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How to Cope with Panic Attacks

Anxiety is a normal part of life. You likely feel keyed up or on edge when you’re waiting for medical test results, when a car suddenly pulls out in front of you, or when you realize you’re running short on money and payday is still a week away. Anxiety is a normal reaction to these events because all three examples share one thing in common: they’re threats. Bad news from the doctor and a car pulling out in front of you can both mean your life is in danger. Running out of money can mean you might lose your home or won’t have enough to eat.

Normal anxiety is useful. It can energize you and help you focus on your final exam. It can help you react quickly to avoid an auto accident. It can help you figure out the solution to a problem.

When anxiety reaches a level to where it is causing you distress and is going on for some time, you may have an anxiety disorder or possibly posttraumatic stress disorder (PTSD). People with anxiety disorders often report ongoing fear and worry, irritability, sleep disturbance, muscle tension, and other symptoms.

What is a panic attack?

Some people with anxiety occasionally experience panic attacks. While anxiety gradually builds up, a panic attack is a sudden, intense bout of anxiety that usually lasts for several minutes and rarely more than an hour. During a panic attack, you may feel an extreme sense of dread, racing heart, shortness of breath, sweating, shaking, chest tightness, dizziness, and feeling disconnected from yourself or your surroundings. You likely feel exhausted and still at least somewhat anxious after a panic attack subsides. Panic attacks are terrifying, and sufferers often feel like they are dying or going crazy. Fortunately, neither of these are true – panic attacks are actually harmless.

You can’t stop a panic attack once it starts; it will stop on its own. If you’ve had your first panic attack, please see a physician to ensure that your symptoms are not caused by something else. If you know you’re having a panic attack, here are some steps you can take to help you cope while it is occurring.


When you feel a panic attack starting:

1. Talk to yourself.

It’s helpful to identify the panic attack, because the nature of panic is to frantically search, either in your head or in your environment, for any source of danger. In a panic attack, you cannot run from it or fight it, as there is no source of danger. Stay in the present.

During a panic attack, you may have scary and negative thoughts like “What if I’m losing my mind?” or “What if I pass out?” Interrupt these thoughts as they come.

Instead, say to yourself, “I’m having a panic attack. I know I’m not in any danger, I’m not going crazy, and I’m not dying. I know this will be over soon.” Try repeating a specific phrase to yourself, such as “I am okay” or “Ride it out.”

2. Choose your position.

Some people find that sitting or lying down is most helpful during a panic attack. Sometimes, sitting on the floor is best because it feels more stable. Other people find that pacing is more soothing, just stay where you are if you can. You don’t have to leave where you are for the panic to subside – relief will come to you.

3. Breathe.

Focus on slowing your breathing by inhaling through your nose to a count of five. Fill your lungs with air all the way down to the very bottom. Your stomach should expand before your chest rises. It may help to place one hand on your stomach and the other on your chest. As you breathe in, make sure your belly expands. Then breathe out through your mouth to a count of five. Repeat until your panic attack begins to abate.

4. Look at something or just close your eyes.

Since your vision becomes very acute during a panic attack, visual stimuli can be overwhelming. Choose an object to focus on. If it’s helpful, describe the object by saying its name, color, shape, purpose, etc. If closing your eyes helps more, do that.

5. Wait it out.

Although it feels like it will never end, a panic attack, by definition, is time-limited. Read more about that below. Relief will come no matter what, so just wait.

Between panic attacks:

1. Know what they are, and what they aren’t.

Knowledge is power. Knowing what is going on in your body when you’re having a panic attack can help you cope and prevent you from misinterpreting the symptoms as something more severe.

We share an amazing survival feature with most of the animal kingdom: the fight or flight response. Be grateful you have this ability – when faced with real danger, it can save your life!

Your body keeps a reservoir of a chemical called adrenaline at the ready in case it is needed. When faced with an immediate, life-threatening danger, your brain quickly sends signals to your body to help you survive. Your body dumps the adrenaline (and another chemical, cortisol), which causes physical changes that help you to defend yourself or escape. Your heart rate increases to pump blood more quickly into your large muscle groups. Your pupils dilate to help you perceive the environment more clearly. Your energy level soars. Your digestion slows to divert energy to your muscles. Along with these effects, you feel terrified and may experience shaking, sweating, skin flushing, chest tightness, shortness of breath, elevated blood pressure, tunnel vision, and dry mouth.

A panic attack is a sort of “misfiring” of this natural response to danger. When the fight-or-flight response begins due to non-lethal stress or no apparent stressor at all, we call it a panic attack.

You can see why panic attacks are so terrifying and distressing! Fortunately, your adrenaline reservoir “burns out” in a short period of time, and the panic attack ends. It takes your body a certain amount of time to rebuild that reservoir of adrenaline so that it is ready for the next time it is needed.

2. Learn and practice relaxation techniques.

Relaxation is the opposite of anxiety. When you learn and practice relaxation-inducing behaviors, your anxiety is reduced. Just like training for a marathon, you must practice these techniques for them to help you. Too many anxiety sufferers try these techniques once and decide they don’t work. You didn’t develop your anxiety problem overnight, and you won’t cure it overnight. Make a commitment to yourself to practice relaxation techniques every single day, whether or not you feel anxious.

Some types of relaxation techniques that have been shown to be helpful include abdominal breathing, progressive muscle relaxation, mindfulness, and visualization.

3. Exercise regularly.

Did you know that exercise is one of the best mental health treatments? Exercise helps relieve anxiety as well as depression. It really doesn’t matter what kind of exercise you do, but aerobic exercise may produce the best mental health effects. Yoga is also a great way to reduce anxiety, as it combines physical activity with deep breathing and mental focus.

4. Seek support.

Keeping a good social support system can help you by knowing you are not alone, increasing your quality of life, helping you feel connected, and even helping you live longer. Stay in regular contact with friends and family, even if it is just to ask them how they’re doing.

5. Get help.

Panic attacks usually begin after you’ve been under a lot of stress over a period of time. Counseling can help you learn to manage your day-to-day stress so that it does not build up. A mental health counselor can help you learn the techniques you need to manage your anxiety and stress as well as cope during panic attacks. Our counselors in Cary can provide the anxiety treatment you need.

There are medication options for people with chronic anxiety and panic attacks. If medication is needed, we can refer you to psychiatrists in Cary and the surrounding areas to discuss medicine that might help.

If you have struggled long enough and want to talk about your symptoms with a therapist who understands, give us a call. We are happy to help you.

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