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Mental Health First Aid: Anxiety disorders not only a matter of the mind

Kaley Conor, Mental Health First Aid trainer, teaches a recent class at High Plains Mental Health Center. Behind her is how the students depicted a person who might be experiencing anxiety.
A Hays Post series focusing on mental health issues.

Hays Post

Your hands are sweaty. Your heart is pounding. You feel like you can’t breathe. All your senses seem like they are on overload. Everything is too bright, too loud and even your clothes feel like sandpaper on your skin.

You may think you are having a heart attack, but these are also symptoms of an anxiety attack. One in five Americans will suffer an anxiety attack in their lives. Some might only have one instance and never experience an attack again. However, about 3 percent of Americans suffer from reoccurring anxiety attacks, which is also known as panic disorder. The broader category of anxiety disorders affects 18 percent of U.S. adults and may coexist with other mental illnesses.

Mental Health First Aid, which is course regularly offered by High Plains Mental Health, offers people steps to aid a person in a mental health crisis, including an anxiety attack or an anxiety disorder.

“We all get anxious about some things,” Amy Bird, MHFA trainer, said. “Anxiety serves a purpose. It makes us do things. If I’m not anxious about getting my documentation done, then I would just sit back and whatever happens. But if I know my supervisor is watching that list, I better do that. Sometimes it can become overwhelming and inhibits us …”

Bird gave the example of hearing a loud bang. We might jump, our heart might start to pound. A person may step in say, “Sorry, I was moving a file cabinet and I dropped it,” but it can take up to an hour for us to return to normal after an extreme state of anxiety.

Panic attacks occur when our bodies release fight or flight chemicals. These physical responses are needed if we are running for our lives or fighting off a bear, but are no so helpful if you are sitting talking with a friend over lunch.

In addition to the scenario listed above, other symptoms of an anxiety attack can include:

  • Trembling and shaking
  • Abdominal distress or nausea
  • Dizziness, lightheadedness or feeling faint
  • Feelings of unreality or of being detached
  • Fear of losing control or “going crazy”
  • Fear of dying
  • Numbness or tingling
  • Chills or hot flashes

Anxiety and anxiety disorders can be very physical.

“How many kids are going to come to you on the first day of school and say, ‘I’m anxious’?” Bird said. “They are going to say ‘I have a stomach ache or a headache,’ and they probably do.”

The median age for the onset of panic disorder is 24, but the median onset for specific phobias is 7 and the median age for all anxiety disorders is 11.

How you can help

An anxiety attack can mimic symptoms of a heart attack or other serious medical emergency. If a person presents with symptoms, and you are uncertain they are having an anxiety attack, it is best to call 911. Some people may wear a medic alert bracelet indicating panic disorder, so look for that.

Anxiety attacks do not necessary have a precipitating event, but can come “out of the blue.”

The course offers the acronym ALGEE to help first aiders remember the steps in aiding in a mental health crisis.

  • Assess risk of suicide or harm.
  • Listen non-judgmentally
  • Give reassurance and information
  • Encourage appropriate professional help
  • Encourage self-help and other support strategies
Mental Health First Aid students try to draw a picture of what they think a person who is experiencing anxiety might look like.

If you believe the person is having an anxiety attack, try to be calm and  reassuring. Ask the person if they know what is happening and if you can help. Speak slowly and clearly and in short sentences. Because of the person’s state, they may be slow in answering or not be able to answer at all.

“Even if they know that is what it is, with all that adrenaline going through your body that is making all those physical things happen, it makes you scared because that is what tells you flight, fight or freeze,” Bird said.

Try to be patient with the person and acknowledge their fear. An anxiety attack is not life threatening, but it may seem like it to the person having one. Try, ‘I can see how scared you are.’ Reassure the person that he or she is safe and the symptoms will pass.

“When you are panicked you can’t make a decision,” Bird said. “There are lots and lots of thoughts going through your head. ‘I’m dying. I can’t breathe. All these people are watching me. What is going to happen? I don’t know what to do.’ Sometimes the best way to help is say, ‘I’m going to tell you what to do.’ ”

Ask the person what you can do to help. Byrd noted some people feel more threatened when people try to surround them or touch them during an anxiety attack. Others may feel comforted if you hold their hand.

Although anxiety attacks usually peak within 10 minutes, it could take up to an hour for someone who has had an anxiety attack to come back to feeling normal. Reminding a person the attack should peak in 10 minutes might not be helpful. The person might not have a good concept of time or could become obsessive over the duration of the attack.

Avoid expressing your own negative response to the anxiety attack. Saying things like “Calm down” or “Get over it” are not helpful. Also don’t have the person breathe into a paper bag. This is a myth.

Bird suggested first aiders have the person having the attack look at you. Breathe in for three counts and exhale for three counts.

Risk factors

Anxiety disorders also includes phobias, social anxiety disorder, post traumatic stress disorder (PTSD), general anxiety disorder, obsessive-compulsive disorder (OCD) and agoraphobia. Anyone can suffer from an anxiety disorder, but there are some risk factors, which include:

  • Having a more sensitive nature and a tendency to see the world as threatening
  • Having a history of anxiety as a child
  • Being female
  • Alcohol abuse
  • Having a traumatic experience
  • Difficult childhood (physical, emotional, sexual abuse or neglect)
  • Family background of poverty
  • Family history of anxiety problems
  • Family history of separation or divorce
  • Some medical conditions
  • Side effects of some prescription medication
  • Use of alcohol or drugs
  • Withdrawal from alcohol or drugs

Some anxiety attacks or flashbacks in the case of PTSD have triggers. Just because something might be benign to you, it may cause great distress to a person who has PTSD or a phobia. People who have PTSD can be triggered by a sound or a smell. Veterans may be triggered by loud sounds or fireworks.

The most common phobias are spiders, bugs, mice, snakes and heights. The most common causes of PTSD include war, accidents, assaults or witnessing a significant event, which can include a mass shooting, terrorist attacks or severe weather events, such as a hurricanes, tsunamis or tornadoes.


If a person has persistent issues with anxiety or anxiety attacks that are affecting their daily lives or functioning in their job, you can suggest the person seek professional help. If a person who has experienced a traumatic event still can’t stop thinking about the event, is upset and fearful, feeling jumpy, and has suffering relationships four or more weeks after the event, professional help is advised.

Talk therapy and/or medication may be used.

High Plains also has a 24-hour crisis line that can be reached at 1-800-432-0333.

The local National Alliance on Mental Health (NAMI) support group meets on the first Monday of the month at 6 p.m. at the Hadley Center. For more information, contact Ann Leiker, coordinator at 785-259-6859 or email her at [email protected].

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