Clara: Hi, how are you? I haven't seen you in class for a while.

Ben: Good, thanks. You? 

Clara: Great, as long as I don't think too hard about all the essays I have to write this term!

Ben: Yeah … 

Clara: Hey, are you OK?

Ben: I have to admit, I'm struggling a bit. Maybe even a lot. I've not been sleeping well at all and then I can't concentrate. And all these things are just going around and around in my head.

Clara: Mmm … that doesn't sound good. So, you're sleeping badly and you can't concentrate. Is that all it is, do you think?

Ben: Well, if I'm honest, it's more than that. I'm starting to dread going outside. I find myself worrying about stupid things like what if I forget the way home. Or, what if I go to class thinking it's Monday but actually it's Friday and I'm in the wrong place at the wrong time. It sounds even more stupid when I say it out loud. It took me two hours to leave the house today.

Clara: It doesn't sound stupid at all. It actually sounds a lot like me last year.

Ben: Really? But you're so together!

Clara: I've learned to be, but even I still have bad days. I used to have panic attacks and everything. When you were trying to leave the house today, how did you feel?

Ben: Like I couldn't breathe. And my heart was going way too fast.

Clara: Hmm … that sounds like a panic attack to me.

Ben: I thought I was going to die.

Clara: You'd be surprised how common they are. Loads of people have them, they just don't talk about it.

Ben: How did you get over them?

Clara: I actually talked to a doctor about it, and you should too. But I learned some practical things as well. Though they're easier said than done, and they're going to sound weird, so hear me out, OK?

Ben: OK …

Clara: So, one thing I did was to try to reduce the power of the anxiety and the panic attacks when they came. So – and this may sound strange – at a time when you're feeling safe and OK, you literally do things that make your heart start racing faster and your breathing speed up. Like spinning around on a chair until you're dizzy or hyperventilating so you're short of breath.

Ben: That sounds awful!

Clara: It is, but it means you get used to the symptoms, so they feel less scary. 

Ben: Right. 

Clara: Then you have to deliberately do the things that usually make you feel panic. So, if it's going to class on Monday and being scared you've got the wrong day, on Monday you go to class. If you let the anxiety control you by making you stay at home, it just makes it worse the next time you really do have to go out.

Ben: And what did you do if a panic attack came anyway?

Clara: I had a distraction plan. So, I walked everywhere instead of taking the bus because the exercise helped, but also I did things like count trees or red cars or something. Whatever it was didn't matter, as long as I had something else to focus on.

Ben: I can't tell you how much I appreciate this. I thought …