What triggers a panic attack?

A panic attack typically happens when you are under physical or emotional stress. The effects of stress can accumulate so slowly that you may be unaware of the extent of your stress until a panic attack happens.

A panic attack starts with the amygdala, the brain region involved in processing fear, explains Dr Aaronson. When the amygdala perceives danger, it stimulates the sympathetic nervous system, she says, which triggers the release of the hormone adrenaline.

Adrenaline prompts an increase in the heart and breathing rate to get blood and oxygen to the muscles of the arms and legs. But during a panic attack, this response is exaggerated beyond what would be useful in a dangerous situation.

The intense rush of fear or anxiety you feel during a panic attack is usually accompanied by at least four of the following symptoms, says reachout.com.

• racing heart or palpitations
• sweating
• shortness of breath or feelings of choking
• dizziness, trembling or shaking
• numbness or a tingling sensation
• hot and cold flashes
• fear of dying or of losing control
• queasy stomach or nausea
• feeling detached from yourself and your surroundings.

How to react to a panic attack

Panic attacks come on rapidly, but usually subside within 10 to 15 minutes. Dr Aaronson believes the most important technique to help you ride them out is recognising that you’re having a panic attack and not a more serious medical crisis.

“Just knowing what it is helps people,” she says. To be sure, double check that you’re not experiencing any heart-attack specific symptoms such as pressure in the chest or pain that builds or radiates into the arms or jaw.

If you see someone having a panic attack (or are experiencing one yourself), try not to ‘feed the fear’ by responding with anxiety or fear, advises Justin Kenardy, Professor of Clinical Psychology at the University of Queensland. He suggests the following:

• Calmly remind the person that even though the experience is unpleasant, it’s not dangerous and will pass.
• Help to re-focus their mind away from the thoughts that are causing stress.
• Help them to slow and pace their breathing. For example, calmly ask them to breathe in for four seconds, hold their breath for two seconds, and then breathe out slowly over six seconds. Repeat for a minute or so, or as needed.

• walk to your colleagues’ desk instead of calling or emailing them
• stand up while reading this article.

If you work on your feet all day, follow these tips to prevent leg and foot injuries:

• buy proper footwear that fits your feet, preferably with leather uppers, and allow your toes to have plenty of room to wiggle and move
• get off your feet as often as possible, and during your breaks, elevate them if you can
• if possible, alternate shoes each day
• soak your tired feet in water to soothe them after a long day at work.

As soon as the media on COVID calmed down, it was replaced by fear-inducing articles about climate change. The big COP26 Climate Change Conference in Glasgow in late 2021 also put climate change on the top of everyone’s worry list. “This is our last chance to save the planet” was the main theme. “We must act now or everything will be destroyed.”

Climate change makes many people more anxious than COVID does

Not surprisingly, this news has made many people extremely anxious. Studies have showed that even in the midst of the uncertainty of a public health pandemic, concern about climate change significantly exceeded COVID-19. Study authors said, “These attitudes were consistent across countries rich and poor, big and small: from the United States and the United Kingdom to Brazil, the Philippines, India and Nigeria.”

This fear has a name: eco-anxiety.

The American Psychological Association defines eco-anxiety as: “the chronic fear of environmental cataclysm that comes from observing the seemingly irrevocable impact of climate change and the associated concern for one’s future and that of next generations”

But is it as bad as we fear?

Dr Hannah Ritchie, Senior Research Fellow at Oxford University, says no.

In her article, Stop Telling Kids They Will Die From Climate Change, Ritchie points out the gap between the data and the fear-mongering.

“Let’s be clear: Climate change is one of the biggest problems we face,” says Ritchie. “It comes with many risks – some certain, some uncertain – and we’re not moving anywhere near fast enough to reduce emissions. But there seems to have been a breakdown in communication of what our future entails.”

She says things aren’t as bad as we think, and that the media messaging of certain death is making things worse. Too many people are claiming that humanity will be wiped out and annihilation is locked in, says Ritchie. “The worst thing about this message is that, rather than inspiring action, it resigns us to the falsehood that we are already too late. There is now nothing we can do.”

Ritchie points out a few key truths:

- Although government action on climate change is moving slowly, at least it’s moving and “at an increasing pace”.

- “Politicians might be slow, but technological change is not.” Renewable energy such as solar and wind power is now cheaper than coal.

- Death rates from disasters have fallen significantly over the past century. We have better technology and higher resilience to natural disasters.

So what can we do about our own eco-anxiety?

