The pain of panic attacks

Crushing chest pains, nausea and drenching sweats left Nicola Coleman convinced she was dying. Yet specialists failed to spot an illness that affects one in ten of us

I hadn't planned to die on 10 August 2003. In fact, I was just entering a new phase of life. Having emerged from a hostile and excruciating divorce, I was on holiday in Cyprus with my new man.

I finished breakfast and left for the two-minute walk down the steep hill to our bedroom. It was very hot, even though it was only 9.30am. And then it hit me. Halfway down the hill, the most excruciating pain I had ever experienced thumped me in my chest and sucked my breath away as it travelled down my left arm.

"Oh my god," I thought, "I must be having a heart attack." I was 45 years old.

By now sweating profusely, I summoned up everything I had, forcing myself to walk slowly back to our room, hoping I'd arrive before I kicked the bucket. Once there, I collapsed on to the bed, still perspiring, very nauseous and groaning with pain. I could hear my man happily showering and singing "If You Gotta Go, Go Now", unaware that only yards away I probably was about to go, right then.

The pain was indescribable. I tried to slow down my breathing, willing it to pass. I was on the verge of calling out for help when, just as suddenly as it had come on, the pain vanished, leaving me fragile and exhausted. Having had a friend who'd suffered with angina, I concluded that that was what it was. Not a heart attack but a warning for me to give up smoking, lose weight and take more exercise. I decided to keep quiet (why ruin the holiday?) and to see a doctor when I returned home.

However, once back I reasoned it was probably a one-off, and I'd be fine. How wrong I was. A couple of months later, the same crushing chest pain woke me one morning. Yet again, I was too scared to see the doctor.

The next attack came on six weeks after that, the fourth around a month later, the next a week later. What was happening to me?

In a chateau in France for new year in 2003, I awoke in the morning with the by-now familiar crushing chest pain. This time, the colour apparently drained from my face and, feeling very sick, I rushed to the bathroom, only to pass out on the way. My boyfriend deftly caught me just before I hit the floor while losing control of all my body functions. Enough was enough; it was time to see a GP.

Over the course of the next 18 months I was referred to a neurologist, a gastroenterologist, a cardiologist, an endocrinologist, a gynaecologist, several therapists and a urologist. I had EEGs, ECGs, endoscopies, colonoscopies, manomentries, ultrasound scans, allergy tests, hormone screening. I stopped smoking and drinking, started taking far more exercise and I went through a process of food and drink elimination, testing possible triggers one by one.

I was prescribed low-level anti-depressants, drugs to control acid production in my stomach and Nifedipine - which alleviates angina symptoms. Still the episodes continued, increasing in number and intensity until I was having up to four a day.

By now I was truly terrified. I was convinced that despite all the tests, they'd missed something major. Was it my heart? Something to do with my respiratory system? This was taking over my life. I was frightened to be alone lest I faint, fall and injure myself.

Then a family friend suggested that I might be having stress-induced panic attacks. I pooh-poohed this amateur diagnosis. Yes, I may have been through a brutal divorce. Yes I was under pressure. But I just wasn't the sort of person who would be prone to panic attacks. I could take the heat.

One day, in an idle moment, I typed "panic attack" into Google. Over 1.2 million results came back. I couldn't believe my eyes.

A panic attack, I discovered, is a severe attack of anxiety and fear that occurs often without warning and for no apparent reason. The cause is not clear. Stressful life events such as bereavement may sometimes trigger one. The site I was reading went on to describe my symptoms exactly.

Good god. Could it really be possible that this was all simply a physical manifestation of what was going on in my mind? Later, a counsellor explained that once the body starts to react in this extreme way, it becomes conditioned to that reaction until any bit of stress can trigger an attack.

My next port of call was Dr Elizabeth Bradley, a second GP, who listened carefully then agreed with my diagnosis, immediately referring me to a psychiatrist, who initially suggested I take heavy-weight antidepressants, undergo Cognitive Behavioural Therapy (CBT) and have breathing lessons. I refused the drugs. I didn't feel depressed, but by now just chronically anxious about my world.

I'm now six months down the line of CBT with chartered clinical psychologist, Judith Halperin. She's worked with me to re-frame the attacks as "moments of anxiety" and now I no longer feel that they may kill me. I now also recognise the pre-cursor signs of a "moment", and can often take averting tactics.

Although I'm still having my moments, their intensity has lessened. Part of that change is down to my recognising them for what they are. I'm still off the fags and now just have to tackle losing the weight I have gained as a result. Getting to this stage has taken two and half years of blood, sweat, tears - and lots of dosh. Now at least I'm having some days totally free of moments, and I'm quietly optimistic that these will become the norm.

For further information on panic attacks and stress-related anxiety disorders, visit www.patient.co.uk