Panic attacks are scary and overwhelming. After one occurs, you probably feel exhausted. This is totally normal. You may even feel a bit disoriented, and want to just rest. Panic attacks are close to the top of the scale of intensity with anxiety. Panic really means your nervous system is responding strongly to a threat. Your mind, body, and nervous system is hyper-focused on just surviving. One way to explain it is that your brain perceives a threat as if it's actually happening. For instance, think of being in a realistic situation like this: a bear just came out of no where and in front of you, it's staring you down. Right directly face to face, you probably begin to panic, as your heart races, mind rambles, blood pressure raises, and ultimately you are in a fight, flight, or freeze state.
Now you may be wondering how does this apply when I'm driving down an empty road, safety is not a concern, nothing happens, weather is clear and sunny. Then a panic attack arises and you panic more naturally in a reaction to it. Note; a panic attack will pass by, and then you may feel scared as to when it's going to happen again. This can escalate into panicking about engaging in the same activity, such as driving and worrying that you will have another panic attack during that time. The avoidance, creates more anxiety anticipating when you will have to engage in that activity, on top of the worry of when the panic will come next.
Now that we understand what your experience is like with a panic attack, and realize it's normal to feel that way when or after having a panic attack, we can work on understanding what can help during a panic attack. The first panic attack always feels the scariest because it's the fear of the unknown. Not understanding what's happening. Next we can recognize the steps we can take to prevent a panic attack and also what to do when we recognize the early signs of one.
Preventing a Panic Attack:
Try thinking about a panic attack being at the top of a thermometer of anxiety, then we realize that we can work on reducing our daily levels of intensity of anxiety at set intervals throughout the day. This can look like breathing exercises at each meal time, or when we transition from one activity to another task throughout the day. If we are managing and coping with our anxiety and stress day to day, this can drastically reduce our chances of having an unpredicted panic attack.
Avoidance might often feel as though it is the easiest route to take when coping with these types of attacks. If we are engaging in avoidance of our thoughts, and emotions, then this can directly escalate our risk of experiencing a panic attack. Journaling our thoughts can be an effective way of teaching ourselves to be more aware of what's bothering us, which might lead us to more clarity and insight to drive our coping strategies to help RESET the anxiety levels throughout the day.
Engaging in mindfulness practices enables us to scan our body, engage in and focus on breathing, and just observing where we are feeling a lot of tension, anxiety, or worry. Utilizing these coping mechanisms can help us increase our sense of knowing when the panic attack is coming. Relaxation techniques such as meditations, yoga, breathing exercises can be helpful as well to help release tension, and calm the body/mind.
Developing a self-care routine is also helpful in preventing panic attacks. It's important to engage in self-care routines that include activities that focus on physical care (nutrition and exercise), mental care (journalling, reading), emotional (self-validation, recognizing emotions/talking about them), spiritual (prayer, meditation, reading), social (connecting with those who matter to us). Self-care is preventative and helps us in more ways then we often realize. By creating a routine, it becomes a habit and feels normal to do it.
Consider how you manage your stress levels each day. What can you do differently? Maybe that means doing more of something that you have stopped doing, that used to help.
Actually having a panic attack:
Panic attacks are extremely scary and overwhelming when they occur. It can become a cycle of becoming anxious, then feeling on edge as to when itwill happen again. Then it happens and it the cycle starts over again. Starting with developing your awareness with the increased cues in your body and mind, telling you, that you are about to start a panic attack is necessary. One way to start increasing this awareness with mindfulness observation skills. Mindfulness engages our observing mind to recognize the early signs of when a panic attack is coming by recognizing and then tuning into our body when it start. This is crucially important to "catch it before it becomes so intense that it's hard to keep control". Combining mindfulness observation with another strategy of journaling each day helps us recognize the patterns that present. This helps us to increase our sense of control over managing our anxiety, by knowing when it's starting, then how to prevent a panic attack with taking action to stop it from becoming severe.
Once you are already in a panic attack mode- this mindfulness strategy of using your 5 senses helps ground you. Check out this video on the mindfulness 5 senses techniques.
Another grounding exercise is to just focus on feeling your body in the position it is in. That starts with bringing your attention to feeling your feet on the ground, your back and body on the chair, or seat. Just bringing awareness to the present time, by talking yourself through where you are right now. Describe the environment, and then locate the date and time. Tell yourself who is with you? Alternatively, you can ground yourself also, by taking off your shoes and socks. Place your feet on the ground and feel them being planted like roots of a tree, deeply rooted into the ground. Allow that ground to feel like it's supporting your entire body from you feet, all the way up to your mind. As you breathe in and out, focus your attention on feeling your body standing strong, muscles contracted, and feeling planted on the floor. Feeling so strong, that if a wind blew, or anxiety came it wouldn't blow you over.
Recognizing a cue to your anxiety or panic sensations starting, is the ideal time for you to focus on your breathing patterns. Try to inhale count to 4, and then exhale while you count to 8. By counting during each part of breathing, it helps you to distract your mind. Mindfully being present, and feeling your feet on the ground or your body on the chair. This helps you to bring your awareness and concentration to the present moment, and feel less panicky.
When you are away from home, or with a group of people and a panic attack arises. You can create space from the situation that is overstimulating to you. This may include exiting a store that you are inside of. Even just stepping outside to get fresh air for a few minutes and feel less confined can be helpful. If you are in a group of people, you can leave the group, or leave the room. Just take some space away from others to feel less overwhelmed and have space to breath.
Lastly, if you are someone who copes best with mental distraction then try these strategies. Engaging in distraction through counting backwards from 100 by increments of 7 helps to distract you mentally. If you are more a brain oriented person who prefers "letters", then start with the alphabet and say each letter starting from 'Z' all the way to 'A' in order. Or you can name each letter, such as "A" then come up with as many words starting with "A", then "B" then come up with as many words starting with "B", and so on. Repeat until you get to the end of the alphabet. This is also a strategy that can be combined with breathing exercises for an extended distraction too.
Create a Panic Attack Crisis Coping Plan: Start by writing down the signs that you are recognize in your body, and mind presenting when a panic attack is about to start. Think about the physiological signals that your body and mind send you, when a panic attack is coming. This may include (sweatiness, tightening of your chest, shoulders, jaw, heart beating faster, throat closing in, breathing becomes more rapid). How long do these sensations last for you? If you are aware, and if you are not aware, then when it happens again you can tune into that. It helps us to cope if we know what to expect. Reflect on in past experiences of anxiety or a panic attack occurring, what has helped you feel the most calm, and comforted? You can also create a 5 senses soothing box or bag to bring with you wherever you are. You can write down this as a cue to cope on your plan, and carry with you. You can also write down names of people whom you find supportive to contact during or after a panic attack. Also take note on this plan that describes what you need to do after a panic attack, to help yourself feel safe and comforted.
Seeking informal support: It can be helpful to talk to a partner, a friend, or someone that you trust when you are having anxiety. If they happen to be available or nearby when you start panicking it can help to have this person guide you through which coping strategy works for you. Try sharing your crisis coping plan with your support person, as they can then guide you through using your coping strategies that work for you.
Seeking professional support, is recommended for more individualized support plans to help you manage your anxiety and panic attacks. As always, this blog post is intended to give tips for coping, and does not in any way replace professional support.