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What to Do When You Have a Panic Attack

I’ve Had Panic Attacks For 19 Years — Here’s What’s Helped Me


If you've ever experienced a panic attack, you might feel that, aside from the attack itself, the hardest thing was trying to then explain it to someone. Frequently, psychologists and psychiatrists will prompt you to do this, often asking for you to describe to them just why a panic attack is terrible. For years, the best I could come up with was "it's just awful."

But recently I started becoming better at articulating what it truly feels like to have a panic attack: I'm drowning, can see the surface just above me, and I want to get to the top as fast as possible to find relief. This need for fast relief is typically what has makes my brain shut down so I can "escape" what's happening.

What to Do When You Have a Panic Attack

In that flooded mental state, where my frontal lobe isn't working properly and my senses are overloaded, it can be hard to find my skills, my toolbox of tips that I know can speed me through the panic attack. For everyone, this kit looks different, but here are some of the most common things to try when you're having a panic attack.

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Breathe From Your Diaphragm

You've likely heard people tell you to "just breathe" but unless you're doing diaphragmatic breathing correctly, you're actually not doing yourself any good. "Diaphragmatic breathing is very helpful during a panic attack and the person can certainly continue engaging in deep breathing after the attack has subsided, though I wouldn't say it's necessary," says Paraskevi Noulas, PsyD, clinical assistant professor in the Department of Psychiatry at NYU Langone Health. So how do you do it? Try the 4-7-8 technique.

  • Take a deep inhale and let your lungs fill up for four seconds.
  • Hold that breath for seven seconds (if you can).
  • This is the most important part: not only are you going to expel all of that air, but you're going to do it through your diaphragm. Place your hand on your stomach so you can feel it move, and expel air slowly for a count of eight.

Walk Outside or Change Your Environment

Leaving your immediate environment isn't just about finding space; there's a lot behind it. "When someone is having a panic attack, it's difficult for their frontal lobe to function at its peak. They're essentially flooded with their senses, so if they can be in an area where the external factors and input coming in are minimal or reduced, that helps the person stabilise well," Dr. Noulas explained. If you've ever felt overwhelmed by the people around you, especially if they're asking you things like, "what's wrong," or even worse, telling you to calm down, there's an actual reason you feel the need to step away. Plus, sometimes it can help reduce other negative feelings as well. "In addition, having a panic attack in public often heightens the anxiety because the person experiences discomfort, shame, or embarrassment because they're in front of others."

Get Grounded

The grounding technique is a proven method for doing just that — getting yourself grounded and anchoring yourself to the present. There are a number of different ways to do it, but an easy one to remember is the 5, 4, 3, 2, 1 technique.

  • Find and identify five items you can see, four you can touch, three you can hear, two you can smell, and one you can taste. Repeat them to yourself.
  • Even if you're seated in a chair and need to get grounded, you can focus on things like how your feet feel against the floor, how your back feels against the seatback, or ambient noise you may be hearing.

There are other ways to do this too. "[Try] counting all the objects in the room, putting ice packs on your wrists and neck, smelling lavender, or even listening to classical music," Dr. Noulas suggested. All of these help focus your mind on the present, which can reduce symptoms.

Talk to Yourself

You can be an advocate for yourself even if you're experiencing all of the symptoms of a panic attack. Say, for example, you're on a crowded train that's just broken down and you immediately start having catastrophic thoughts about being stuck on the train forever, and you feel your heart racing. You can intervene! Tell yourself that you're safe. Actually say it to yourself: I will eventually get off this train. I'm not in any danger.

"Self-talk is extremely helpful. It slowly helps to soothe the mind and body because you're assuring yourself that there is no reason to panic," Dr. Noulas said. "I often tell my patients to be their own therapist in the moment and coach themselves through the attack. It's hard at first, but as they learn what their triggers are and as they learn that it's not a physical issue (heart attack, etc.), they can sense when it's coming on better and manage it well." In the moment finding this advocate within is challenging, but it's something you can continue to work at.

What Else Can You Try?

You don't have to do it alone. "In the moment, if you're able to, call a loved one for support, find a place to sit down, try to drink some cold water or hot tea to ground you and help you reconnect with your physical body," Dr. Noulas said. If you're seeking treatment for panic attacks and have prescribed medication and know how to safely use it, that might be the right time to consider using it. "Depending on the severity and frequency of the attacks, people engaged in mental health treatment are provided with short-term anxiety medication by their psychiatrists to help manage the acute symptoms if deemed appropriate by the provider."

The biggest thing to remember is that panic attacks end. They always, always end. If you can remind yourself that the terrible thing you're experiencing is only temporary, you can help guide yourself through it.

Image Source: Unsplash / Anthony Tran
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