The suggestions on this site about overcoming anxiety and panic attack symptoms apply to everyone, and you can choose from them which ones are most suitable for you. Quite rightly it has focused on you, your bodily sensations and your thoughts, but we also need to consider the personal circumstances surrounding each situation in which you have one.

Now we will look at the issues involved in having an attack when you are on your own, and my next article will look at your attacks in relation to your friends and family.

The fear of having an attack when you are on your own is one which hasn’t been mentioned yet. From my own experience, I know this can be a potent one. It layers itself on top of the other fears you may already have about the actual attack itself. For me it seemed to paint a picture of the worst scenario I could imagine (there was my fertile imagination being put to no good again!) I remember one attack I had when I was traveling to Greece to join some friends who had gone there on holiday the week before.

Unfortunately, work had prevented me from going at the same time, but I knew I needed a good break so although I had never traveled abroad on my own before, the prospect of eventually sitting on a sun-drenched beach, miles away from the source of my worries but only yards away from a taverna, inspired me on.

Obviously I hadn’t acknowledged how excited but also how anxious I was about doing the trip, which involved a train, a plane, a connection to a ferry, and a ferry trip out to an island somewhere, and then an attempt to find the hotel. I was anticipating the language barrier to be a problem. Would I be able to recognize the sign for Naxos written in the Greek alphabet, I wondered, or would I end up on Paros, Milos or Karos?

Feelings of unease started on the train to the airport. Trying to fight down the sensations, I eventually came unstuck when I got off the tram and reached the glaring lights inside the airport where the thought came rushing through, swifter than the train I’d just been on, that I would be on my own on the plane and for the rest of the journey until I (hopefully) reached my destination. This thought of being alone provided the final cue for which my attack was looking, and off it went.

The thought of being on your own can be additional fuel to stoke up background anxieties. You start to anticipate situations where you might be on your own and therefore equate them with having an attack. This specific fear can then work on two levels: as an immediate thought cue, and as a ‘what if’ worry to fuel anxiety prior to the next attack.

Tracking my thoughts back to that time, I know that it seemed less fearful to think of having an attack when I knew someone was to hand. You might feel the same. For example, Theresa, a young, single, assistant lawyer living on her own acknowledges that ‘having no-one around became part of the problem’. And someone like Jimmy, 15 years old and still at school at the time, found that being on his own was the only time when he had panic attacks. Perhaps your experience of how awful the attacks are makes you want to have someone there to support you through them. Previously, without knowing what the attacks were and believing you were going to die or have a heart attack, you could be forgiven for not wanting to be alone. Let’s face it, who would want to think of dying with no one around? Who would phone for the ambulance? Would you end up writhing on the floor for hours or days in agony before your last breath came? I never voiced the thoughts in so many words, but that is what fleetingly passed through my mind and manifested itself as a fear of having an attack on my own.

This whole issue brings to mind one of the theories of causation, linking panic attacks to separation anxiety. This may begin in childhood and be the result of having to face demanding situations without the supportive presence of a parent or some other significant person. The similarity between this and the fear of having to face a panic attack without the support of another person seems quite clear. The theory is supported by the fact that some people experience their first attacks after the real or threatened loss of an important relationship.

This may explain why the thought of having a panic attack when you are on your own can fill you with even more fear and anxiety. It might be rekindling this basic unresolved dread effacing a demanding situation without the strong support of someone else being there.

There are two things which might help to counter this particular fear. One is to accept that anyone who has a panic attack has it on their own. They can’t share it with others. So even if, for example, you have an attack while sitting at the dinner table, you will still be experiencing it on your own, regardless of who or how many people you might be with. Others might not even notice you’re having one. What I am trying to stress is that there is nothing special about being on your own and having a panic attack. The attack will still just run its course and eventually subside. It will not be any worse because you are on your own, although your fear beforehand might cue one to start. Otherwise, the attack will be experienced in the same way as if you were with friends/family/a room full of close colleagues.

The other fear which I had was the thought about the practicalities which I mentioned above. Who would phone for the doctor/ ambulance/undertaker? This was before I understood what the attacks were and what had caused them. In my fear through ignorance, my vivid imagination thought the worst. Because like you, I now understand the reasons why, and that the attack will not harm me, I could rationalize that thought if I had it again. Back to reattribution, and back to ‘a thought is a thing’. Now you know you will be all right, that it will pass without doing you any lasting damage, you can forget about thinking you need someone there to rescue you from death’s door. You won’t need anyone because you’re not going to be at death’s door, and never will be because of a panic attack.

Think over these things and perhaps read through them again until you really do understand, know and accept these facts. They are powerful tools for your panic prevention kit.