Many clients and readers of my book have asked me what to do in the event of a panic attack ever arising. The general reason for this is they have concluded that, with an adequate knowledge of hypothetical strategies and techniques, they can face the outside world with the safety of knowing what to do if the ‘fear’ suddenly starts and leads to an overwhelming, panicky state.
A panic attack can be described as is when an intense feeling of fear, dread, loss of control and entrapment overwhelms a person. The trigger of the panic attack is often unidentifiable and to many people they seem to strike from nowhere. People who suffer from anxiety or a panic disorder can often find themselves panicking many times a day – with their lives becoming extremely disrupted by the condition. These are the people that I often successfully work with.
During my eventful bout with a panic disorder, I began to recognise and subsequently fear the symptoms that lead up to a panic attack. These symptoms would include worrying over harmless heart palpitations, becoming hyper aware of being lightheaded or slightly dizzy, feeling detached from my surroundings (derealisation) and obsessing over small aches and pains in my head, chest and sternum area. These were a few pre-panic attack symptoms identified from my own panic disorder – but during my research and through working with my clients, I have discovered that many people have their own thought and worry routines which contribute towards their overall panic.
The main symptom however, which is almost universal in people who struggle with panic attacks and excessive anxiety, is the symptom of ‘panicking about the next panic attack’. This symptom seemed to be strikingly prevalent in nearly all of the people I have worked with – including myself during the time living with anxiety. Basically, the sufferer often finds themselves in a state of constant fear due to how intense the last panic attack was, so they try to apprehend another one happening by constantly thinking and trying to keep one step ahead it – a paradoxical strategy. The panic attack is often remembered as being so frightening that the person who experienced it, quite rationally, never wants one to happen again. This often leads to people becoming hypersensitive to any changes in their body, mind and environment. The sufferer becomes hyper aware and obsessional because they dread that next wave of panic creeping up on them.
So, what do you do when you can feel yourself becoming tense and your thoughts start racing around in a constant loop? What do you do if your chest flutters or you become dizzy? What do you do if you find that you feel detached from your surroundings and you feel like you’re going insane? Ultimately, what do you do if you start panicking?
The answer is simple and very effective: educate yourself.
Below is a step by step guide to calming yourself in the event of a panic attack and hopefully preventing many more in the future:
Step 1 Remind yourself ‘this is just anxiety’
The symptoms of anxiety – including those feelings of tension, worry, rapid thoughts, breathing difficulty and detachment from surroundings – are completely harmless. As part of anxiety they are completely normal. If you feel the onset of panic coming on, just remind yourself that the many symptoms that accompany it are not life-threatening and will pass in due course. It is important to note that you cannot stop them, but you can dramatically reduce the time they are present. Nothing ‘bad’ will happen. It is just anxiety.
Step 2 Acknowledge the biology of the situation
So you’ve reminded yourself that this is just anxiety, however the feelings of fear and dread still remain. Perhaps you’re finding it difficult to turn your thoughts off and they’re all pointing towards the worst case scenario of the given situation. Now, you need to remind or teach yourself that all that is happening is that your body has released a chemical called adrenaline into your bloodstream. On top of this, there is also the chemical called ‘cortisol’ (the stress chemical) already in your bloodstream. These two combined can cause all sorts of weird and wonderful changes in your body – more widely known as ‘fight or flight’ mode.
Adrenaline, during episodes of high anxiety and panic, can be primarily responsible for:
Increase in heart rate / palpitations / pounding chest (“Fight or Flight”)
Sudden and continuous sense of derealisation / detachment from surroundings
Racing, looping thoughts (“Fight or Flight”)
Difficulty maintaining steady breathing / shortness of breath (“Fight or Flight”)
Dizziness / Light headedness / vision distortion
Excessive sweating / Hot flushes
Muscle Tension (“Fight or Flight”)
All that is happening during a ‘panic attack’ is that adrenaline is flowing through the veins causing all sorts of harmless changes. It also causes the mind to rapidly forage and scan for danger. During a panic attack, and when there is no visible or identifiable danger, the mind decides to conjure its own reasons for why there’s so much adrenaline – usually the unlikely worst case scenario of the situation. This is why many people end up in the emergency room, or think they’re dying, or going insane, and so on. Acknowledge the biology of the situation. It is all normal and harmless.
Step 3 Contextualise the situation
If you’re struggling to rationalise the situation even on top of reminding yourself that it’s ‘just anxiety’, you can put what you’re feeling into a relatable context. Try comparing your symptoms to a time where adrenaline was pumping through your system but you understood it and therefore didn’t panic about it. For example, image how you felt before a job interview, or a first date, a medical examination, the birth of a child, being chased by a dog, etc.
In these scenarios the same biological process is happening as that of a panic attack. However, what is different is that the mind cannot attach a reason as to why there is so much adrenaline and cortisol flowing in the system. This causes confusion. Confusion causes panic. Contextualise the situation.
Step 4 Remind yourself that this does not last long
The adrenal gland will eventually exhaust itself so it can’t produce any more adrenaline. So if you’re panicking that this feeling will be endless and never cease, then remind yourself that this is biologically impossible. The feeling will pass as the adrenal gland can’t maintain producing all of this adrenaline.
Step 5 Don’t be harsh on yourself
Many anxiety calming techniques are floated around the internet and can be found within various healthcare organisations with them mostly being written by people who have never experienced anxiety. These include breathing techniques, tapping, EMT, mantras etc. I personally don’t think these are helpful during episodes of panic because they enforce the need to ‘control’ what is happening. You simply can not control biological processes – only influence them. Therefore, if your breathing is rapid then don’t worry about it. If your chest is pounding then simply let it. Once adrenaline has left the bloodstream these subconscious processes return to normal anyway. Just remind yourself this is just adrenaline and try to resist the urge to take control immediately.
Step 6 When the panic attack has finished
When the panic attack has passed it is vitally important that you reflect on the fact that nothing bad had actually happened during it. It is also important to congratulate yourself for enduring what I consider to be one of the worst experiences a human can go through. By looking back positively on what was a harrowing experience, you can actually desensitize yourself and debase the importance of avoiding panic attacks in the future.
So, during the event of a panic attack you can actually capitalise on the opportunity to prevent any future attacks from occurring. Invite the panic attack, rationalise the situation, remind yourself it’s just anxiety and adrenaline, put it into context, let it pass then reflect on what just happened. By doing this, panic attacks will rapidly diminish because the fear of them becomes less. Sir Francis Bacon once famously said that ‘knowledge is power’ – a quote that applies to dealing with panic attacks. Use your knowledge and understanding of what is happening biologically during episodes of high anxiety and panic instead of being swayed by a panicky mind foraging for irrational answers.