Panic attacks are a terrifying experience that usually leaves one calling the ambulance or going to the emergency department. This is because the symptoms experienced during a panic attack are so intense that the person believes there is something life-threatening happening (such as a heart attack). Fortunately, panic attacks are not dangerous and there are a range of things you can do to help manage panic and get back into life.
What is a Panic Attack and what is Panic Disorder?
A panic attack is a short, but abrupt period of anxiety where you may experience a range of intense physical and mental symptoms including:
• heart pounding
• sweating, shaking
• shortness of breath
• tightness in the throat or chest
• dizziness or feeling lightheaded
• Hot/cold flushes
• numbness or tingling
• feelings of unreality
These symptoms can be extremely distressing and are usually interpreted as a sign of life-threatening illness. Some common thoughts going through the mind of someone during a panic attack include “I’m having a heart attack”, “I’m going to suffocate”, “I’m going to die”, and “I’m losing control”. Unfortunately these thoughts only lead to more anxiety and an increase in the symptoms, and so the vicious cycle of panic goes.
People will also become highly sensitive to normal physical sensations and interpret these as threatening. Over time, they become less and less confident in handling bodily sensations and develop a low tolerance to their feelings. People who have experienced a panic attack often become extremely worried of having another attack and so will make a range of changes to their lifestyle to prevent another attack. This includes avoiding certain situations, places or activities and these disruptions to your normal lifestyle is what is often referred to as panic disorder.
What can be done about panic?
During a panic attack you will naturally do anything you can to prevent what you think could be a heart attack or dying. However, unfortunately these coping strategies (known as safety behaviours) can make things worse and this is what keeps panic attacks returning. Here are some sound clinical strategies to help you manage your panic more effectively:
1. Rule out any real medical conditions.
Panic symptoms are similar to those of some medical conditions such as hypertension, iron deficiencies and hyperthyroidism, so it’s essential to rule out any medical conditions before starting psychological treatment. Go to your doctor and ask for a full physical examination and blood test to rule out any medical conditions.
2. Understand that panic attacks are scary but not dangerous.
When you rule out any medical condition, the next step is to then learn that panic symptoms are scary but not dangerous. Your symptoms are simply a result of your fight-flight response being activated without any real reason. Does it feel like you’re having a heart attack? Yes. Does it feel like you’re losing control? Totally. Does it feel like you’re going to lose your mind? Absolutely. Panic feels scary because of what you are telling yourself during the panic attack. However, panic symptoms won’t last forever and will eventually pass. Once you get the all-clear from your doctor you can reassure yourself that these symptoms are not dangerous.
3. Don’t fight the panic
Trying to control your symptoms or telling your panic to go away will only have a reverse effect and can make things worse. A panic attack is made worse by seeing it as something you need to control, get rid of or disassociate from to get better. Learn to handle your uncomfortable sensations in the same way you perhaps handled them when you asked someone out on a date, or when you go for a job interview: very uncomfortable feelings that you need learn to sit with and accept.
4. Shift your attention away from your body
Because people believe that panic symptoms are signs of a life-threatening problem, they will often focus intensely on their symptoms (this is called selective attention). Paying a lot of attention to your symptoms has the effect of intensifying them and can make you feel worse. The best thing you can do is shift your attention away from your symptoms to anything outside of yourself. Use your five senses to describe your surroundings or bring your attention back to what you were doing before you started to panic.
5. Drop your safety behaviours
Safety behaviours are things that you do before or during your panic attack to help reduce your anxiety. Some examples include carrying a water bottle, taking deep breaths, looking for an exit, or carrying medication. Unfortunately some safety behaviours can have the effect of increasing your symptoms, and they also leave you convinced that you need to do them to prevent something bad from happening. Slowly try to drop your safety behaviours and this will teach you that you can cope with panic by yourself and not rely on safety behaviours.
6. Learn to sit with your feelings
Our bodies will often experience a range of uncomfortable, but normal physical sensations and feelings. However, for people who panic these feelings can seem intolerable and can trigger worry and panic. Rather than seeing your feelings as scary and threatening, try sitting with your uncomfortable physical sensations and feelings in an open and curious way, learning about what they feel like. Over time, you will learn to tolerate uncomfortable feelings more effectively and will be less likely to become alarmed and panicked by them.
7. Question your thinking
Panic attacks are driven by inaccurate beliefs about what is happening in your body and your sense of control. These beliefs are what keeps the vicious cycle of panic going, and they are also what makes it more likely that you will experience panic attacks in the future. Learn how to identify what thoughts are driving your panic and explore your beliefs about being safe and in control, and then develop more accurate and helpful thoughts and beliefs that will help you feel reassured.
8. Slowly confront your avoidance
It makes sense that we avoid the things that we fear most. However, avoidance only provides temporary relief and rarely leaves you feeling more confident and capable. When you learn to cope with your panic using the strategies above, you will be in a stronger position to slowly confront the things that you have been avoiding because of the fear that you will panic. This can include places (e.g. shopping centers, lifts), activities (e.g. driving, exercise) and situations (e.g. parties, going to work). Take small steps and you will build your confidence one step at a time.
Seek professional help
If you continue to experience distressing panic, it helps to get some additional support and guidance from an experienced professional. Speak to your doctor or contact us for more help. You can learn to manage panic effectively and get back into living life to its fullest.
By Michael Tomek, (Clinical Psychologist), Lakeside Psychology