I recieved an email requesting help in the case of a teenage boy suffering from panic attacks. As I am not a doctor, and have never met the person in question, I did not want to give out specific advice. I did however want to share some ideas with them, so I wrote the following reply. If anyone cares to differ about any of the advice or has something to add I would be very pleased to hear from you. I have blanked out a small part of the following to protect the privacy of those involved.
I am sorry to hear about this chaps current problems, sadly these difficulties are not uncommon amongst teenagers and young adults. I will advise you as best I can as someone who has been in a similar situation and come through it, but I should stress now it would be unethical of me to diagnose or be overly prescriptive as to your next step. I can however give you food for thought.
Also, I don’t know the — area but I think the treatments available should be more or less uniform across the UK. I don’t know what relation you are to the chap involved, but I will address this email to "you" assuming you are a close friend or relative!
OK, the first thing I want to say comes directly from my personal experience. When something like this happens (a series of nasty panic attacks) the first casualty can be your self-esteem. You don’t know what’s wrong with you, you think you are mad, people think you are mentally ill, they talk about you behind your back, it can be a really demeaning experience. So my first piece of advice is do not treat him any differently, he is not mentally ill and is just as capable as anyone else. Make sure he is in control and that his personal space is respected. Make sure his point of view is listened to and his decisions about his own life are treated with respect. Never, and I mean Never, run rough shod over his opinions are try and take the reigns of his life in any way shape or form, however frustrating it might be if you think he is doing some wrong. Of course those around him will make suggestions, but they must stay as suggestions which he clearly has the right to disregard, not the kind of suggestions that demand to be acted on. Respect him as a young adult, don’t be a busy body, even if you think you are just being caring. This is not your problem, it his his problem, which he has to get over with the kind support of those around him. Stop and think about whether you are caring or controlling, don’t worry if you think you have been controlling, just change. From personal experience I think this issue is very important.
Secondly, attitude is very important. You mention he thinks he is going to die. This is natural it is also extremely distressing. The truth is panic attacks are harmless: don’t kill, don’t make you mad, don’t have long lasting effects. Just very very unpleasant. I really recommend the books and tapes/cds by Dr Claire Weekes. They are fantastic and not very expensive, you can I am sure get them second hand on amazon. I have said a bit more about them here.
You say he has been put on medication. I wonder which sort. Probably either a SSRI, a tranquilizer like Valium, or beta blockers. Either way in my personal experience, and accepted psychological opinion, it is imperative that these drugs are not treated as a cure. They are not a cure they are an aid while a cure is sort. There are all sorts of weird and wonderful cures on the market, most of which are complete rubbish. Please save your money and don’t go for anything which promises instant success. The power of marketing is strong and these people are after your money. I can not stress this enough!!!!!!!!!!!!!!! I don’t want you to waste the thousands I wasted!
That brings us to counseling and therapy. In my experience the NHS has been very bad about anxiety issues. I can’t tell what your friend needs in terms of counseling and therapy. I do know that he needs a several month long weekly or fortnightly programme. Ideally this would start with Cognitive Behaviour Therapy (CBT) and maybe assertiveness training where necessary. If CBT was not fully successful (and it is very good!) then other types of more analytical therapy should be considered. Bad news: the NHS uses almost all of its budget for this kind of thing on serious mental illness. Care for those with panic attacks is sadly lacking as you have found out. It is worth demanding CBT and seeing where it gets you. The only option might be private consultation which is likely to cost somewhere between £25 and £50 a session. There is also a book called Mind over Mood which is good.
I expect there is a local support group who will be able to advise you further on what is available in your area and where you might find a therapist. I would speak to MIND, the mental health charity. They are bound to know of something in your area, and you can find your nearest Mind office through their website.
Anyway, I hope this has been some help to you, and please to write back with any further questions and do let me know how your friend gets on!