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- Panic attacks are sudden, intense reactions to anxiety that occur unexpectedly and last about 20 minutes.
- Panic attacks can be triggered by stress, like heavy workloads of public speaking, and are characterised by physical and mental symptoms such as chest tightness, shortness of breath, and a sense of dread.
- If an employee experiences a panic attack, stay calm, find a quiet place, and help them control their breathing.
- To support an employee who has panic attacks or a diagnosed panic disorder, find out which adjustments could make them feel more comfortable at work, such as flexible working, regular check=ins, regular breaks, and mental health support.
If you manage an employee who has panic attacks at work, it's important to be prepared and know how to support them ahead of time. Panic attacks can happen to anyone, and for no obvious reason. Although visceral and frightening, panic attacks aren’t physically dangerous, and will usually subside in about 20 minutes. Of course, 20 minutes feels like a really long time when you’re struggling to stand, think or catch your breath.
The really nasty thing about panic attacks is that they can create a cycle of fear about when, where or whether another one is going to happen. And that can have a big impact on someone’s day-to-day life. In this guide, we’ll look at how to recognise the symptoms of a panic attack and how to support an employee who experiences panic attacks at work.
What is a panic attack?
A panic attack is a rush of intense mental and physical symptoms which can come on very quickly and for no apparent reason (NHS)
A panic attack is a strong physical reaction that happens when a feeling of anxiety – a sense of worry or unease – tips over into intense fear or terror. Panic attacks can be a reaction to prolonged stress (like being overworked), sudden stress (like public speaking, intense exercise or crowds), or a symptom of a mental health disorder. They can also be triggered by some medications, or drugs like caffeine and alcohol.
What causes a panic attack at work?
Panic attacks are not predictable or logical experiences, which is part of what makes them so scary. So what causes a panic attack? There’s still a lot that science doesn’t know about exactly what tips a feeling of anxiety into a full-blown panic attack, but the prevailing wisdom is that it’s based on our brains misinterpreting signs of stress and danger.
Our bodies respond to danger by releasing hormones like adrenaline and cortisol. This ‘fight or flight’ response is automatic, and was designed to keep us safe as cavepeople. It makes us breathe harder and diverts oxygen to our muscles so that we’re primed and ready to escape a woolly mammoth. When someone experiences a panic attack today, those same hormones flood their system – except there’s no physical danger to respond to when a panic attack is happening at work. For that person, it’s a sudden and scary episode, which might be made worse by being surrounded by your co-workers or the commuters on the no. 42 bus.
A high-pressure work environment can also case a panic attack at work. Common triggers include:
- A heavy workload and tight deadlines
- Public speaking or presenting
- Conflict with managers or coworkers
- A big change or step up in responsibility (e.g. a promotion or role change)
- Social events or after-work drinks
Is a panic attack considered a mental illness?
Panic attacks can be a one-off, or a symptom of an ongoing condition. Someone might experience panic attacks as part of a wider anxiety disorder, but panic disorder is a distinct mental health condition, too. You might be diagnosed with panic disorder if you experience regular panic attacks, and are living with a continuous fear of having more in the future. This fear can stop people wanting to go out in public or on their own, so it’s best to seek treatment as soon as possible.
The difference between anxiety and panic attacks
Panic attacks can often be confused with anxiety attacks, and the two share a number of symptoms. The main differences between panic attacks and anxiety attacks are related to two key areas:
- The intensity of the symptoms: anxiety attacks symptoms tend to be less intense than panic attack symptoms
- How long the symptoms last: panic attacks tend to start quickly and finish abruptly (usually peaking after around 10 minutes), whereas anxiety can build and persist over time (sometimes lasting for several months).
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What are the symptoms of a panic attack at work?
Someone having a panic attack in the workplace may have a combination of physical and mental symptoms, including:
- A tight chest and racing pulse
- Feeling faint, dizzy or nauseous
- Shortness of breath or a choking feeling
- Chest pain
- Shaky legs
- Chattering teeth
- Ringing ears
- Feeling too hot or too cold
- Distorted vision
- A sense of dread or apprehension
- A feeling of dissociation from your mind, body or the world around you
- A strong fear that you’re going to faint, die or lose control
💡 Most panic attack symptoms last for five to 20 minutes
Panic attack symptoms tend to come on suddenly, without warning and sometimes for no apparent reason. It might sound obvious, but when someone’s having a panic attack, they will be unable to work. They’re likely to feel exhausted, shaky or shaken for a while afterwards too, so it might also be difficult for them to work for a few hours.
Therapy is shown to help people cope with underlying feelings of anxiety, fear and stress which can lead to panic attacks.
What to do if an employee has a panic attack at work?
The first time someone experiences a panic attack, it’s difficult to know what’s happening or when the symptoms will stop. Understandably, plenty of people think they’re having a heart attack. If someone you work with experiences sudden symptoms like these and they can’t communicate with you, then it’s always worth calling an ambulance and letting the pros take over – just in case.
How to support a colleague who is experiencing panic attacks
1. Stay calm. Try to keep your voice and movements measured and predictable.
2. Ask what they need. Use clear yes or no questions like “Would you like me to go outside with you?” If they refuse your help, give them a bit of space (but stay nearby). They might just be feeling overwhelmed or embarrassed that this is happening while they’re at work.
3. Find a quiet place. Steer them towards somewhere private to sit, if you can.
4. Help them to control their breathing. If they’re open to your help, model slow and deep breaths (in through your nose for 5, out through your mouth for 5) and ask them to breathe along with you. Some people find that stamping on the spot helps them to control their breathing.
5. Remind them that this will pass. Reassure them that these symptoms are not dangerous and will be over soon. Getting them to place their hand over their heart and focus on the beat is another way to tune into their senses and remind them that they are still okay and breathing.
