5 Tools to Make Panic Attacks Less Awful

Dr. Hannah Singer

One minute you’re casually cruising the aisle of the grocery store deciding between cheddar and colby jack and the next you feel a wave of fear wash over your entire body. Your heart starts pounding. Your chest feels tight. You suddenly feel like you’ve come down with a flu… or food poisoning... on a roller coaster.... With an elephant sitting on your chest.

Sound familiar?

I’m not gonna sugar coat it. Panic attacks suck. Luckily, there are some powerful techniques to make them suck a little less.

What is a panic attack? 

“I’m having a panic attack” has become a popular figure of speech, but a true panic attack is different than feeling mildly overwhelmed, flustered, or nervous. A panic attack is a sudden rush of intense fear accompanied by at least 4 of the following symptoms

• Irregular heartbeat

• Sweating
• Trembling or shaking
• Feelings of choking
• Shallow or rapid breathing
• Chest pain
• Nausea
• Diarrhea
• Feeling dizzy or lightheaded
• Chills or hot flashes
• Numbness and tingling sensations - especially in the hands and feet
• Feeling detached from your body or “floaty”
• Fear you will lose control or “go crazy”
• Fear that you are seriously ill or dying. You may even call 911 because you fear you’re having a heart attack or a severe allergic reaction.

Panic attacks come on suddenly and reach a peak within a few minutes. They typically last about 10 minutes, however, some symptoms may ebb and flow over the course of several hours.

There are two types of panic attacks: 

1. Unexpected panic attacks seem to come out of the blue without any obvious cue or trigger. They often occur even when the person is completely relaxed or in a deep sleep.
2. Expected panic attacks have a specific cue or trigger, perhaps a stressful situation or a distressing memory. Sometimes triggers can be very subtle and difficult to identify.

The unpredictable nature of panic attacks can lead to feelings of powerlessness and vulnerability. Working with a therapist to identify subtle triggers can demystify the experience of panic and help restore a sense of control and predictability.

​If you find yourself limiting or avoiding certain places, situations, or activities due to fear of having a panic attack, I highly recommend seeking help from a qualified mental health professional who will teach you effective tools to reduce panic, stop avoiding, and get back to living your life!

Are they dangerous? 

The #1 most important thing to remember while in the midst of a panic attack is that they are not dangerous.

Extremely frightening and uncomfortable? Absolutely!  But, not dangerous.

Still, it’s always a good idea to get checked out by a doctor to rule out medical causes of panic symptoms. Getting a clean bill of health will also give you peace of mind -  if you happen to have another panic attack, you will be able to reassure yourself that you are not in any danger.

What is a panic attack? It’s a completely natural and harmless bodily process (activation of the emergency fight-or-flight response) that gets turned on out of context. Your brain mistakenly perceives a cue in your environment as a threat and signals your body to secrete a large amount of adrenaline and cortisol to prepare to fight or flee from the supposed danger. It’s this surge of hormones that causes all the uncomfortable physical symptoms.

Negative Feedback Loop 

It is very common for people to interpret their panic attack symptoms as being dangerous, which actually adds fuel to the fire and prolongs the panic attack.

For example, some people think “my heart is beating so fast that I am going to have a heart attack” (You won’t. A healthy heart can beat up to 200 beats per minute for weeks without causing long-term damage, so a panic attack will not cause heart failure.)

When you interpret your bodily symptoms as dangerous, your brain is now creating imaginary danger and ramping up your fight-and-flight system even more.

Moral of the story is, the more you can just ride it out and observe the uncomfortable feelings of the panic attack without engaging in catastrophic thoughts, the sooner the panic symptoms will subside. Once the body sees it made a mistake and there is no real danger, it will turn off the alarm system. The surge of adrenaline that was released into your body will break down and be reabsorbed within three to five minutes and you will begin to feel better.

5 Tips to "Ride it Out"

What can you do to interrupt this negative feedback loop and make it easier to "ride it out"? Here are some simple, but effective methods. 
​ 

1. Replace catastrophic thoughts with reassurance. Choose 2-3 soothing statements and continually repeat them to yourself. Try one of these phrases: ​I am safe. Nothing serious is going to happen to me. This is uncomfortable, but not dangerous. I can handle these body sensations. Even though I’m having these uncomfortable sensations, I completely and totally accept myself.
2. Move around. Physical movement helps dissipate and absorb the extra adrenaline created by the fight-or-flight response.
3. Practice Belly Breathing.  Come on - You didn’t think a therapist would write an article about anxiety and panic without mentioning deep breathing, did you? Place one hand on your heart and the other on your belly button. Breathe so that the hand on your belly moves with each breath and the hand on your heart stays still.  Downloading a free guided breathing app on your phone ahead of time may be helpful.
4. Distract yourself. Talk to somebody nearby, read a magazine, try to think of 20 different types of condiments, name every red object you see around you….. Basically anything that takes your focus off your bodily sensations until the symptoms subside.
5. Demand more! This paradoxical intervention is one of my favorites. It’s based on the premise that suffering is not caused by your experience. Rather, suffering is caused by resisting your present moment experience. Once you drop the struggle and are willing to allow your present moment experience to be there (even when uncomfortable) suffering decreases. Try it. The next time you’re having a panic attack, talk back to your panic. Say “hey panic! is that all you got? Come on!!! I demand more!” The hard part is, you gotta really mean it!

So there you have it. Five simple, but powerful techniques to stop the negative feedback loop that prolongs a panic attack and make it a little less awful. Hope these are helpful! 

If fear of having additional panic attack is affecting your quality of life (ie: you’re avoiding situations like driving because you’re scared of having an attack and losing control) I encourage you to seek help from a therapist experienced in treating anxiety disorders. It’s important to know that you are not alone and Panic Disorder can be effectively treated with therapy and/or medication. In my practice, I have helped many individuals drop their struggle with panic and anxiety. If you're interested in working with me in individual therapy, click here to learn more. 

Do you have other techniques that are helpful for managing panic attacks? Feel free to share them in a comment below!