According to the Anxiety and Depression Association of America (ADAA), approximately six million Americans suffer from panic disorders, and women are twice as likely to experience them as men. That’s a lot of women, and a lot of panic. A panic disorder is characterized by “spontaneous seemingly out-of-the-blue panic attacks,” as well as the intense fear of suffering from more panic attacks. There are things you can do to try to prevent attacks, but if you’re someone who suffers from them regularly, it’s important to have strategies in place for how to handle a panic attack when you’re already in one.
First things first, however: What is a panic attack? The ADAA defines a panic attack as “the abrupt onset of intense fear or discomfort.” It can reach its height in the space of only a few minutes, and is characterized by the following symptoms:
- Accelerated heart rate, heart palpitations, or chest pain (some people suffering from panic attacks at first assume that they are having heart attacks).
- Shortness of breath
- Intense fear of losing control or dying
Not everyone will experience all of these symptoms or experience them in the same way. Visit the ADAA for more info and a full list of symptoms.
Read on for things to try when you are in the midst of a panic attack; these simple measures may help you get through to the other side. But I want to be clear on this first: I am not a medical doctor, nor am I an authority on anxiety. If you are experiencing debilitating anxiety or repeated panic attacks, go talk to your doctor. Although some people experience a single panic attack and never have another one, others develop panic disorders characterized by chronic attacks. These attacks—and the fear of having more—lead many sufferers to avoid situations and places that will cause anxiety. Although this avoidance might seem logical on its face, it can ultimately turn into a deeply debilitating condition called agoraphobia (“fear of open spaces”).
So if you’re having multiple panic attacks (or you even have one really scary one), talk to your doctor and get a referral for someone who specializes in anxiety and panic disorders. He or she may be able to help you significantly, through suggesting lifestyle changes, medication, and techniques like cognitive behavioral therapy. After all, if you can treat your panic disorder before an attack starts, you won’t even need to worry about stopping an attack mid-stream, and you can read this article about puppies making fools of themselves instead of this list of suggestions. And that’s a win for both you and the puppies.
But if you DO find yourself facing a panic attack, here are some strategies you can use to help work your way through it:
1. Recognize the signs of a panic attack
If your panic attacks give you intense physical symptoms (like chest pain or heart palpitations), it’s a good idea to get checked out by a doctor to make sure that there really is nothing physically wrong with you. Once you have that assurance, try to remember it when you feel a panic attack starting. Although your emotions may be screaming, “I can’t breathe! I’m going to faint! I’m dying!”, try to distance yourself from that noise and recognize these symptoms as perfectly normal signs of a panic attack. Simply knowing that what is going on is a normal panic response and that it is a symptom of psychological, rather than physical, distress may help you to power through to the end of the attack.
2. Be reflective
John Tsilimparis, director of the Anxiety and Panic Disorder Center of Los Angeles, tells Psych Central that he recommends that patients “Be reflective, not reactive.” He suggests that panic attack sufferers write down the negative thoughts they’re having (“I’m dying,” “I’m losing my mind,” etc.). Writing down these thoughts creates distance between the thoughts and the thinker, reorienting the panic sufferer into a more reflective mode. Tsilimparis advises patients to then write down more rational thoughts (i.e., “I am having a panic attack right now,” “My doctor said my heart is fine,” “I am not all alone.”).
3. Breathe deeply
When we’re panicked or stressed, we tend to breathe rapidly from our chests; this is a shallow form of breathing that usually has the effect of making us feel even more stressed and out of control. Counteract this response by practicing deep, slow breathing. Place one hand on your chest and one on your belly; as you breathe in, try to make your belly expand with air, rather than your chest. Inhale slowly through the nose or through pursed lips (you may find it helpful to count silently up to four on your inhale, and then exhale for a count of four). Close your eyes and focus on your breath, on your hand as it rests on your belly, on the air as it enters your nose and flows down the body. This focus will help you to slow your panicked breathing and your racing heart rate, as well as give you something to focus on besides your panic.
Mara Wilson (of Matilda fame) helpfully demonstrates a breathing technique for panicky moments in the video above. (The whole video is worth watching, but for just the breathing part, skip to the 1:30 mark.)
4. Ground yourself
Panic attacks can cause feelings of disorientation, so it can be helpful to ground yourself. Your mind may be telling you to flee, but try to stay where you are and bring yourself into the present moment. Linda Esposito explains in Psychology Today, “Grounding strategies include feeling your feet on the ground, or your hands on the steering wheel, or bracing yourself against a wall.” That connection to something solid may help your feelings of being out of control.
5. Remember, it’s only temporary
Although it can feel like a panic attack is never going to end, it’s important to remember that it is temporary. Most panic attacks peak within ten to twenty minutes or so (though some symptoms can last longer). Remind yourself that the panic will end, and that you will survive it.
6. Tell the people close to you what to do
The people who love you may mean well, but they simply might not know what to do when you’re having an attack. Take the time when you’re not panicking to verse them on how best to help you when you’re in the midst of an attack. Tell them what they shouldn’t do (like saying, “You’re just being silly; this is all in your head!”), as well as what they should (Do head massages help you? Show your partner how to do it! Does it help to do a body scan? Tell your best friend how to lead you through one.)
Finally, everyone’s panics attacks are a bit different, and so everyone has different needs when it comes to combatting them. If you’re having panic attacks, a therapist will be able to help you come up with strategies for dealing with attacks in the moment that are customized to your attacks and your triggers.