A panic attack is a frightening and sudden experience that makes you feel as if you are having a heart attack, losing control, or even dying. Most adults experience only 1 or 2 attacks in their lifetime, but many others have repeated panic attacks, and this may be an indication of an underlying condition called panic disorder. Panic attacks are attacks of intense fear that come on suddenly for no apparent reason accompanied by very noticeable physical changes, such as a racing heart rate, sweating, and shortness of breath. Here are steps you can take to stop panic attacks and help prevent them from happening again in the future.
Step
Part 1 of 2: Deal With Attack Immediately
Step 1. Recognize the physical symptoms of a panic attack
During a panic attack, the body feels a physiological response known as fight-or-flight, which is a response when faced with a dangerous and very scary situation, only that there is no dangerous situation here. Common symptoms experienced during a panic attack include:
- Discomfort or pain in the chest
- Dizziness or weakness
- Afraid to die
- Fear of losing control or fear that something bad will happen
- Feeling choking
- Feeling separated from the surroundings
- Feeling unreal
- Nausea or stomach ache
- Numbness or tingling in the hands, feet, or face
- Heart palpitations, fast or pounding heartbeats
- Sweating, cold, or hot
- Shaking or body shaking
Step 2. Control your breathing
Most panic attacks trigger rapid, shallow breathing that intensifies the attack, making the symptoms last longer. By controlling your breathing, you can help bring your heart rate back to normal, lower your blood pressure, slow down your sweating, and restore self-control.
- One method of slowing your breath is to take a deep breath and hold it for as long as you can. This balances oxygen and carbon dioxide levels and reduces feeling like you can't breathe.
- After holding your breath, begin the deep diaphragmatic breathing technique. Inhale slowly and deeply, then exhale more slowly.
- To practice diaphragmatic breathing, try sitting in a chair with one hand on your chest and the other slightly under your ribs. Sit comfortably, knees bent, shoulders and neck relaxed.
- Next, inhale slowly through your nose and allow your stomach to expand, holding your upper chest as still as possible. Slowly exhale, tighten your abdominal muscles, and keep your chest in an upper position. The hand placed on the stomach area should move outward when you inhale, then move back in when you exhale, while the hand placed on the chest remains still.
- Another way is the 5-2-5 method. Inhale with your diaphragm for 5 seconds. Hold your breath for 2 seconds. Then exhale for another 5 seconds. Repeat 5 times.
- The old way of breathing into a paper bag is no longer recommended. This method is not as beneficial as once believed, and may even be detrimental.
Step 3. Use the prescribed medication
One of the most effective ways to stop a panic attack is to use drugs that are classed as anti-anxiety drugs, usually benzodiazepines.
- Common drugs to treat panic attacks that are classified as benzodiazepines include alprazolam, lorazepam, and diazepam. These medications take effect fairly quickly and can help relieve panic attack symptoms within 10 to 30 minutes.
- Other drugs in the benzodiazepine group that may be prescribed work more slowly but stay in the bloodstream longer. Examples are clonazepam, chlordiazepoxide, and oxazepam.
- These drugs are usually prescribed in low doses to be used regularly until panic attacks can be managed with other types of treatment, such as selective serotonin reuptake inhibitors or following cognitive behavioral therapy.
Step 4. Try to continue your activity
As much as possible, stay normal and continue with your daily activities and routines so that panic attacks don't overwhelm you.
Keep talking, moving, and focusing your mind. This way, you send your brain and panic a message that you feel that there is no danger, no warning, and no reason to be afraid
Step 5. Don't run
If you have a panic attack in a certain place, such as at the convenience store, you may want to run and leave the store as soon as possible.
- If you stay in place and control the symptoms of an attack, you are taking steps to train your brain to recognize that there is no real danger in the supermarket.
- If you run, your brain begins to associate that place and possibly all convenience stores with danger, and creates a feeling of panic every time you enter the convenience store.
Step 6. Focus on something else
With the help of a therapist, you can learn how to focus your thoughts naturally and control your panic.
- Examples include drinking a hot or cold drink, taking a short walk, singing along to your favorite song, talking to a friend, and watching TV.
- Other ways to try to get yourself to focus on something other than panic include stretching exercises, doing a puzzle, changing the room temperature, rolling down the car window, getting out for some fresh air, or reading something that interests you.
Step 7. Distinguish between a stressful experience and a panic attack
Although these two experiences are almost the same in terms of the physical reactions that occur, such as increased blood pressure, sweating, and increased heart rate, the two conditions are very different.
- Stressful experiences happen to everyone at one time or another. The fight-or-flight instinct may activate during stressful or worrisome situations, much like a panic attack, but there is always a trigger, event, or experience that is directly related to the reaction.
- Panic attacks are unrelated to an event, are unpredictable, and the severity of attacks can be extreme and frightening.
Step 8. Apply relaxation techniques
Calm yourself down by using proven relaxation methods to control excessive tension or anxious experiences.
