What is a panic attack?
Have you ever felt intense and overwhelming fear or anxiety that lasted for several minutes? If so, it is possible that you experienced a panic attack. Panic attacks are characterized by 4 or more of the following symptoms that develop quickly and reach a peak within 10 minutes:
- Palpitations, pounding heart, or fast heart rate
- Sweating
- Trembling or shaking
- Shortness of breath
- Feeling of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded or faint
- Feelings of unreality or feeling detached from oneself
- Fear of “going crazy”
- Fear of dying
- Numbness or tingling sensation
- Chills or hot flushes
What causes a panic attack?
If you were to come face to face with a bear or another immediate danger, your brain would turn on its fight or flight response. This response would pump your body with many chemicals, including adrenaline and noradrenaline, which would trigger changes in your body including: accelerated heart rate, dilated pupils, trembling, pale or flushed skin.
A panic attack occurs when the fight-or-flight response is triggered and this can even happen when there is no immediate danger. Some things that could lead to this include ongoing stress (which leads to higher than normal stress hormones), acute stress, having too much caffeine, a quick change in environment, intense exercise, or illness. There are also some medications or drugs that can induce a panic attack as well. Your panic can also increase by the thoughts that you have, including thinking that you are having a heart attack or dying, which can lead to you noticing your body symptoms even more. This can lead to an even more intense fight-or-flight reaction.
Panic Disorder
For many people, experiencing feelings of panic only occurs during specific moments or with specific triggers. However, some people may have panic attacks frequently and unexpectedly. They can happen even when there is no obvious danger or trigger. If a person has more than one panic attack a month and then begins to fear that they might have future attacks or worries about their consequences, they may have developed a panic disorder. If this sounds like you, it might be helpful to seek further help in dealing with your panic. In the meantime, there are several strategies that may help you deal with the panic attacks you are experiencing.
Learn to gain control over your breathing
It is very common to hyperventilate during a panic attack. What this means is that you are taking deeper breaths which can lead to you feeling out of breath, thus leading to dizziness and disorientation. If you learn how to have a more stable breathing rate, this can help stop the panic you are feeling.
It can help to find a quiet place to lie down or sit if it is possible.
Then,
- Take a deep breath in through your nose for a count of four.
- Hold for a second.
- Breath out through your nose for a count of four.
- Repeat for several minutes until you feel more calm.
You can use this link to help control your breathing:
Use Progressive Muscle Relaxation
This technique involves tensing and relaxing all of your muscles from your toes all the way up to your head. When you are having a panic attack, you are already extremely tense. By tensing your muscles even further, this can actually lead them to become more relaxed than they were at baseline.
Here is a step by step guide:
- Find a quiet place to attempt this, either sitting or lying down. Close your eyes if you feel comfortable doing so.
- Take a deep breath in through your nose for a count of four.
- Hold for a second.
- Breath out through your nose for a count of four.
- Repeat 3-4 times
- Then, on your next inhale, squeeze all of the muscles in your toes and feet, and while squeezing and inhaling, count to four.
- Then, exhale slowly and relax the muscles you’ve been squeezing.
- Pay attention to the differences between tension and relaxation.
- After about 5 seconds, move your attention up to your calf.
- On your next inhale, squeeze all of the muscles in your calf, and while squeezing and inhaling, count to four.
- Then, exhale slowly and relax the muscles you’ve been squeezing.
- Then, repeat all of these steps of tensing and relaxing as you slowly move up your body to your:
- Knees
- Thighs
- Entire leg
- Buttocks
- Stomach
- Upper Chest
- Hands
- Arms
- Shoulders
- Jaw / Mouth
- Eyes
- Forehead
- Entire face
- When you have finished your entire body, pay attention to how you feel. You should be in a state of increased calm and relaxation.
- Try and repeat this once a day, even when you are not actively having a panic attack. The more you practice, the easier it will be to return to this state when you are feeling extremely anxious.
Use Grounding
Grounding involves focusing your attention on the present moment and away from any anxious thoughts or sensations you may be feeling. One technique is known as the 5-4-3-2-1 technique. This can be done anywhere at any time, and people have found that it can really help in reducing panic.
What are 5 things that you see?
- Look for things in your immediate environment that you haven’t noticed before, such as the way light is reflecting in the room, or cracks in the walls.
What are 4 things that you feel?
- These are physical sensations, so notice the feeling of the chair against your leg or arm, the feeling of your hair against the back of your neck, or pick up an object and notice how it feels in your hand.
What are 3 things that you hear?
- Listen to the sounds you weren’t paying attention to, such as the clock or the AC blowing.
What are 2 things that you smell?
- Try to notice smells in your environment. You could also pick up a candle or candy near you.
What is 1 thing you can taste?
- Try to have gum or candy near you, and pretend you are eating it for the first time in your life, focusing on all of the flavors you are experiencing.
Change your body temperature
While it may seem strange, putting your face in cold water (such as in the sink or a bowl of water) or taking an ice pack out from your freezer and putting it against your face can actually slow your heart rate and activate the parasympathetic nervous system. This can decrease the symptoms of a panic attack.
Do some movement
Consider doing some quick intense movement, such as running in place, doing a quick set of push ups or sit ups, and doing jumping jacks. During the fight-or-flight response, our body is prepped for running away or doing some other type of intense activity. Moving can help de-escalate intense emotions and release the pent up energy.
Remind yourself that you are not dying or in danger
The symptoms of a panic attack can be uncomfortable and scary, but if you can convince yourself that you are okay and these are normal feelings that happen during the fight-or-flight response, this may help your brain calm itself down.
Consider seeking a CBT Therapist
Cognitive Behavioral Therapy (CBT) is an evidenced-based therapy that is often used to treat panic attacks and panic disorder. In this therapy, you will learn new ways of thinking, feeling, and reacting to the overwhelming sensations that you may experience during a panic attack. One aspect of this may include desensitization, which involves slowly being introduced to more fear inducing situations and learning coping strategies for dealing with each situation. Other aspects include being exposed to bodily sensations that occur during a panic attack (also known as interoceptive exposure), identifying thoughts that you have when you are anxious and being able to to correct misinterpretations of these sensations, and becoming skilled in ways to reduce physical tension.
If you would like more support on how to implement these practices and manage panic attacks or other types of anxiety, please reach out to me, Dr. Hannah Gilfix. Using CBT, I can work with you to feel more confident in managing panic symptoms and get back to the life you desire.
