What is a Panic Attack?
A panic attack is a sudden, intense, often mounting, surge of physiological arousal, largely caused by an increase in adrenaline and cortisol, that is initiated sometimes seemingly out of no where or by an internal or external stimulus which in reality is not dangerous or life threatening — though it may feel so to the person experiencing it. A panic attack usually develops abruptly and reaches a peak within about ten minutes. Most panic attacks subside within thirty minutes and rarely last more than an hour.
A panic attack is an extremely uncomfortable and overwhelming experience which has physical and psychological symptoms. Common physical symptoms associated with panic attacks include heart palpitations, shortness of breath, tightening in the chest or throat, hot or cold flashes, dizziness, faintness, nausea, sweating, shaking, and tingling in the hands and feet. Common psychological symptoms include feelings of unreality, an intense desire to run away, and fears of going crazy, dying or losing control.
It is such an unpleasant experience that a first panic attack often leaves a person with a strong anticipatory sense of anxiety about the possibility of a recurrence. Sometimes people only experience one such attack in a lifetime, while others develop a chronic condition involving several attacks a week.
How to Manage Panic Attacks
The good news is that panic attacks can be managed. Lifestyle choices can make a difference. Living a lifestyle which involves a regular practice of relaxation of some kind (e.g., meditation), having a regular exercise regime that involves increased cardiovascular activity, eliminating stimulants from your diet (e.g., caffeine), and developing habits of thinking that are calmer and more accepting towards yourself and life, all make a difference.
In addition to these lifestyle choices, there are several strategies and techniques which can be employed to help control panic attacks. One such strategy is to use your mind in the midst of a panic attack to deflate the sense of danger you experience and to soothe yourself with comforting thoughts. During a panic attack it is really common for a person to think catastrophically, i.e., to add to the physical sensations they are experiencing by thinking scary thoughts such as “I am going to die, or go crazy or faint or lose control somehow”. The very definition of a panic attack is that it involves fear without real threat or danger. If you can use your mind to talk yourself through a panic attack by saying things to yourself such as “This is just a panic attack”, “I am not really in danger or at risk”, “The sensations I am experiencing are unpleasant, but not dangerous”, “This will pass ” and so on, you will be calming yourself down and you will not be fueling the unpleasant sensations with your thoughts.
A related technique is simply stick with the physical sensations that you are experiencing moment-by-moment. You do this by giving them a name or a label such as “tightness in chest” or “sweaty palms”, or “upset stomach”. This technique does two things: it keeps your mind occupied and not catastrophizing, and it reminds you that all an anxiety attack is is a series of highly unpleasant sensations.
Another technique is to accept and not fight against the symptoms you are experiencing. This involves cultivating an attitude that is tolerant of the sensations and encouraging of yourself. You don’t tense against the sensations, you simply feel them. You say to yourself things like “I am okay”, “I can handle this”, “This is familiar and I have gotten through it before”, and “This will end soon; it always does”. The idea is to be a watchful observer of yourself and your physical sensations and a compassionate coach to yourself.
Yet another technique to manage panic attacks is to teach yourself how to identify the very early stages of a anxiety and learn to intervene before it becomes full blown. This is different from fighting against a panic attack that is already full blown. It involves knowing and catching your own idiosyncratic early warning signs of anxiety. If you can identify the early stages of the anxiety response, you may be able to take action to calm yourself down. Examples of taking action include:
- using various breathing techniques to stimulate your parasympathetic nervous system (sometimes referred to as the “relax response”),
- engaging in physical activity to burn off the cortisol and adrenaline,
- retreating temporarily from the anxiety-inducing circumstances until you feel that your anxiety is under control,
- confiding in a supportive person that you are feeling anxious,
- using various grounding techniques to keep yourself oriented to the present, such as using all of your senses to take in your immediate environment,
- engaging in an activity that is either soothing (like taking a bath) or requires focused attention (like reading a book),
- seeking something either pleasurable (like good food) or comforting (like a hug),
- replacing anxious thoughts with supportive, calming thoughts, and
- practicing muscle relaxation techniques