Experiencing a panic attack can feel debilitating. It is described by people who have experienced them as ‘feeling as though you’re about to die’, ‘I felt like I was having a heart attack’, ‘I couldn’t breathe and was shaking’. Panic attacks feel excruciating because they tend to appear out of ‘nowhere’ and can come on at any time. However, despite how frightening they are, they pass within 10-20 minutes.
The constant fear of having a panic attack can make panic feel impossible. The thought ‘this can happen at any time’ keeps the anxious mind on look out and can actually cause a panic attack. In my work with people with anxiety and who suffer from panic attacks, my initial goal is to offer my clients tools for identifying and managing panic. Often, my clients will tell me that ‘not much was happening’, or ‘I don’t know why I had one, I was feeling fine’. I then ask general questions about the days leading up to the panic attack. My goal is to comb through any small piece of information that would cause anxiety to build into a full-blown panic attack. In fact it is the very small and unexamined voices within us that cause panic to explode.
For example, a woman experiences a panic attack in the middle of the day at work. She has had an average uneventful day and cannot understand why she experienced panic. She explains that the week has been ‘good’, the ‘usual’. Then she describes tension she’s had with her sister in which she feels some guilt. She explains that she was late for work the other day, but that her boss understood. She reports that she feels like she’s not getting anywhere in life and that she wants to take courses. In this scenario, the woman mentioned is experiencing a build up of subconscious thoughts that trigger feelings of guilt & questioning of self-worth. Without her understanding, she has gone on with her week ‘as usual’ but has not identified the underlying conversation and messages in her mind, such as: “I’m late for work, I’m going to be fired, my boss is going to hate me, I’m a bad sister, I should do more, I feel like a failure, I will never get anywhere’. The pressure from these unchallenged thoughts result as panic, shutting her system down and leaving her even more vulnerable to negative self-messages.
While experiencing a panic attack it is difficult to access the underlying thoughts until your nervous system has stabilized. Here are some helpful tips on what to do when panic strikes.
1. Repeatedly tell yourself you are having a panic attack and that you are not going crazy (even if you feel like you are). By identifying the panic, you begin the cognitive process of gaining ‘space’ from the experience.
2. Get to a safe place. If you are in public, this could be a restroom or a park bench. If you are on a train, get off at the nearest stop. If you are driving, you can pull over. The impulse to resist panic (or any feeling) actually increases it. By stopping what you’re doing, you are making time to address these feelings, which gives you a greater sense of control.
3. To stabilize your central nervous system, breathing is essential, yet feels impossible at the moment. Therefore, try to take one deep breath and hold it for 10 seconds if you can. Breathe out and again take a deep breath and hold it for 10 seconds. If you can do this at least a few times, you will feel your internal system slowing down. Breathing allows you to return to your body and out of your thoughts. Remember: There is no ‘right’ way to breathe.
4. Squeeze your eyes tightly closed and slowly release the tension. Try and do this 3 times. This is often helpful if you feel like you’re losing your vision or feeling dizzy. Again, the purpose is to feel your body and gain control slowly.
5. Tap on your forehead (in between your eyes) with your index and middle finger for one second. This technique can be helpful for interrupting negative self-talk and anxious thoughts. It also has a calming effect on your nervous system.
6. If you are able, lie down. If not, you can sit in a chair and put your head between your knees (this brings blood to the brain) and can help with feeling faint.
7. Take a bag of ice, an ice pack or frozen peas and place it just below your skull on the back of your neck. This shocks your mind out of the panic and brings you back into your body (for the floaty dissociated feelings). You can also use this for when you feel a panic attack coming on, or are extremely anxious.
8. Eat some food and drink water. This again is to help tell your body and mind that you are not dying but that you need extra nutrients from expending so much energy from having a panic attack.
9. Plan on getting extra rest that night or later in the day. Panic and anxiety can be exhausting. Again, the goal is to reset your nervous system and let it rest. If you are able to do something enjoyable and low key that is a good idea too.
10. FORGIVE yourself for having a panic attack. The worst thing to do during or after a panic attack is to judge yourself. Tell yourself again that you had a panic attack and that you are safe. Give yourself credit for getting through it the best you could. Often, it is the self-judgment that increases and prolongs the panic.
If you feel your anxiety and panic are impeding your ability to live the life you desire, talking to a therapist can be extremely helpful in decreasing your symptoms, as well as increasing your confidence to effectively manage the anxiety before it becomes panic.
