For those who suffer from panic attacks, the onset of symptoms is undeniable. They often can seem to come out of nowhere and mimic medical emergencies such as a heart attack. The pressure and mounting stress set off a chain of events in the body leading to a panic attack, which is characterized in the Diagnostic and Statistical Manual of Mental Disorders (DSM5) by the following symptoms:
- Increased heart rate
- Shortness of breath
- Pressure in chest
- Light-headed or dizzy sensation
- Feeling hot or cold for no reason
- Numbness or tingling
- Feelings of detachment from reality or body
- Fear of losing control or dying
Why Panic Attacks Happen
Panic attacks happen when the body’s nervous system activates the fight/flight response. This response has an important biological function as it alerts the body to possible danger and prepares to fight or run away. The problem with the fight/flight response is that it can become overly cautious and activate when there is no identifiable danger. It may be a smell, sound, sight, or internal sensation that triggers the fight/flight response.
When the body activates the fight/flight response when there is no danger, it does not know how to protect itself from the unseen danger. As a result, the body is ready to run or fight without a known reason and direction, which causes the panic sensations. This is especially a common reaction for people with a history of traumatic events, but panic attacks can happen to those without past trauma as well.
Tips for Handling a Panic Attack
The first thought for many people when a panic attack starts is something is wrong. The second thought is often, make this stop!
When a panic attack starts, fear tends to take over, and it feels like there is real danger. Many struggle to know how to calm themselves and may feel helpless. These steps may help to calm the panic and restore calm in the body.
1. Step Away from the Situation
The first step is to move away from the situation or current location. Even if there is no danger in the current situation, this is an important protective step since moving to a different location may help reduce the brain’s alarm. If possible, find a quiet place with limited noise, light, screens, etc. This may help the brain to focus more on the body and less on the distractions of the outside world.
2. Deep Breathing
This strategy is often suggested when talking about anxiety and panic attacks. It has become a little cliché as it is used to encourage people to calm down in all situations, but the reason it is mentioned often is because biologically it works. Here’s why. As the fight/flight response starts, it activates the body to fight or run by increasing heart rate, promoting shallow breathing, and slowing digesting and non-essential body functions.
By focusing on slow, deep breaths that go to the diaphragm/abdomen, the body is flooded with oxygen, which helps to regulate the nervous system and decrease the stress hormone in the body.
Try this. Focus on your breath. Notice it going all the way to the belly and slowly inflating the abdomen. Notice the breath going in and out in a slow rhythmic pattern. If the mind wanders, return your focus to the breath.
3. Grounding Strategy
Grounding is a technique used to help center the mind and body to the present place and time. It is done by noticing the connection between your feet and the ground, your chair under your body, or something held in your hands. The purpose of grounding is to get the brain to stop focusing on the perceived threat and connect back with the moment.
Try this. Notice the connection between your feet and the ground. Feel the pressure and sensation. Notice where the pressure decreases. Notice how your body feels sitting on a chair. Pay attention to temperature, pressure, or sensations.
4. Orient to the Environment
Orienting is similar to grounding, except this strategy uses sight to center the body back into the environment. Orienting involves looking around the room or area and noticing the colors, textures, or light. This strategy can be calming as it helps the brain to scan the environment for threats and while orienting to the room, the brain is able to notice the safety within the space.
Try this. Pick a color and look around the room to notice all objects of that color. Move your head and neck slowly to see the whole room. Count or name the items of that color.
The parts of the brain responsible for the fight/flight response are primitive in that their main functions are to alert you to possible danger and automatic body responses. As a result of these basic features, this part of the brain does not differentiate between memories and present. That is why thinking about traumatic events can trigger the same bodily response as occurred during the event. Calming visualization can help soothe this part of the brain, thus calming the nervous system.
Try this with your eyes closed. Visualize a serene and calm environment. It may be a mountain, stream, forest, a cozy cottage, a bedroom, or a grandparents’ home. Visualize being in that space. Imagine the smell, the sounds, the colors, the sensations, and feelings.
6. Repeat a Mantra
Repeating a mantra during a panic attack may help calm the brain and encourage the brain to focus on the mantra rather than the anxiety. The mantra may be “this will pass soon,” “I am in control,” or something more specific to help calm the most challenging symptoms like “there is enough air in this room.” It is helpful to have these planned before a panic attack as thinking of a mantra to repeat may be difficult in the moment.
Try this. Repeat the mantra slowly over and over out loud or internally. Be sure to go slow and notice each word.
Another important step to managing panic attacks is to seek out therapy. A therapist can help process the trauma or anxiety, which may be causing the panic attacks. The therapist will also be able to help teach and practice strategies to help reduce the frequency and intensity of the panic attacks.
Panic attacks are scary and uncomfortable. The symptoms can often seem to come out of nowhere. It’s a good idea to rule out any major medical health issues. If it is determined that the symptoms are related to panic attacks, these strategies can help the body reduce the intensity of the symptoms and calm the nervous system.