The hustle and bustle of nursing life, helping people and working on the frontline is – for many people – one of the main appeals of the job. However, with it comes great responsibility, potential burnout, stress and anxiety.

According to Reach Out, up to 40% of Australians will experience a panic attack at some point in their lives, and with around 30% of our lives (on average) spent at work, there is a strong chance that one of these will happen at work. Pair that with a busy job where other people’s health and wellbeing relies on you and it doesn’t exactly scream a calm and relaxing workplace!

First off – what’s the difference between anxiety and panic attacks?

While we often throw around the terms ‘anxiety’ and ‘panic attacks’ quite loosely, they are actually quite different. Although there are a couple of similarities between the two such as shortness of breath and a racing heart, there are also some major differences between the two.

All about anxiety

It might sound contradictory to what we are saying, but anxiety is actually a normal part of life and is completely healthy for the most part. It’s when that anxiety starts to consume you and impact your daily life that it becomes a problem. Anxiety is your body’s way of telling you that there is danger, from which it then goes into the fight flight or freeze response.

Signs of anxiety include:

·       Racing heart

·       Shortness of breath

·       Feeling tense or achy – especially in your neck, back and shoulders

·       Sweating and/or feeling dizzy

·       Shaking

·       Feeling sick or ‘butterflies’ in your stomach

Where anxiety differs from panic though, is that it often builds up over a longer period, before coming to a peak in the form of an anxiety attack. An anxiety attack is a response to a perceived threat or stressor. Symptoms of anxiety also become gradually more intense over minutes, hours or days, according to Medical News Today. These symptoms can then potentially hang around for long periods.

Unpacking panic attacks

As touched on above, panic attacks often feature similar physical symptoms of anxiety which is why they are so often confused. The main difference between the two though, is that while anxiety and anxiety attacks are your body’s response to a perceived threat or stressor, panic attacks usually occur without a trigger. Lifeline describes a panic attack as “a sudden rush of intense anxiety or fear together with a surge of frightening physical sensations. They can occur frequently and unexpectedly and are often not related to any external threat.”

Along with the above listed symptoms for anxiety, other features of a panic attack can include:

·       Feeling out of physical or emotional control

·       Difficulty concentrating

·       Numbness or tingling

·       Derealisation

Anxiety and panic attacks at work

Both of these experiences are unpleasant enough, but when you throw that in with stress at work it’s downright awful. Having a panic attack at work can be terrifying and frontline worker Gemma Thompson* says she deals with a level of anxiety every time she goes to work, due to the stress of the job. “I deal with it by knowing that my patients are more anxious than myself,” she says. “I know they are looking at me with panicked eyes and needing my help, and I can’t be of any help if I am an anxious mess as well. So, my response is the opposite. I become calm when others are stressed or anxious, because I know I need to be that person for them right now despite my own feelings.” She also speaks about how she experiences constant anxiety around whether she is making the right decision or not and whether her choice will do more harm than good. We asked her how she works through this anxiety and she advised us that “you just gotta trust your gut and be confident that all those years training and studying was not for nothing.”

Telling yourself that there’s nothing to worry about though (while it might sound nice in theory) doesn’t usually help when trying to combat panic and anxiety. If you find yourself with anxiety building up, here are some things to try according to Medical News Today:

• Let yourself know that it’s ok to have these feelings. They are normal reactions, and you can’t be too hard on yourself when you experience these thoughts and feelings.
• You’re not going to get fired. This thought may send your anxiety into a meltdown but take a deep breath – it’s going to be ok! Remind yourself that mental illness is just as valid as physical illness – you wouldn’t get fired for having a cold!
• Work with rather than against your anxiety. It can be easy to hate how you feel when you’re anxious and dread these feelings, but if you work with your anxiety rather than against it, you begin to normalise it. Working against your anxiety essentially means that you are fighting with yourself. Observe your thoughts as you’re feeling them and just let them pass by – even picture each anxious thought as a cloud passing in the sky or a leaf floating in a stream. They are there, but they will pass. It’s also important to remind yourself that stress and anxiety aren’t bad things – they show that we care about something.

Find what works for you. Everyone has their own method of dealing with stress. Some like to do yoga or meditate, some read books, some go for a run. There is no one size fits all method. Find what works for you and what makes you feel good.

When it comes to panic attacks, these can come on much quicker than anxiety and often with little to no warning. If you find yourself having a panic attack at work, here are some ways to deal with it according to Healthline:

• Deep breathe. Often when we panic, we hyperventilate which can in turn increase the panic you are experiencing. If you teach yourself to deep breathe, you can put this into practice if you find yourself panicking. To deep breathe, focus on taking deep breaths in and out through your mouth, feeling the air slowly fill your chest and belly and then slowly leave them again. Breathe in for a count of four, hold for a second, and then breathe out for a count of four. This can help your heart rate return to its normal rate.

• Acknowledge that what you’re experiencing is a panic attack. It may sound silly, but panic attacks often cause us to catastrophise and with our racing heart, many of us assume we are having a heart attack and are going to die, which causes us to panic more. Tell yourself that you are safe and not having a heart attack.
• Close your eyes if you are in a safe enough space. This can eliminate any distractions that may feel overwhelming and cause more panic.
• Force your brain to think again. Your brain is in fight-flight-or freeze mode when you experience a panic attack, where its sole aim is to survive. Nothing you try to rationally tell it will work as your mind thinks your life is at risk. To bring the rational thinking back into your mind, try a simple exercise such as counting backward from 100 by 7’s (harder than it sounds) or focusing on 5 things you can see, 4 things you can hear, 3 things that you can feel, 2 things you can smell and 1 thing you can taste. This mindfulness brings your brain back to the present and helps to normalise thinking.

Working on the frontline is something that comes with its own stressors and anxieties, so panic attacks and other anxiety are certainly not wanted! We’ve listed some ways in which you can try and deal with anxiety and panic while you’re at work, however, if anything you feel gets too much, it may be worth reaching out to a counselor or your local GP.

Remember – you are safe, you are strong, and you’ve got this!!

*Name has been changed for privacy reasons.