How to Deal with a Panic Attack in the Moment + Tips to Prevent Panic Attacks in the Future
Panic attacks … do not always occur in relation to a particular trigger or stressor. They can be unprovoked and unpredictable, which is in part why they can be so terrifying. Furthermore, while a single panic attack may only last a few minutes, the effects of the experience can have a lasting imprint, which is why we are going to look at what to do during a panic attack and how you can prevent and/or manage them in the future.
We have all experienced moments where we feel so overwhelmed that we begin to shut down. Sometimes it feels like our brain and body just forget how to work. These kinds of situations can be very frightening, especially when they develop into fully-fledged panic attacks. This is why, as I discuss in this week's podcast and blog, it is so important we learn how to prevent and control these kinds of incidents before they do untold damage to our mental and physical health. (Photo by nikko macaspac on Unsplash)
But what exactly is a panic attack, and why is it so scary? It is a sudden episode of intense and often overwhelming fear that immobilizes someone's thinking and, in many cases, movement. They may trigger severe physical reactions, even when there is no real danger or apparent cause present, and can be very alarming. When panic attacks occur, someone might think they are losing control of their body, having a heart attack or even dying.The signs and symptoms of a panic attack occur sharply and abruptly, and usually reach their peak within 10 minutes. They rarely last more than an hour, with most ending within 20 to 30 minutes. Panic attacks can happen anywhere and at any time; you may have one while shopping, walking down the street, driving in your car, or even sitting on the couch at home watching TV.
Many people have around one to two panic attacks in their lifetime, and the problem can go away when the stressful situation ends. However, if you had or are experiencing recurrent, unexpected panic attacks, and are in constant fear of another attack, then it's important to find the root causes of your panic attacks (and see a medical professional if symptoms persist), as they can seriously damage your mental and physical health if they are swept under the rug.
It is important to note that an anxiety attack is different to a panic attack. An anxiety attack can make you may feel fearful and apprehensive, and, during the attack, you may feel like your heart is racing or are short of breath. This, however, is usually short-lived, and when the stressor goes away, the anxiety attack frequently subsides.
Panic attacks, on the other hand, do not always occur in relation to a particular trigger or stressor. They can be unprovoked and unpredictable, which is in part why they can be so terrifying. Furthermore, while a single panic attack may only last a few minutes, the effects of the experience can have a lasting imprint, which is why we are going to look at what to do during a panic attack and how you can prevent and/or manage them in the future. Learning how to control these attacks can help assuage the constant feeling of fear and anxiety as you anticipate the next attack, which can be extremely disabling.
In fact, if you battle from anxiety or panic attacks, I would recommend memorizing the steps I am going to talk about in this blog, which may help prevent the development of certain phobias as a result of your panic attacks. Say, for example, you avoid certain situations or environments because of you had a panic attack there. This avoidance may be based on the belief that the situation you're avoiding caused a previous panic attack, or you may just avoid places where escape would be difficult or help would be unavailable if you had a panic attack. Taken to the extreme, this avoidance may develop into agoraphobia, which can have a serious impact on your quality of life.
It is also important to note thatpanic attacks can also be caused by medical conditions and other physical causes. According to the Mayo Clinic, if you're suffering from symptoms of panic, it's important to see a doctor to rule out the following possibilities:
1. Mitral valve prolapse, which is a minor cardiac problem that occurs when one of the heart's valves doesn't close correctly
2. Hyperthyroidism (overactive thyroid gland)
3. Hypoglycemia (low blood sugar)
4. Stimulant use (amphetamines, cocaine, caffeine)
5. Medication withdrawal
So, what exactly are the general symptoms of a panic attack?
• Sense of impending doom or danger
• Fear of loss of control or death
• Rapid, pounding heart rate
• Trembling or shaking
• Shortness of breath or tightness in your throat
• Hot flashes
• Abdominal cramping
• Chest pain
• Dizziness, lightheadedness or faintness
• Numbness or tingling sensation
• Feeling of unreality or detachment
Generally, these occur when:
• You are faced with something you cannot avoid.
