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Panic attacks are intense and often overwhelming bouts of anxiety. Panic attacks can 'come out of nowhere' or can occur when we're faced with things that we fear (e.g. heights, social situations, driving after a car accident, trauma triggers, etc.). Before we look at ways to manage panic attacks, let's take a closer look at the most common symptoms of panic attacks.
Most people report a range of these symptoms during a panic attack:
Panic attacks can be terrifying and many people present to the Emergency Department of their local hospital due to their intense symptoms of panic. They are often convinced that their symptoms are due to a physical or biological cause. People experiencing panic attacks and anxiety symptoms undergo a range of medical tests, only to be told that there is no physical cause to the symptoms. This can often indicate that their symptoms (which are experienced in an incredibly physical way) are in fact anxiety and panic symptoms.
Following are some helpful tips to help you manage your panic symptoms.
1. Slow down your breathing
During panic attacks people often think that they are not getting enough oxygen. So, they tend to breath as deeply and quickly as they can. Chances are, rather than not getting enough oxygen, you may be over breathing, which can then lead to hyperventilation. When this happens, the oxygen levels in our blood actually rises, while carbon dioxide levels fall, and we then experience a range of hyperventilation symptoms that can make us panic even more. Hyperventilation can induce dizziness, numbness and tingling in your fingers, hands, and extremities, altered vision, light headedness, and chest tightness and pain. As you can imagine, this feeds into the panic cycle, leaving the panicking person more convinced that these symptoms are proof that there is somethings terribly wrong.
Start to notice your breathing when you are feeling relaxed, and when you are feeling more stressed and anxious. You can even count how many breaths you are taking pre minute, to give you a guide of your 'normal' breathing rate, and your 'anxious' breathing rate. To combat hyperventilation, if you can catch panic symptoms coming on, start by holding your breath for 5-10 seconds, then slowly and steadily exhale for 3-10 seconds, then inhale as slowly and steadily as you can for a further 3-10 seconds, trying your best to slow your breathing down as much as you can. Now keep this up for 2 minutes. The goal is to slow your breathing down, which reduces the effects of hyperventilation, which reduces physical symptoms, and reduces your panic symptoms.
2. Watch your thoughts
Our thoughts have an incredibly strong effect on the way we feel. This applies in general, and also in the midst of a panic attack. Whenever we're feeling strong emotions, it's just about guaranteed that there are also strong thoughts happening in the background. We can be more or less aware of these thoughts. Some people know quite well what's running through their mind from moment to moment, while others have less awareness of their thinking patterns. Below are some common thoughts that occur during a panic attack;
"I'm having a heart attack"
"I'm going crazy"
"I'm losing control"
"I'm going to die"
If panic symptoms have already begun, and then some of the anxiety-inducing thoughts above take hold, you could imagine the impact that this would have on a person's anxiety levels and panic symptoms. Here are some more useful, realistic, and anxiety-reducing thoughts to try instead:
"Although it feels unpleasant, anxiety can't harm me"
"I've felt anxiety before, and I've never had a heart attack"
"I've felt anxiety before, and I haven't gone crazy"
"Anxiety is natural and normal"
"Everyone experiences anxiety from time to time"
"Anxiety and these difficult feelings always pass, they never last forever"
3. Increase your awareness of places you might be avoiding
When we have panic attacks in certain places, we can start to avoid those places. Lets say I've had a panic attack at my local shopping centre. Returning to that shopping centre may become very difficult because my anxiety gets triggered when I approach the place where my panic symptoms occurred. This happens through a process of conditioning. Although it feels uncomfortable to go back to the shopping centre, there is actually nothing dangerous or troublesome about the shopping centre. Confronting any avoided or anxiety triggering places, at the right pace and in a manageable way, can help you to incrementally overcome your anxiety. Approaching the places that you fear can be incredibly beneficial, but it needs to be done right. If it's too challenging and overwhelming, then we might experience more intense episodes of anxiety and it might make it harder to go back next time. If it's too easy, then we're probably not growing, overcoming the anxiety, or challenging ourselves enough.
4. Talk to a professional trained in the treatment of panic attacks
Talking with your GP about your anxiety symptoms is a good place to start. This will rule out any physical health concerns that could be presenting as anxiety. Clinical Psychologists are trained in a variety of effective psychotherapy approaches to help people manage their panic attacks. Some components of Cognitive Behavioural Therapy (CBT) that form the core of panic attack treatment are interoceptive exposure (exposure to the feelings of panic, to experience them as manageable, ok, and as not dangerous), cognitive therapy to challenge unhelpful thinking patterns, exposure therapy to approach avoided locations, and relaxation and mindfulness training to help to control anxiety symptoms. Talking to a Clinical Psychologist can also provide you with more information about panic attacks, the symptoms of panic, and strategies to manage panic attacks so that you can better understand what's happening when panic kicks in.
CBT for the treatment of panic attacks has been extensively researched. Most people who engage in CBT for panic attacks will overcome their symptoms and will be able to resume their normal daily activities. Panic attack help is available and a panic attack Psychologist can help you to get back on track and living your life to the fullest.
Dr Mark Bartholomew is a Gold Coast Clinical Psychologist. MHM Psychology is located in Coomera and we provide treatments for a range of psychological concerns including panic attacks, anxiety, PTSD, depression, and more. To find out more about our services, you can contact MHM Psychology on 1300 848 072.