If you suffer from panic attacks or panic disorder, having therapy with a cognitive behavioral therapist will help you learn relaxation strategies that can help control panic when it starts to attack
Step 9. Use your senses to counter the attack
Whether you're experiencing panic attacks, anxiety attacks, or are in a stressful situation, focusing on your senses even if it's only for a few moments, you'll be able to calm the unwanted physical symptoms that are occurring.
- Use your eyesight to notice the pleasant things in your immediate environment. If you're somewhere safe, try closing your eyes and visualizing your favorite flower, favorite painting, favorite beach, or something that makes you feel more relaxed.
- Stop and listen to the sounds around you. Try finding music in the distance, hearing birdsong, wind or rain, or even the hum of traffic on a nearby highway. Try to find new sounds you can hear, in addition to heartbeats and voices that are part of a stressful event.
- Continue to use your senses by identifying the smells around you. Maybe you're in the house and smell the food coming from the kitchen, or you're outside and can smell the rain in the air.
- Focus on the sense of taste. You may not realize this, but the truth is you're always touching something. If you're sitting down, focus on the feel of the chair you're sitting on, or notice whether the table you're resting your arm on feels cold, or warm, or whether you can feel the breeze caressing your face.
- By taking the time to pay attention to what your senses are experiencing, you have shifted your focus away from panic, anxiety, or stress.
- It doesn't address the cause of panic, anxiety, or stress, but concentrating on your senses can be very helpful for dealing with unwanted physical reactions your body may be experiencing.
Part 2 of 2: Preventing Future Attacks
Step 1. Discuss your panic attacks with your doctor
Your doctor can treat you with recommended medications or refer you to a mental health professional who can evaluate your condition and prescribe treatment. Both a GP and mental health professional will likely recommend a cognitive behavioral therapist.
Panic attacks are generally associated with underlying disorders, including several mental health conditions and medical problems. Talk to your doctor to determine if there is an underlying medical condition for your panic attacks
Step 2. Seek medical help as soon as possible, don't delay
Studies show that people with panic attacks and panic disorder who receive early treatment get better overall outcomes with fewer complications.
Step 3. Use medication as prescribed
Drugs that are commonly used include benzodiazepines, both with fast and medium action.
Benzodiazepines are thought to be addictive, so make sure you only use them as directed by your doctor. Amounts used chronically in excess of recommendations can be harmful and cause serious and potentially fatal side effects
Step 4. Use fast-acting medications only when needed
Quick-acting medications help manage symptoms when you feel a panic attack coming. This medication is often prescribed just in case it is needed, or when you start to have a panic attack.
- Use this medication only when needed to avoid tolerance to the prescribed dose.
- Examples of prescription drugs used when an attack begins, when an attack occurs, and only when needed are lorazepam, alprazolam, and diazepam.
Step 5. Use longer-acting medications regularly, or as prescribed
Intermediate drugs take longer to start working, but their effects last longer.
- This medication is often prescribed in regular doses, to help avoid attacks, and may be used until you take the next step, such as cognitive behavioral therapy.
- Examples of intermediate-action drugs include clonazepam, oxazepam, and chlordiazepoxide.
Step 6. Use selective serotonin absorption blockers
This type of medication is often abbreviated as SSRI, from selective serotonin reuptake inhibitors, effective for treating panic attacks and panic disorder.
SSRIs approved by the US Food and Drug Administration for use with panic symptoms include fluoxetine, fluvoxamine, citalopram, escitalopram, paroxetine, and sertraline. Another closely related drug is duloxetine, this drug is also approved to treat panic symptoms
Step 7. Get into therapy with a cognitive behavioral therapist
This type of therapy is key to training the brain and body to cope with panic attacks, and helps to reach a point where panic attacks are unlikely to occur again.
- Know what you will encounter in cognitive behavioral therapy. Therapists trained in this type of psychotherapy use the 5 fundamentals when working with panic attack sufferers. The 5 focus areas are as follows:
- Learn about this condition to help you better understand what causes the scary symptoms you experience when a panic attack occurs.
- Monitoring and recording the date and time of events, such as a diary or journal, will help you and your therapist to identify the triggers that started the attacks.
- Use breathing and relaxation techniques as part of the means to reduce the severity of symptoms.
- Use rethinking techniques to help change the perception of an attack from what feels scary to a realistic thought.
- Provides controlled and safe exposure to places or events that trigger attacks, to help train the brain and body to react differently.
Step 8. Consider undergoing a panic disorder evaluation
Panic disorder is diagnosed when you experience four or more of the symptoms listed above.
Early treatment of panic disorder will improve overall treatment outcomes and reduce the likelihood of complications associated with ongoing attacks
Tips
- Some serious heart problems and thyroid problems can sometimes look like panic attacks.
- Make an appointment with your GP to determine if you have any other medical conditions.
- Seek help immediately to treat a panic attack, don't wait until later.
- Share your condition with a close family member or friend, especially if you need immediate support during an attack.
- Pay close attention to your body and mind. Adopt a healthy diet, get enough rest, avoid drinks with high caffeine content, be physically active, and regularly participate in activities you enjoy.
- Consider learning a new relaxation method, such as yoga, meditation, or mindfulness exercises.