• You have unresolved issues.
• You are experiencing specific physical issues.
So, how can you deal with a panic attack in the moment?
1. Controlling your breathing helps reduces cortisol levels in the brain and body that are blocking your cognition, and helps you decompress. Hyperventilating can make a panic attack worse, while deep slow breathing calms you down, reducing your adrenaline and cortisol and my your HPA axis (which controls the stress reaction) work for you and not against you, preparing you for positive action. One technique to control your breathing I highly recommend (and use often!) is to breathe in deeply for 4 seconds, hold for 4 seconds, and breathe out for 4 seconds. You can also breathe in one side of nose and out the other side, which also helps you decompress.
2. Now, recognize that you are having a panic attack, not a heart attack. Tell yourself this is temporary and will pass. Tell yourself you will be okay. Try find a loved one and just ask them to be there beside you if possible and encourage you. Take away the fear that you are dying, tell yourself your body is resilient enough to handle this. As you do this, you are using your mind to control your sympathetic and parasympathetic nervous systems and relax your brain and body. You are activating genetic switches in the brain that actually increase your resilience!
3. Close your eyes. Some panic attacks come from triggers that just overwhelm you. If you're in a fast-paced environment with a lot of stimuli, this can feed into your panic attack.To reduce or eliminate these stimuli, close your eyes during your panic attack. This can block out any extra provocations and make it easier to focus on your breathing and your mindset. Just focus on your breath; you can even imagine a place in your head where you were happiest or most at peace. Focus on how you felt then and what this place was looked like.
4. Now, focus on an object: find a single object to focus all your attention on during a panic attack. Pick one object in clear sight, and consciously and deliberately note everything about it that you possibly can: describe the patterns, color, shape, and size of the object to yourself. Focus all of your energy on this object; this will help you control the symptoms of the panic attack.
5. Take action: go for a walk, listen to music... do something mechanical as soon as you are able to move about. These kinds of neutral actions can help reduce your stress levels, calming down the high-alert/tense mode you have been in since the panic attack. Indeed, you will need a bit of time to allow your neurochemistry and the signals of your body and brain to get back into balance, and movement can help do this, while also clearing your mind as your oxygen levels increase.
How to prevent panic attacks in the future:
Once you are calm, I recommend taking the following preventative measures when you are in a safe space with no external pressures. You will essentially be doing a "post-mortem" on your panic attack, finding out more information and putting in place measures to prevent it from occurring again in the future.
1. Now that you are calmer, try objectify the situation: Once you are in a safe space, talk to yourself in the third person (as though you are helping someone else); put your problem/issue into a mental "box", LOCK this box in your mind and DESCRIBE the situation, separating your emotions from the information. Visualize what is in the box in an objective, "bystander" way—this actually changes the structure of your brain! For example, say something like "this person just started panicking because she was triggered by a text message...". Now imagine putting that in a box. Now, continue to describe the facts: "the text was from ... They said ... What does this mean? It means ... ". This process helps balance the seesaw effect of the panic attack and brings clarity and wisdom to the situation, which, in turn, helps you discover the root cause(s) of your panic attack. Indeed, you can't fix anything if you are immersed in it, but, once you are in a safe and calm space, you can begin to discover why this incident occurred through this objective visualization technique. You can, using your mind, bring order out of chaos!
2. Write down your experience. Identify your triggers by creating a story board in your journal or on paper (this allows you to recall information when needed), which brings cognitive fluency and brings more order and insight into your thinking. Start asking, answering and discussing your attack in a logical and objective way (as though you are talking about a friend or colleague), and seek out the causes and triggers of your panic attack in a very analytical, distant way (as though you are a doctor completing an autopsy), which helps prevent it happening again. For instance, write something like "this happened because..." or "I smelt this... then I...".
