COPING WITH A PANIC ATTACK
During a panic attack you are likely to breathe more quickly or more deeply (or both) than you usually do. This will have the effect of reducing the amount of carbon dioxide you have in your lungs, which in turn will give you a bunch of unpleasant feelings in your body** and may make you feel strange. These feelings can make you feel more frightened because if you don’t know what is causing them you will tend to think the worst – that something awful is going to happen to you. That type of thought makes you more frightened, which will probably make you breathe more, which will increase the unpleasant sensations, making the frightening thoughts seem more real, and so on. The vicious circle of fear leading to over-breathing, leading to frightening physical sensations will cause more fear and so on. The process looks much like the diagram below:
It is possible to get control over this process. To do this, you have to increase the amount of carbon dioxide in your lungs. The best way to do this is to change both your breathing and the way you react to the body sensations when they occur. This involves breathing less air at times when you start to get the physical sensations that go with an attack.
These steps can also be helpful in situations where you expect to get frightened or have these feelings. Then you can possibly stop the panic attack altogether.
It is usually best to start with small steps. Try the sequence below. You may need a slightly different sequence, but it will be similar.
- Take the steps slowly. First, notice carefully just what it is you are feeling, what happened just before the feelings started. What were you doing? Where were you? What symptoms do you have now? Rather than being fearful of the panic attack itself, accept that it is has happened.
Every time you panic it is an opportunity to learn more about what happens and how to gain control over your anxiety.
- Notice your breathing. Is it fast? Is it deep? Are you sighing a lot?
- Try to breathe smoothly, regularly, slowly, and gently in the pattern you learned with your therapist.
- Notice what’s going through your mind. What do you think is the worst thing that could happen right now?
- Remind yourself that breathing quickly has almost always resulted in similar physical sensations and frightening thoughts.
- Continue to breathe as gently as you can at the sort of speed you learned from your therapist. You may find it helpful to remember the calm voice your therapist used when teaching you the deep breathing exercise; focus on this memory as you control your breathing.
- As you slow down your breathing, you will notice that you will want to breathe more deeply. Try not to let this happen too much. Remember, the ideal pattern you are aiming for is smooth, slow, regular breathing in a way that doesn’t allow you to over-breathe.
- If you have managed to slow down for a few seconds but feel out of breath you will often want to take big gulp of air….try not to. Resist it by swallowing several times. If you find you have taken a gulp, hold it for 5-10 seconds and then let it out slowly. Then go back to breathing as before. This may help prevent taking a gulp, increasing your anxiety.
- As the breathing is reduced, notice what happens to the body sensations. As they get less because of your breathing control, think about what this tells you. Does it mean that the sensations were caused by the things which you were more afraid of, or is it more likely that what is happening is the vicious circle of body sensations → frightening thoughts → over-breathing → more body sensations → more frightening thoughts → and so on? Would you expect to control your thinking and breathing to stop the symptoms if you were seriously ill and in danger? To sum up, breathe in and out as slowly and evenly as you can and avoid any big increase in depth as you do.
Notice the thoughts of disaster that happen when panic starts and which add fear to the symptoms, then remind yourself that the symptoms are, in fact, signs of a harmless but frightening change in breathing. Reducing your breathing is both useful and harmless and will start to give you some control over the panic attacks.
You may want to work on preventing the most severe attacks before they happen, but until then, take heart and know that a panic attack is temporary. While it has its own set of symptoms, you’ll want to confirm with a qualified medical professional that they are not indications of a medical issue that needs attention from a doctor.
** Most common symptoms include some combination of the following:
- Tight chest and shortness of breath
- Heart racing and/or palpitations
- Dizziness/feeling faint
- Hot or cold flushes
- Numbness or tingling
- Weak legs
- Feeling shaky
If the doctor has ruled out medical issues, consider contacting a therapist who can help you uncover the root cause to your panic and offer solutions that work for you!
Note: The information in this article is not meant to replace a full assessment by a qualified medical or mental health professional. Please always see your doctor to rule out the need for further medical treatment.