You are out with friends, dancing the night away, all of the sudden you realize just how many people are there. Your heart begins to pound, your chest becomes tight, you're finding it increasingly hard to breathe, you begin to feel dizzy, you feel like you are dying, you grow extremely fearful and desperate to catch some air. This is just one of many scenarios that cause panic attacks and anyone who has experienced them knows just how scary they can be.
Panic attacks are common, especially in people who suffer from anxiety or depression, however you do not need be diagnosed with a mental health disorder to experience one. Research shows that most people will experience at least one panic attack in their lifetime.
What is a panic attack and why does it happen?
Some people experience panic attacks when they are placed in a situation that stimulates fear, such as before or during a public speech. If the fear of the situation is intense enough, the panic attack can occur at the thought of the event. For instance, a person who is fearful of public speaking may experience a panic attack at the simple thought of making a public speech. Speaking in front of a large crowd provokes fear in many people, so for this example it may be easy to say "just avoid public speaking." The truth is that many people experience panic attacks for situations that are much more common than making a public speech. Some of the most common situations that cause panic include: being in large crowds, flying on a plane, worrying about an upcoming event, meeting new people, a recent breakup or divorce, death of a loved one, and extreme stress.
How to control panic
There are many things you can do to help reduce the intensity and severity of a panic attack and/or stop them from occurring all together. Below are some ways to alleviate panic symptoms:
Daily breathing exercises: When we are experiencing a panic attack our breathing becomes very shallow which increases our heart rate and worsens the symptoms. Controlling our breathing, by taking slow deep breaths into our diaphragms, and exhaling slowly, we slow our nervous systems down which in turn slows our heart rate and eventually eliminates panic symptoms. In my article Anxiety and the Impostor Syndrome, I discussed deep breathing exercises that can help reduce daily anxiety. One of the breathing techniques I recommend is 4-7-8 breathing, in which you inhale for 4 seconds, hold the breath for 7 seconds, and exhale for 8 seconds. It is important you practice this daily to get yourself very familiar with this technique (If you wait until the panic attack to try this technique it will not work!). This type of breathing takes time to perfect but if you practice I promise it will work when needed.
Grounding Techniques: Grounding techniques such as 5-4-3-2-1 help bring our awareness to the here and now. Grounding is extremely helpful to use when you are experiencing a panic attack. grounding techniques work by shifting your attention away from fear of experiencing a panic attack and directs your attention to concrete information in the room. The 5-4-3-2-1 technique works by having you name 5 things you see, 4 things you hear, 3 things you can feel, 2 things you smell, and 1 thing you taste. This technique works because it forces you to shift your attention from the thoughts that cause the panic to concrete things in your surrounding-therefore reducing panic symptoms.You may need to repeat these steps a few times and it can be a good idea to change the categories each time. for example, on your second round you could name 5 countries, 4 cars, 3 colors, 2 family members, and 1 positive thing about yourself.
Meditation: Meditation helps us center ourselves and clear our minds, thus reducing or even eliminating panic attacks. Meditation is a work-out for the brain, which eventually leads to the ability to regulate your emotions better. Meditation helps you build awareness of your mind and body which makes it much easier for you to identify your triggers, such as thoughts and bodily sensations, that signal the beginning of a panic attack. You can find techniques and a link to my favorite app for guided mediation in my article Anxiety and the Impostor Syndrome.
Cognitive behavioral therapy (CBT): This is one of the most researched and proven therapeutic interventions out there for panic and anxiety. Most therapists use some form of CBT with their clients. The main idea behind this approach is that your thoughts, feelings, and behaviors interact and influence each other. The diagram below will help you better understand how thoughts, emotions, and behaviors are all connected. CBT helps you identify the initial thoughts, emotions, or behaviors that are leading to your anxiety and panic and help you make small shifts in one or more of these areas, therefore reducing anxiety and its symptoms. For example, Imagine you say something to a bunch of people and they all start laughing. If your initial thought is “I said something funny and I made them laugh” you may have felt excitement (emotions), which may lead to you telling more stories or jokes (behavior). If on the other hand, your initial thought is “they are laughing at what I said, I must have said something stupid” it may lead to feelings of insecurities and worry (emotions) in which you are less likely to say anything else (behavior). In both cases it is clear that the thought created a feeling which then influenced behavior.
Systematic Desensitization: One technique that works extremely well with panic related to phobias (such as fear of flying on a plane) is called systematic desensitization, which requires the guidance of a Mental Health Professional. With this technique you and the therapist will work together to slowly expose you to your feared event or object, in the safe space provided by the therapist's office, until the fear is extinguished. You will first learn relaxation techniques, followed by some exposure to your fear in small levels until you can face your fear in its entirety. The chart below is a simplified example of the steps.
Panic attacks are extremely common and although it may feel like you are dying, you will be okay! The most important thing is to practice your breathing and relaxation skills daily.
I would love to hear your thoughts and stories about panic attacks you have experienced, what was it like for you and how did you handle it?