Case study: Taking part in panic attack research: Tracy's story

Berkshire's Tracy McWalter received Cognitive Behavioural Therapy and a blood pressure drug as part of a University of Oxford study into panic attacks.

Tracy, 42, from Maidenhead, said she has not had a panic attack since joining the ‘Cognitive­ Behaviour Therapy (CBT) and Losartan’ study, in which participants receive one session of CBT, which involves breaking down overwhelming thoughts into manageable parts and finding practical ways to deal with them.

Half of the participants receive one dose of losartan, a drug used to treat high blood pressure. Research has shown losartan may improve processing of emotional information, possibly by stimulating a brain mechanism involved in making new connections and retaining information.

The other half receives a placebo dummy drug for comparison. Participants do not know which they received.

Tracy, Creative Services Manager at Swyft Home furniture, has suffered panic attacks since childhood, worsening as a teenager.

She said: “It could happen anywhere I felt like I couldn’t escape from. It could be anything mundane like a meeting at work or getting on a train, even just going to the hairdressers.

“If I felt like I was in a situation I couldn’t get out of very easily, I would spiral and it would escalate to the point where it would feel like I was about to die, which sounds very irrational but it’s very real.”

“It is like your worst fears combined. You have very physical symptoms, heart racing, nausea, palpitations, feelings of doom. You can’t escape from it.

“I have had CBT and counselling before but it just wasn’t that helpful, it didn’t seem to work.”

She found the study while searching online and said: “I had a few friends who’d involved themselves in research so I thought I’d give it a go. I love knowing we’re constantly researching to improve our outcomes on things so I was drawn to it.”

She said: “The researcher was brilliant, very reassuring about it all and didn’t make me feel like it was unusual. She was very confident she could help me which made me feel quite excited. It was lovely.”

The study involves two visits to Oxford on consecutive days and an overnight stay for participants travelling far. Time and travel expenses are reimbursed. Participants complete questionnaires and online cognitive tests before talking through their behaviours and the safety mechanisms they use to help them manage feelings of panic. Feedback is provided by questionnaire over six months.

Tracy, who took husband James, one of her safety mechanisms, said: “We figured out what my thinking patterns were and the behaviours that were maintained in the panic attacks for me. We went through the thought processes and behaviours to find out what happened when I was having a panic attack and what made them more likely to happen. 

“My thoughts when having a panic attack were commonly that I would be sick or pass out, but they would escalate. If I had tightness in my throat, I thought I would stop breathing.  If I had pain in my chest, I thought I would have a heart attack.

“With the help of Andrea, the CBT challenged those thoughts and the safety mechanisms I always used to try and stop the panic attacks, such as deep breathing, always carrying water, listening to calm tracks and having a safe person with me.  What I didn't realise was that by using the safety mechanisms and trying to prevent the panic attacks from occurring, I was reinforcing the thoughts and behaviours that were actually making them worse.

“By doing this and challenging myself in a safe environment I basically tricked my brain into thinking differently and reacting in a different way.

“It was challenging for me. Taking a drug and not actually knowing what it was was a bit scary. It was a real mixture of excitement and nervousness but I’m really glad I managed to challenge myself to do it.”

Tracy, who has a degree in fashion design, said “Since the study, I’ve kept doing things that I would never have done before or that I would have avoided doing and it’s getting a lot better.

“I haven’t had a panic attack since. It definitely has done something to my brain. It’s almost like something’s clicked. It's a big change in life quality. Now, I can go to places further away on my own on trains or by car that I wouldn't have done before, such as day trips out with my children.

“I was really emotional on the day because I realised when I was doing it, ‘why did I not get help before?’ But it wasn’t really there at the time. And that’s the thing about research, we’re learning more and more by doing these things and I think if we’re not prepared to, then we’ll be stuck in this sort of situation and we won’t get the help we need.

“If you want to improve the outcomes for people with mental health issues then I think this is a really important thing to challenge yourself to do. It’s not unusual, it’s not strange. The research is amazing.”

Adults who experience panic attacks, including very strong physical symptoms like heart racing, breathlessness, dizziness or nausea and strong fears of having a heart attack, fainting, suffocating or going mad may be eligible to take part.

For more information and to sign up contact Dr Andrea Reinecke on 01865 618320 or andrea.reinecke@psych.ox.ac.uk.