6 Ways to Deal with Panic Attacks

Panic is no picnic.

You get hit with a tidal wave of fear, your body short-circuits, and you think this is the end - you’re either dying or going crazy.  In short, it’s a pretty awful feeling, and the 1 in 4 Americans who have experienced it often go for months or even years without knowing what panic is or what to do about it.  

See also: What Is Panic Disorder?

 

Luckily, panic is straightforward to treat.  Working with a trained cognitive-behavioral therapist is best, but here are 6 methods you can try on your own:

Tip #1: Practice Having the Scary Sensations

I know, inducing symptoms is often the last thing folks with panic want to try, but hear me out on this one.

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Interpreting the symptoms (a pounding heart, feeling lightheaded) as dangerous (“I’m dying!") throws fuel on the fire.  Symptoms snowball and over a matter of moments, you find yourself in the throes of a full-blown panic attack.

So, try inducing the very symptoms you’re afraid of, practice having them outside the context of an attack, and you’ll stop seeing them as dangerous.  You’ll learn that your body can handle a racing heart or a tight throat.  When you practice having your own symptoms, you’re always in control and you’ll get the chance to habituate, or, as I like to say, your brain will get bored.  

If you’re worried about a pounding heart, hop on the treadmill.  Terrified of feeling dizzy?  Sit in an office chair and spin around and around. Shortness of breath?  Breathe through a coffee stirrer.  Lightheadedness?  Crouch for a minute and then stand up quickly.  One of my patients was terrified of feeling overheated and decided to practice by hanging out in the always-too-hot copy room at his office.  It was brilliant and it worked like a charm.

Tip #2: Bring it On

This sounds weird, but with panic disorder, which is fear of having a panic attack, a little reverse psychology works wonders.  When you start to worry about panic or feel that first twinge, tell yourself “Hey body, I want more.  Bring it on!  Hit me with your best shot.”  

Ironically, being willing to feel panic symptoms will help to stop the cycle of escalation.  After all, panic is the fight or flight response gone haywire, so when you try to fight panic itself, you end up between a rock and a hard place and it all just amplifies exponentially.  By contrast, when you welcome in the sensations of fear, your body has no reason to fight or flee.

Tip #3:  Remember - It’s Just Anxiety, Not Reality

Panic is all in the interpretation.  Think of it this way: It’s 3am and the phone rings.  What happened?  Well, it could mean your sister is dead, your brother needs to be bailed out, or your teenager is in the emergency room.  But it could also mean a wrong number, a prank call, or someone who got their time zones seriously mixed up.  Until you pick up the phone, the reason for the call is a product of your interpretation.  

So it is with anxiety.  Instead of interpreting it as “I’m dying,” think, “This is just my broken burglar alarm.  I’ve felt this before.  I wasn’t dying then, and I’m not dying now.”  Interpret the anxiety not as something dangerous, but as something annoying you’ve handled before, and can handle again.  It’s just anxiety, not reality.

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Tip #4: Come Up with a New Thought

The thoughts that go through our heads - the cognitive symptoms we described a couple of weeks ago on the episode Am I Having a Panic Attack? are scary: "I’m dying, I’m going crazy, I’m going to pass out, I’m going to throw up and humiliate myself.”  The list goes on.

So when you feel panic starting to rise, talk back to your thoughts in a new way. One patient of mine made her new thought “I got this.”  Another thought of it as a smackdown between her and anxiety.  And a third decided on none other than “F--- you, anxiety!” Choose something that works for you.

Tip #5: Slowly Inch Into Panic Situations

One patient of mine had a panic attack in a fitness class and not only didn’t go back, but also stopped exercising entirely.  She wouldn’t even take the stairs.  She was worried that getting her heartrate up would induce another panic attack, something she never, ever wanted to experience again.  

So, to fight her panic she did two things.  First, she challenged the thought that her heart couldn’t handle exertion, and second, she started slowly getting her heartrate up, a little at a time, first by jogging a few steps, then by jogging a block, then around the block, and slowly, she got herself back to the gym.  

If it’s a place you fear, like being worried you’ll have a panic attack in a crowded movie theater, start by going to the theater and sitting as close to the exit as possible.  Next time, move up a couple rows.  Then move in a couple seats.  And so on.  Don’t move on to the next step until your current step is easy.  Remember: Your brain has to get bored.

Tip #6: Avoidance Feeds Panic

Think of a situation that makes you panicky - I’ll bet you white-knuckle it until you can’t stand it anymore, and then quit, which makes you feel better.  But consider this: While quitting does make you feel better in the short-term, it  also reinforces the idea that what you’re doing is dangerous.  

This makes sense if you’re feeling panicky about swimming with sharks while you have a nosebleed, but it doesn’t make sense if you’re feeling panicky about crossing a parking lot, sitting in a restaurant, or riding the subway.  You must be willing to endure a little anxiety - emphasis on little; never more than you’re ready for - so your brain can round the corner and start getting bored.  

Your anxiety will rise when you first try out something you’re scared of - remember our movie theater example or my patient who was scared of her heartrate?  Your anxiety should rise at first, in order to give you something to work with.  

But you don’t have to jump in with both feet.  Aim for inducing about a 3 on a 1-10 scale.  Experience the 3, and then wait it out.  Your anxiety might escalate to a 4 or 5 at first, but if you stick with it rather than quitting, it will go back to a 3, then a 2, and then a 1.  

Try it out.  Your brain will get bored, but you have to let it get over the hump. Then you can move on to the next step.  As you master more and more situations, even the things you thought would be 9s or 10s will start to look easier.  

Before you know it, you’ll be driving across bridges on windy days and sitting smack in the middle of a crowded restaurant - which is infinitely more fun than sitting in the emergency room with doctors telling you nothing’s wrong.

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Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.