If you’re their manager, encourage them to take some time to recover once the panic attack has passed. It might be nice for them to hear that you know panic attacks can happen to anyone, and this won’t change the way you see them at work.
6 ways to support an employee who has panic attacks at work
If an employee tells you as a manager that they’ve been having panic attacks or have a diagnosed panic disorder, it’s important to find out which adjustments you could make to help them feel more comfortable at work. Every employee is different, so ask open questions and try not to second guess what might help them most.
1. Consider more flexible working
If your colleague finds that your workplace environment is making their anxiety worse, then think about whether working from home or from a different location for a while would help. Tweaking their hours slightly to avoid a busy commute might also make a big difference, depending on what situations seem to trigger their panic attacks.
2. Have regular check-ins
More one-to-one meetings with your colleague will help you to keep an eye on how they’re doing, and give them an opportunity to say whether they need any further adjustments to their role. A robust employee wellbeing survey could also help you to recognise and step in if your team’s mood takes a dip.
3. Keep them safe
If your employee drives as part of their role, then a panic attack could put them (and others) in a dangerous position. Move them away from driving duties until they are no longer at risk. Legally your colleague needs to disclose a panic disorder to the DVLA, too. Find out more about driving with a health condition on gov.uk.
4. Break the stigma
Talking about mental health in your workplace is the best way to get employees to open up when they’re struggling. Panic attacks have no reflection on how capable someone is as an employee. And in the right environment, the person who’s experiencing panic attacks might actually find it liberating to discuss their challenges with colleagues. Besides training up your management team to recognise poor mental health when they see it, there are plenty of other low-cost ways to make mental health more visible in your company.
5. Encourage everyone to take their breaks
Both long term stress and short-term stressors can trigger a panic attack. Stop stress from building up in your team by making sure everyone actively prioritises a healthy work/life balance. Normalise taking all of your holiday allowance by talking about your days off – you could even set a KPI around taking time off, if you notice that people are hesitant. Encourage your team to take regular breaks from work and to get outside at lunch, too. One good way of making breaks more visible is by adding an emoji to your Slack status when you’re taking a walk or stepping away from your desk.
6. Point to the right resources
As a manager, you can’t diagnose a colleague with a panic disorder, and it’s not your responsibility to recommend treatment options, either. But once you’re having a conversation with your employee about panic attacks, it’s a good idea to remind them of any professional mental health support that your business offers. If you haven’t got any external support, then a good place for your colleague to start is with their GP.
If your employee is experiencing panic attacks as a symptom of an anxiety disorder, take a look at our tips for managing someone with anxiety at work.
Treatment for panic attacks
Panic disorder is treatable, and the sooner someone seeks help, the better. Treatment usually involves a combination of medication, lifestyle changes and therapy, where a therapist will talk through the circumstances that surround a panic attack and suggest coping strategies to manage triggers when they come up.
How effective is therapy for panic attacks?
There are several therapies that can be used to treat symptoms of panic disorder. Cognitive Behavioural Therapy (CBT) can be particularly helpful for employees struggling with panic attacks, where a therapist will explore the triggers and suggest coping strategies.
💡 Research suggests that therapy can be highly effective in reducing the frequency and severity of panic attacks
In fact, about 80% of people with panic disorder who complete a course of CBT are panic-free at the end of treatment.
With Spill's corporate therapy, your team can choose to speak to qualified therapists with over 80 specialisms (including anxiety and panic disorders) to get targeted support when they need it and help them feel psychologically safe, valued and cared for at work.
While panic attacks at work can be incredibly distressing and uncomfortable, they are not usually dangerous in and of themselves.
However, during a panic attack lots of people experience physical symptoms like chest pain, shortness of breath, or a pounding heart. These symptoms can feel very scary, and can often make people feel like they're having a heart attack or other medical emergency, leading to further panic and distress. It's important to remember that these symptoms will pass, usually in 5-20 minutes.
We would always suggest proper therapy as the best way to address panic attacks, because the nature of anxious thoughts that undermine someone's confidence and self-belief make it extremely hard to manage without professional help.
That being said, here are some tips to try yourself or share with employees:
Grounding techniques for panic attacks
You can’t stop the worry arriving, but what you do with these thoughts CAN be managed. Worry is just a feeling and NOT always a truth; we need to learn to see it but not always act on it. When this emotional thought pops in (which they do), build in a pause. This pause is crucial, and allows you space to choose what you do next. Grounding is one way to pause. Here are some grounding techniques and other ways to pause:
- Take 5 deep breaths. Notice how you feel. Take 5 more if you need. Repeat as required. Breath is the one area of our nervous system that we have power over. We can choose to calm the system by slowing it down. Don’t underestimate the power of breath
- Recite the alphabet/your name backwards
- Notice 5 things around you starting with the letter ‘T’
- Notice what you can smell, hear, see, touch
- Feel your feet grounded into the floor or your hands on a desk. Connect with your environment. Take a breath
- Massage your hand with your thumb from your other hand. Focus on the sensation
- Press your palms together hard
Coping techniques for panic attacks
The pause means you are not automatically doing what the emotional thought tells you. From here you then PIVOT and decide what to do next (this is coping). This may include strong affirmations such as:
- I choose to let that worry go (and get on with something else)
- I can cope (with hard things/with X)
- I am capable (and then plan any actions that may help)
- I don’t know what will happen but I am supported (knowing you don’t have to do this alone)
- It’s OK I don’t know right now, however when the time arises I will find what I need.
All of these things are practical skills and therefore take practice. The more you do, the better you get at it. There’s no magic pill or behaviour – it’s feeling fear, giving it a wink (pause) and walking forwards. You have everything you need inside of you or around you to manage this.
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