I first started experiencing panic attacks when I was a child, four decades ago, between the ages of ten and twelve, but I only sought professional help in 1996, when a series of dreadful shocks, including the sudden deaths of three friends, one of whom was murdered, triggered a period of debilitating attacks. This was also the year that I set up my first business and was working all hours. My cognitive behavioural therapist said the attacks were my body’s way of saying, ‘I’ve had enough. Your turn’.

He told me to cut out caffeine, alcohol and all other stimulants – to dial it down, so that my body, in his words, ‘felt too boring to have an attack’. I didn’t take much persuading. I was in such a state, I felt I had no choice but to take his advice. In the most acute period, I was having 3-4 attacks a day. It felt like playing 3-4 games of squash a day. I was exhausted. I was unable to sleep, sometimes unable to have a shower or go shopping for fear something dreadful would happen. Even knowing on some level that I was unlikely to die, that the fear was excessive, did not help – the attacks were so distressing, that the threat of them filled my life with dread. A debilitating fear of the fear. I knew I had to find the tools to manage the panic attacks so that I could function.

It took time. Events in our life can shape and change our perceptions, and this in turn can have a profound impact on our mental health. I went through another very acute period of panic attacks in 2001: my sister died four weeks before I got married, and that personal loss was compounded by the horror of 9/11 two weeks before the wedding. Eventually, though, I learned how to avoid being overwhelmed by events that are outside my control. The key was understanding that I do have some control – not over the event itself, but over how I choose to react to it.

The tools that put me back in control included CBT and mindfulness techniques (what used to be called ‘self meditation’). I became so good at these I could do them standing up on a crowded tube on the way to work. I became more aware of my stress triggers and thought patterns, so that I could to some extent avert or minimise the attacks. I also learnt about what happens in my body and brain during an attack, the fight and flight response. All of this helped me to accept that once a scary thought is triggered, there’s not much point in fighting your reactions too hard. Acknowledging the arrival of scary thoughts, letting them pass through me, and then noticing when they have gone, is easier. And this gave me the space to be kinder to myself during an attack, instead of making it worse by desperately attempting to shut it down or control it.

Being kinder to myself also enabled me to reach out to others for support and let them know how they could help. Little by little, the panic attacks became less intense, and less frequent. Now they are rare.

I am always aware that they can return. What is different, is that the idea of them doesn’t scare me in the same way. Changing my mindset, with the help of therapy, and my amazing support network of family, friends and colleagues, has allowed me to live with them in a way that felt impossible before. I learnt to allow myself to think more flexibly, to frame the situation I was in more accurately, and to connect – to my body, to myself, and to those who could support me.

Tab Ahmad

Over this last year I’ve also been spending as much time as possible outdoors. I’ve found the mindfulness techniques to be even more effective if I practise them while sitting in the garden; it isn’t just the fresh air or the sun on my face that soothes, it is the sounds – the trees rustling and birds singing. The theme of this year’s Mental Health Awareness Week is ‘nature’, and there is increasing recognition that access to outdoor spaces, and enjoyment of nature, is important to our mental wellbeing.

It is only very recently that I have gone public with my personal story of living with panic attacks. I am speaking openly because I feel well enough to do it, because awareness is improving, and because I want to play my part in breaking down the stigma.

Mental health professionals are warning that the mental health toll of the Covid pandemic will be huge. Covid has blown a hole in the notion that we are in any sense in control of our world. My worry is that for people who are already affected by panic attacks and other mental health challenges, the pandemic may be experienced as a vast additional pressure. Supportive working cultures have never been more important. The good news is that employers appear to have some awareness of this. At EmployAbility we are hugely encouraged by the increasing willingness of corporate clients to reach out to us so that they can support their people.

I spent years hiding my panic attacks from friends and, especially, from colleagues at work. Despite the therapy I was receiving as far back as the mid ‘90s, I felt my panic attacks were private and personal, something I needed to cope with on my own. I thought if I was too open, there would be a professional price to pay. If I was starting out in my career today, I hope I would feel very differently. It is up to all of us to make that change, to provide a safe space in which people feel comfortable to reach out for support.

Tools that can help you cope with panic attacks

  • Being supported by CBT
  • Understanding the mechanism of what happens to your body during an attack
  • Learning self-meditation/mindfulness techniques
  • Becoming aware of your triggers and thought patterns, as well as the connection between thoughts and physical sensations
  • Prioritising physical wellbeing – taking time out to de-stress, eat more healthily and exercise
  • Keeping an eye on emotional wellbeing – selecting a group of supportive ‘go-to’ friends and family
  • Being kind to yourself during an attack, waiting for it to pass, and knowing it will
  • Not shutting yourself off from more and more places and situations

How you can help a colleague who experiences panic attacks

  • Don’t minimise or try to rationalise someone’s fears – they know it is not rational, but it is still real
  • Do what you can to create a safe space or rest room at work, a place where people can go for quiet if they need to
  • Be explicit, in company policies and everyday interactions with colleagues, that support and adjustments are available and that people will not be judged for reaching out for that support
  • Allow and encourage people to take time out for therapy or wellbeing days
  • Listen, be compassionate, and non-judging
  • Do not feel you have to be a mental health expert – people do not expect this from managers or colleagues. Know instead sources of support, inside and outside the organisation that you can point people to. This can be mental health services and organisations such as EmployAbility which can provide a bridge between the individual and their employer, supporting both

If you’ve been impacted by panic attacks or any other mental health condition and would like to have a confidential discussion about individualised adjustments that may help you in the recruitment process or workplace, please contact [email protected]

If you would like to invite Tab Ahmad to speak about mental health at your organisation, or would like to discuss what your company can do to be more supportive of your employees, please contact [email protected]