• Badulla TH’s ETU’s Snr. MO Dr. Palitha Rajapaksha notes that overall, in all of these cases, many struggle with mental stability and their ability to endure pressure declines

• Parent-children interactions, extracurricular activities such as sports, activities that help build emotional and spiritual well-being such as music, and skills development, are an antidote 

Health professionals had recently raised concerns over a rising number of panic attacks reported among schoolgirls and young women across the country, with nine-20 schoolgirls and seven-eight young women being brought to hospital emergency units each week with symptoms (dizziness, fainting, rapid breathing, chest pain, numbness in the hands and feet, tingling in the fingers and toes, tightness in the chest, excessive sweating, dry mouth, and, in some cases, a brief loss of consciousness) linked to panic attack episodes. 

These episodes are sudden, intense, overwhelming and an uncontrollable feeling of fear – of losing control or of not being able to breathe or of facing certain situations - that can occur without a clear trigger (academic stress and social pressure are common triggers affecting emotional wellbeing). While certain medical conditions such as diabetes, thyroid disorders, anxiety, postpartum changes, or inner ear issues can cause similar symptoms, panic attacks are largely psychological. If no underlying medical issue is found, the best approach is to calm the person and help them breathe slowly, inhaling through the nose and exhaling through the lips every five seconds – to stabilise breathing and ease anxiety, with long-term management through counselling and reassurance.

However, panic attacks are often misunderstood, and many people don’t know how to assist someone experiencing one or when to seek professional help. Misconceptions and stigma surrounding panic attacks can prevent patients from receiving proper care both at home and in hospitals. 

Highlighting this, the Badulla Teaching Hospital’s (TH) Emergency Treatment Unit’s (ETU) Senior Medical Officer (MO) and Government Medical Officers’ Association’s Assistant Secretary Dr. Palitha Rajapaksha explained that this situation makes education and awareness crucial, not only to reduce fear and misconceptions but also to ensure timely and appropriate support. 

According to him, teaching people how to recognise symptoms and respond to the same appropriately can improve recovery. During an interview with The Daily Morning, he underscored the importance of the message that panic attacks are temporary and not signs of a severe illness.

Following are excerpts from the interview:

What is a panic attack?

A panic attack could be described as an instance of sudden panicking. A person experiencing it temporarily withdraws from the ordinary state of mentality. This is not an illness. This is a temporary situation, and could happen to any person. An ordinary person’s day-to-day life includes various states (of mentality). However, those who are prone to panic attacks tend to experience ordinary instances as abnormal and their body reacts to those instances in a different manner. For example, in a certain instance, a person may feel that they would not be able to breathe, that they would die, that they would fall sick or that they would be harmed by someone. In such situations, their body, sometimes without even them realising, loses control and they lose the ability to manage the situation.

What are the symptoms of a panic attack?

The body of a person experiencing a panic attack goes through certain changes. For example, some patients that seek our assistance are unable to speak, appear to be scared, appear pale, sweat profusely, have dry lips and mouths, and breathe faster, which is referred to as hyperventilation. Hyperventilation causes a decrease in the body’s carbon dioxide levels, which in turn can lead to cramping in the fingers. They can also experience issues related to attention.

What instructions can you give in terms of first aid, or handling a person experiencing a panic attack before they reach a hospital?

These symptoms often frighten those around the patient, leading them to perceive it as a serious illness. They usually rush to take the patient to a hospital, often using whatever vehicle is available, such as a three-wheeler. However, this can be dangerous, as these vehicles are sometimes driven at high speeds, posing additional risks to everyone’s safety. At the same time, if a person with conditions such as diabetes, respiratory illnesses, heart problems or hormone-related disorders, or a woman who has recently given birth, experiences a panic attack, they require special attention compared to someone without such conditions.

It is important to remain calm when assisting a person experiencing a panic attack. Panic attacks are increasingly seen in young people including school children. In some cases, teachers and those working with them know that they are prone to panic attacks. It is important not to panic. Encourage the patient to breathe slowly and steadily, as this can help relieve symptoms including finger stiffness. One should rely on these steps only if the patient does not have the aforementioned health conditions. If the person has any of those health conditions, relying solely on these steps could be dangerous. However, they should be taken to a hospital in any case.

Recently, you had raised concerns about more schoolgirls and young women seeking medical assistance for panic attacks. Can you elaborate on this situation?

We have observed this situation earlier as well. There were a lot of young women. However now, we see such situations on a daily basis. We come across at least two schoolchildren a day, and there are office workers on working days. We observe a significant increase in cases.

What do you think has caused this increase in cases? 

Why there is such a surge is a cause for concern.

In the case of school children, several contributing factors include a lack of parental protection and guidance, often due to parents going abroad for employment, relationship issues such as breakups, and living amid various economic hardships. In addition, children tend not to engage in extracurricular activities such as sports or activities that help build emotional and spiritual well-being. Parents often push children to focus on competition rather than skill development. 

This includes Exams like the Grade Five Scholarship Exam, the General Certificate of Education (GCE) Ordinary Level Exam and the GCE Advanced Level Exam, as well as the competitive nature of society in general. As a result, competition builds up among children and the connection between them is often weak. When they don’t have anyone to seek assistance from, they begin to have fear. There are also university students who experience similar issues. Parents should talk to and spend time with children, and encourage children to pick up sports, music and skills development. Such would make it easier for children to deal with this issue through increased mental stability.

Working adults also face economic difficulties as well as challenges related to romantic relationships and marriage. Their mind tries to withdraw them from stressful situations, and the symptoms are ways that this happens.

Overall, in all of these cases, many of them struggle with mental stability and their ability to endure pressure declines.

What steps are taken at the hospital level to assist a person experiencing a panic attack?

At first glance, we may notice symptoms such as hyperventilation. However, to confirm the diagnosis, we check the heartbeat, perform an electrocardiogram and assess for conditions such as asthma. The patient could have an unidentified condition, and these tests help rule out any such possibilities. We make them wear a mask that gives the impression that they are receiving oxygen. In reality, the mask helps retain carbon dioxide, which raises their carbon dioxide levels back to normal. We also talk with them. By gathering information about their condition, medical history, test results and other clinical findings, we give them the assurance that they are physically fine and that what they experienced was a temporary mental condition which anyone could experience.

We refer them to psychiatrists only when necessary, as doing so could be stressful to  the student. However, ultimately, this issue should be addressed with the help of a psychiatrist. If we can resolve the issue before it reaches that point that would be ideal.

What recommendations can you give to the relevant authorities and school administrators to improve the situation surrounding panic attacks among schoolchildren?

The easiest approach would be to begin at the school level. We can bring in resource persons such as doctors, counsellors or other qualified professionals to give lectures to children and raise awareness about the issue. For example, we have seen children as young as 10-12 years seeking assistance after romantic relationships. They should be educated that there is an appropriate age for such relationships, and that engaging in them earlier could lead to problems and that studies should be a priority. It is important to establish a mindset among children to work together and support each other, rather than pushing them into competition. 

At the same time, the same message about competition should be conveyed to parents as well. When a person experiences panic attacks repeatedly, others may perceive him or her as unwell. We should work to prevent such situations. Therefore, raising awareness is crucial.