3. Practice doing all these steps in advance on a regular basis over the next three weeks (it takes around 63 days to build and reinforce a new mental habit), so that you do them automatically next time you feel a panic attack coming on. You are essentially wiring these responses into your brain through repeated effort, so that when you are faced with a stressful situation, your first reaction will be to do these steps rather than allow yourself to panic—you will remember what to do in your time of need. This will be your plan of action, so that next time you feel a panic attack coming on, you will be ready to face it head on. My new app Switch is a great tool for helping you go through this process. It is based on my 5-step program, which is designed to help you identify and eliminate the root of your panic attacks, and help you build a healthy new thinking habits through the mental process of reconceptualization.
4. When you are ready, talk to someone you trust. As you talk through your experience, you will gain more insight into your panic attack, enriching your knowledge, changing the structure of your brain and brining more order to chaos. Moreover, talking to a loved one can create a community support system that can help you deal with and overcome panic attacks, reduce your fear levels (which help mitigate some of the negative effects of a panic and can reinforce your plan of action, helping you avoid similar panic attacks in the future.
5. Avoid claiming panic attacks as your identity. Never say "my panic attacks", as claiming them as your identity can become a self-fulfilling prophecy, since whatever you think about and believe in grows stronger in the brain, affecting what you say and do! Just see them as a reaction, like an allergy. Don't live into the identity of associating yourself with panic attacks.
6. Don't fear getting a panic attack. If you practice panicking about panicking attacks, you are more likely to have one, since, as I mentioned above, whatever you think about the most grows in your brain. Practice prevention, not panic! Tell yourself that no matter what happens, you are ready. You got this! Your plan of action is in place and you are prepared.
7. Have "thinker moments" throughout the day: many of us tend to panic at night as we are trying to go to sleep because our brains are exhausted from chaotic thinking patterns during the day. This is why is it is so important to take "thinker moments", when we take time to switch off to the external and switch on to the internal and just let our minds wander, are also incredibly important when it comes to our brain health. These moments give your brain a rest and allow it to reboot and heal by letting your mind wander and daydream, which increases your clarity of mind and ability to problem-solve when face with a tough situation, rather than just panicking. So, be intentional about creating "thinker" breaks throughout your day by taking a few moments every day, or when you are feeling stressed out, to switch off and just mediate on the internal by taking a few minutes to sit and daydream or meditate. For more information on thinker moments and how to make them a part of your daily routine, see my book, Think, Learn, Succeed. And make sure that before you go to bed at night, sort out your thinking and bring some order to your mind before sleeping. You can also try sleeping propped up, which give your brain and body the signal that you are more in control and can help balance your neurochemistry, calming you down before bed.
8. Focus on your physical health: make sure your brain and body are in good health by eating well, getting enough sleep and exercising regularly (for more information on how to do this, see my book Think and Eat Yourself Smart). A healthy body and brain equals a healthy mind (and vice versa!), which means your body is better able to handle and deal with stress in the moment, and mitigates the negative side-effects of panic attacks. When it comes to my physical health, I love using red light therapy as well (for more on this see my recent blog, and the red light therapy device I use from Joovv—you can get a free gift at checkout with the code DRLEAF), and supplementing with superfoods like adaptogenic mushrooms teas and lattes (I love Four Sigmatic's range of products, and you can try them too less 15% with the code DRLEAF at checkout). These really help calm my mind and destress after rough days.
Throughout this process, you need to recognize that if you don't deal with the reason for the panic attack, you will continue building these structures in our brain and will create a feedback loop that will affect all areas of your life. In sum, things will get a lot worse if your issues are swept under the rug! You will, however, make it through these attacks, and things can get better, if you intentionally and deliberately put these mental safeguards into place and try to reconceptualize the thoughts that kindle your panic attacks.
You have an incredibly resilient mind, and you can change! Remember, there is always hope!