Ecotherapist Phoenix Smith says the first step is to acknowledge your feelings of fear and despair. These are a normal response to this sense of crisis, and there is no point trying to inject optimism and brush aside your negative feelings.

These feelings may be complex and intense, but only by recognising them can you begin to address them.

Then, work on balancing your over-activated nervous system. Try deep breathing mediation or yoga, and if you can, getting out into nature.

Why we might resist going back to ‘normal’.

• You might feel anxious or uncertain about returning to the office. Remind yourself this is understandable as it is another change in a time of great upheaval. Take some time to read your employer’s return to work plan, particularly the physical distancing, cleaning and hygiene measures they have in place to minimise risk. This can help alleviate concerns about your physical safety. And look after yourself physically and mentally. Switch off from work at the end of each day, sleep well, exercise and take regular breaks at work.

• You worry you will miss the freedoms and work-life balance of remote working.

Hybrid working may be a possibility in your workplace, which means you can still enjoy some of the flexibility you have enjoyed. Even if it is not, you can still aim to keep new routines you have developed in place, such as engaging with a new hobby or a regular morning walk.

Think about the benefits of the physical workplace, such as:

• Social connection. For some people, working from home felt isolating and lonely without the daily informal chats with colleagues and the sense of community that the workplace can bring. Younger and newer employees in particular have felt more cut off from their teams. Being together releases oxytocin, which is a feel-good chemical in our brains.
• Professional development. Being with colleagues in person gives you the ability to make connections, collaborate, network, and learn from others – all important for your career development. Technology has helped us connect, but we can’t read nonverbal cues as well as we can in person, and we are often limited by delays and technical glitches.

But is that the best way?

Professor of Psychology and leader in positive psychology, Dr Todd Kashdan, says, “Two types of avoidance cause problems for people: avoiding pleasure and avoiding pain.”

“…expressing frustration, or even too much sadness, is anathema to most folks. It’s as if we expect ourselves to be computers, whose inner processes are largely hidden and divorced from what appears on the screen,” he writes in his book, The Upside of Your Dark Side, co-authored with Robert Biswas-Diener.

“But it misses the point that emotional expressions exist for a reason.”

He goes on to say, “the cultural message that ‘you should feel good and try not to feel bad’ is among one of the most toxic processes known to psychology.”

Dr Kashdan points out that whenever we try to conceal or ignore unwanted thoughts and feelings, they tend to get louder until we can no longer ignore them.

So what should we do about negative feelings instead?

Listen to them, says Dr Kashdan. Use them to gather useful information, and then let them pass.

Importantly, remember you don’t have to believe your thoughts, as they are not always useful or factual.

Isn’t that the same as ACT?

If you are thinking this sounds a lot like ACT, or Acceptance and Commitment Therapy, you are right. Dr Kashdan’s work complements ACT, which is a popular form of mindfulness therapy that encourages us to accept and face any negative feelings – and then move on to focus on what’s most important to us.

ACT can be particularly useful if you find you often get “stuck” in negative loops and feel you can’t move forward.

Emotions are useful tools

Dr Kashdan says all his research over many years can be summarised in three key messages.

- First, emotions are just tools. Don’t make emotions the goal. Research suggests if we take the goal of happiness out of the equation, ironically, that makes us happier in the journey of our lives.

- Second, train yourself to be better able to clarify, describe and understand what you’re feeling, because that will help you better figure out what to do next.

- And the third message is:

You need to know what you value and what you want your life to look like. If you’re happy, then what? If you’re able to get rid of your anxiety, what would you do with your life? If you’re able to end self-doubt, what will you do next?

How to manage your wellbeing in a hybrid workplace

Leader of Microsoft 365 and Microsoft Teams, Jared Spataro, has outlined six “common sense principles” for his teams, to help them manage their wellbeing in a hybrid workplace:

1. Make OKRs your friend

By embracing a framework that ties together clear objectives and key results (OKRs), you are creating a personal framework that makes it clear which work is most important to yourself and others. You can then say ‘no’ more often.

2. Get comfortable with imperfection

“To be crystal clear,” says Spataro, “this is not about lowering the quality threshold for customers. It’s about managing priorities, energy, and expectations for each step along the path toward an outcome.

“Ask yourself, ‘Does this need to be good, better, or best?’ And encourage your team to discuss it.”

3. Own your boundaries

Each of us needs to define our boundaries based on what we can and cannot do.

In practice, this means deciding what time you start work, deciding what time you finish work, and sticking to those commitments while communicating them to your team, whether you are working remotely or in person.

4. Plan meetings with purpose

“Showing up to a meeting has become the signal of doing work. It’s the 21^st-century version of punching the clock,” Spataro says.

