The Anxiety and Depression Association of America (ADAA) defines panic attacks as the abrupt onset of intense fear or discomfort that reaches a peak within minutes and includes several symptoms such as accelerated heart rate, sweating, chest pain, nausea, fear of dying, chills/heat sensations, derealization and more. People can experience panic attacks in many different ways. Some may experience fewer symptoms than others.
Stress, physiological symptoms, or traumatic experiences can often cause panic attacks. Carrie Krawiec, LMFT at Birmingham Maple Clinic, said "Panic attacks can be intense fear mixed with increased heart rate, lightheadedness, and shallow breathing. In some cases, the presence of one of these symptoms can cause a person to fear passing out or heart attack which can actually cause a panic attack [to increase]." She explains to her patients that a panic attack is when your mind and body misreads it's natural fire alarm system and reacts to drills like it's the real deal. She added that once you recognize what is going on you can begin to change your response. Panic attacks can occur unexpectedly so it's important to know how to handle it and care for yourself if one does arise.
If you regularly experience panic attacks, it's important to seek professional help and guidance.
Here are eight things, recommended by certified professionals, to try when you feel a panic attacking coming on.
Acknowledge What is Happening
It may seem like your thoughts and feelings are out of your control but there is an opportunity to take control and welcome in some logic. Dr. Sharone Weltfreid, Licensed Clinical Psychologist, said that when thoughts like, "I am having a heart attack" or "I am losing control" are intruding, you can recognize that these statements are not facts and allow them to pass as quickly as they arose. This is often easier said than done, however, try reminding yourself that you know what is happening and that the panic will soon subside and then stop. This can help you to restore calmness and prevent attacks in the future.
Wrap Yourself in a Blanket or Sweater
This may not sound important however it can make a big difference! Psychotherapist Rev. Connie L. Habash said that being wrapped up in something warm and cozy is calming and can offer relief in the moment. "It’s much like a baby is soothed by swaddling," she said. You may also notice in movies and tv shows that victims are often wrapped in a blanket by first responders after experiencing something traumatic or shocking. This is done for the same reason. If you're not at home, you may find the same comfort by wrapping a sweater or jacket around yourself. In the end, it's what makes you comfortable so see what works and stick with it.
Deep breathing is a common practice for those who feel anxious or nervous. Dr. Danielle Ibelema recommends engaging in deep breathing when you feel yourself start to panic. This helps slow down the central nervous system. She suggests trying to exhale longer than you inhale. "You can engage in deep breathing solo, but there are also apps that you can use for guidance too. Calm is my favorite app for this purpose," she says. If you have an Apple Watch, you can set up notifications throughout the day to help you remember to take a few minutes to practice mindful breathing. If you start to feel anxious, you can click on the Breathe app and it will help you time and pace your breaths. You can set the timer anywhere from one minute (seven breaths) to five minutes (thirty-five breaths). Dr. Ibelema also said that significant anxiety or panic symptoms tend to warrant the help of a mental health professional for counseling or medication if it starts to interfere with your life.
This can be tricky depending on the situation. If you start to feel symptoms of a panic attack, Dr. Laura Dabney suggests trying to remove yourself from the situation if possible. This should help you feel safe and alleviate the fear of judgment. "Once they are removed and safe I have them start really thinking about what has been happening leading up to that point," Dr. Dabney said. If you're on an airplane or about to do a presentation for work or school, you can't really remove yourself from the situation. In this case, take a few minutes and close your eyes. If you can, put on headphones to help create personal space.
Again, this won't be easy to do if your panicking escalates fast but try your best to put aside your overwhelming feelings and focus on yourself and your environment. Psychotherapist, Christine Scott-Hudson gave some helpful tips on how to do this. "Focus on what is going on outside of your body. Count all of the green objects in the room. Practice grounding, feel your feet on the floor. Feel the chair supporting your body." Try thinking and doing different things to distract yourself from the state of panic.
Calm Down with Soothing Music
Dr. Ibelema said that creating a relaxing or inspiring playlist that's easily accessible is a great way to distract yourself. With the help of Spotify, Apple Music, and YouTube, there are hundreds of thousands of playlists that have already been created and are ready to go. You can type in "calming music" or "music to help me concentrate" and find endless lists of recommended playlists that you can instantly stream on your mobile device. "There are times when these options are not enough," said Dr. Ibelema. The important thing is to have a variety of options to turn to when a panic attack arises.
Don't Fight the Fear
Author of Depression Hates a Moving Target, Nita Sweeney, suggests a different way to approach a panic attack. If trying to calm yourself down doesn't work, she recommends inviting the panic in. This may seem like the opposite of what you think you should do but it may help you gain some power over the situation. "If a person who feels the anxiety building toward a panic attack says, 'Come on panic. Give me all you've got' and means it fully, this will often cause the panic to subside," Sweeney said. It usually doesn't come naturally for people to allow the thoughts and body sensations to come and go and not fight them, but if you can train yourself to do exactly this, it can be very helpful Sweeney said.
Did you know that often anxiety stems from unexpressed anger? Dr. Kim Peirano, a doctor of acupuncture and Chinese medicine said that anxiety can be a by-product of anger. The anxiety could be linked with fear but often is actually unexpressed anger. "Think of it like a kettle boiling but with no steam release, the kettle will boil but without the outlet for the excess energy from the heat, the kettle will begin jumping and bouncing around, this is a perfect metaphor for anxiety," said Dr. Peirano. "So when we’re in the midst of a panic attack, going against all of our instincts to retreat and shut down, what can be really helpful is to actually move around and release some physical energy." Anything that gets your heart pumping should help whether it be boxing moves, running, or even push-ups.
Dealing with a panic attack is never easy but hopefully, some of these techniques will help reduce the severity. Remember, if you regularly experience attacks you should ask for help and see your healthcare professional.
If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Health (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.