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The coronavirus pandemic has made many people more anxious. But for some, the threat of deadly infection and the drastic changes to everyday life may have triggered panic attacks.
"Right now, a lot of experts are hypothesizing that people's mental health will be affected by the pandemic. But we have little data on how people are actually affected, and that takes time -- months or years -- to gather. That's a huge problem when we have policymakers trying to draft policy when we don't have data," said study senior author Alicia Nobles. She's an assistant professor in the department of medicine at the University of California, San Diego.
"So our team turned to internet searches to see what people were searching for in the United States," Nobles said. There were 3.4 million searches for panic or anxiety attacks in the two months following the March 13 declaration of a U.S. national emergency due to COVID-19, her team found.
Because the data came from internet searches, it's not clear if people were actually having panic attacks or other conditions that have similar symptoms, like a heart attack.
Vaile Wright is senior director of health care innovation for the American Psychological Association. "Symptoms of a panic attack can be very intense, including physical reactions that can feel like a heart attack -- shortness of breath, rapid pounding heart rate, chest pressure and sweating," said Wright, who wasn't part of the study.
If you've never had a panic attack before, or are unsure if your symptoms are a panic attack or a heart attack, seek emergency care, the Anxiety and Depression Association of America advises. It can sometimes be difficult to tell these conditions apart.
What if you're feeling anxious and aren't sure if your symptoms are severe enough to indicate a panic attack? Wright said, "Panic attacks are a sudden episode of intense fear that typically peaks within 10 minutes."
Symptoms of anxiety include: feeling restless, on edge, worried or irritable, getting easily fatigued, having trouble concentrating and experiencing sleep problems. To be considered a generalized anxiety disorder, these symptoms must last at least six months.
The difference between many anxiety symptoms versus panic attack symptoms has to do with intensity and duration, Wright explained. Panic attacks are very intense, but the episodes are separate events.
For the new study, the researchers analyzed information from Google trends to look for searches that mentioned panic attack or anxiety attack from January 2004 through May 9, 2020.
The biggest jump in those searches occurred between March 16 and April 14, 2020. The number of searches was the highest ever recorded, the researchers said. During that time, social distancing guidelines were put into place, states shuttered businesses and schools, the U.S. Centers for Disease Control and Prevention recommended face masks, and the United States surpassed Italy for the highest number of deaths.
After April 14, searches for panic and anxiety attacks returned to their expected levels.
"In the beginning, COVID-19 was a huge unknown. It could be that over time, people became more resilient," Nobles suggested.
Wright agreed. "In that beginning period when everything had to shut down quickly, there were anecdotal reports of increased requests for benzodiazepines [sedatives that may be prescribed for panic]. But we've come to a new normal and are figuring it out. While there's still uncertainty, people aren't in quite the flight-or-fight mode they were," she said.
Wright's advice if you're still feeling a bit anxious? "It's really important to focus on what's in our control -- our own thoughts, feelings and behaviors. Identify negative patterns, like constant scrolling on your phone, looking at the news and hoping for new info. Take breaks from your devices. Take breaks from the news. Don't watch it constantly. Social media is an anxiety bomb, so limit the time on there," she recommended.
And take care of yourself, Wright advised: "Get enough sleep, eat healthy, be active and maintain social connections [in a safe, socially distant way]. While the anxiety may not go away, all of these things help."
Also, mindfulness, meditation and fun distractions (puzzles like sudoku or dancing in the house) help keep your mind from focusing on your worries, she suggested.
If you have panic attacks, Wright said that talk therapy is an important long-term strategy.
Results of the study were published as a letter Aug. 24 in JAMA Internal Medicine.
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