First ask the most basic question: ‘Do you have to have this meeting? No, really, do you have to?’ If the answer is yes, determine whether the meeting is to disclose, discuss or decide.

5. Follow the science

Spataro says, “Science tells us what the world’s best athletes have known for years: Peak performance requires cycles of rest and recovery. More and longer hours don’t equal higher impact. Create a culture where taking breaks is a mark of intelligence, not of laziness.”

6. Lead with empathy

If ever there were a time to give one another grace, it is now, says Spataro. Help ensure that the quietest voices are heard. Make space for fun. Make space for moments of sadness, and moments of joy.

Like many people, he turned to learning a craft during the lockdown days of the pandemic. And like knitters before him, he found it incredibly soothing during anxious times.

It doesn’t have to be knitting. Even though much of the scientific study around the benefits of craft has focused on knitting, there are positive links between engaging in any creative occupation and physical and mental wellbeing. Benefits include relaxation, stress relief, a sense of accomplishment, and improved memory and concentration.

Crafts such as woodwork, knitting, crochet, and ceramics focus on repetitive actions and a skill level that can always be improved upon. Doing a craft we enjoy allows us to enter a ‘flow’ state, described as a perfect immersive state of balance between skill and challenge.

Working on your craft can be solitary, but it can also allow you to be social. One survey found knitting in a group improved knitters’ happiness, social contact and communication. Organisations like the Men’s Shed movement offers men the opportunity to do collective woodworking, repair and other productive activities, with participants reporting reduced levels of depression.

Interested in trying a new craft? Upskill by searching for YouTube tutorials, or look for a local craft community on Facebook or at your local community college.

If you perform “wet work” you are most at risk of occupational contact dermatitis (OCD). OCD is inflammation of the skin caused by contact with external substances in the workplace. It is one of the most commonly reported and underestimated occupational diseases.

As well as water, other occupational irritants include any strongly acidic or alkaline substances, oils, detergents, shampoos, cleaning agents, dust and fibreglass.

Why is water damaging?

Wetting and drying your hands over and over disrupts the skin’s key protective layer (the stratum corneum). Over time, this leads to dry skin, more disruption of the protective barrier, and inflammation.

Frequent contact with water explains in part why people in the healthcare industry are at greater risk of OCD, as well as hairdressers, hospitality workers, cleaners and mechanics. And with handwashing more frequent during the COVID-19 pandemic, more people may be affected.

Your work is considered “wet work” if your hands are:

• in water for longer than two hours a shift
• handling wet things for more than two hours a shift
• in occlusive (moisture-proof) gloves for longer than two hours a shift, or
• washed more than 20 times a shift.

How do you prevent occupational dermatitis?

Gloves. Gloves can protect your hands, but it’s important to use the right ones for the job as otherwise they may provide inadequate protection or further irritate your skin.

Moisturising creams. These can help prevent dry skin and dermatitis. Water-based moisturisers may be a better choice, as oil-based ones can affect the protective properties of certain gloves.

Hand sanitiser. Alcohol-based hand rubs prevent hands being continually washed and dried and tend to be gentler on the skin, although they are not suitable if your hands are visibly dirty.

If you have any red, dry and itchy areas on your skin, seek help from your doctor or dermatologist.

According to Dr BJ Fogg, Director of the Behaviour Design Lab at Stanford University and author of Tiny Habits, people make two mistakes when trying to change their habits:

1. They start too big and make it too hard.

When a change is hard, even if you are motivated and even if you can see how it will benefit you, it’s unlikely you will stick to it when things get tough.

Dr Fogg advises us to think big, but start small. Make your new habit so easy you could do it on your hardest day.

“The easier a behaviour is to do, the more likely the behaviour will become a habit. This applies to habits we consider ‘good’ and ‘bad’,” says Dr Fogg.

Make a tiny change that fits with your current life, and celebrate every time you do it.

2. They use punishment instead of celebration to motivate themselves.

“Write this phrase on a small piece of paper: I change best by feeling good, not by feeling bad.”

Ever berated yourself for not sticking with a resolution? Or chastised yourself for not having the will-power to make changes? That’s where you are going wrong, says Dr Fogg.

Dr Fogg points out that people don’t change through shame or manipulation. We are motivated to change when the new change makes us feel good - either inherently because it feels good while we are doing it, or because of an immediate reward.

“In order to design successful habits and change your behaviours, you should do three things. Stop judging yourself. Take your aspirations and break them down into tiny behaviours. Embrace mistakes as discoveries and use them to move forward.”