Treating Panic Attacks
What are panic attacks? Panic is an extreme anxiety response or “fight or flight” alarm reaction in the body. However, in the case of panic attacks, there may or may not be an actual perceived threat, and symptoms often come unexpected. The problem is that the “fight or flight” response system has gone awry or out of control. One theory about the origin of panic attacks is that the locus ceruleus, a part of the brain which affects the emotional and neuroendocrine systems, is either hypersensitive to stimulating an anxiety response or that it poorly inhibits one. The problem may be a genetic predisposition, or may have been caused by acute stress or multiple stressors over time. Also, a panic attack may be the end result of a series of factors which stimulated anxiety, such as a poor diet, caffeine, being late to work, having a stressful day with a great deal of worries, feeling rushed, and especially faulty breathing habits. After a panic attack occurs, the fear that it will happen again may be enough to trigger another panic attack.
Most importantly, panic attacks may result from withheld anxiety and fear, or life issues at the time triggering anxiety. Thus, getting to the heart of any psychological concerns and developing self-insight is also of great importance in helping alleviate symptoms through problem-solving and trying to resolve the issues or cope with challenges more effectively.
During a panic attack, the sympathetic nervous system sets off a variety of bodily reactions rapidly and intensely. Such symptoms may include: a racing heart, intense irritability, nervous anxiety, feelings of unreality, diminished concentration, desire to escape or avoid, excessive worry, shaking or trembling, difficulty breathing, tension in chest, feeling of absolute dread, shortness of breath, sweating, choking, nausea, numbness, dizziness, hot flashes or chills, and fear of dying or losing control or going crazy. All of these reactions occur to a lesser degree when we are excited or anxious, but quite often during a panic attack they feel overwhelming. The person experiencing the symptoms feels terrified, as if he or she was having a heart attack. There is often a strong urge to escape, and a fear of returning to the place where the panic attack occurred.
Important points to help get through a panic attack:
- The adrenalin which fuels the panic attack gets reabsorbed by the liver and kidneys within a few minutes. Regardless of how scared or horrible you feel, the symptoms will naturally diminish within a short time. The body when in danger, can create similar anxiety levels, although in the case of panic attacks, it occurs out of context. Still, it is just a strong rise in physiology causing panic level anxiety. What perpetuates panic episodes is the mind / body retriggering the fears that caused the panic episodes prior, and then being in a state of increased anxiety as a result.
- Learn how to deflate the idea of danger, cope through the brief symptoms, and see the panic attack for what it truly is.
- A panic attack may feel frightening, but it is not dangerous. In fact, a panic response is perfectly natural toward intense and highly threatening situations.
- After the initial reaction. If you can “ride out” a panic attack without fighting the symptoms or telling yourself hopeless ideas, it will not result in cardiac arrest in and of itself. It cannot cause you to faint, lose your balance, or stop breathing. You won’t go crazy during a panic attack or lose control of yourself
- By applying breathing strategies and skeletal muscle relaxation, and making supportive and calming statements to yourself rather than reacting, you can learn to manage and get through a panic attack rather than scare yourself into a worse reaction. Often, panic symptoms are escalated by the fear that accompanies the attack. Perception is everything. The tendency for many is to misinterpret the symptoms as catastrophic. This is the time to apply stress management techniques. Learn to see that nothing bad happens after the panic attack, that it is a normal reaction that occurs when we need protection from perceived danger, and that the body is perfectly able to handle the symptoms. Face the panic and don’t fight the symptoms. Accept what your body is doing, see the symptoms as natural, and stay centered through it while allowing the brief time it takes to pass. Be an observer rather than a reactor.
- Hyperventilation occurs when we inhale deeply but exhale minimally. Faulty or uneven breathing can trigger muscle tension and anxiety, and create a mini panic attack, which may escalate when an individual misinterprets or fears that it may be the beginning of a full-blown panic attack. Remember to just exhale deeply (the “sigh” breath) when you feel a panic attack beginning or during its course. Also, move around or engage in some physical activity to dissipate some of the adrenaline and anxious energy.
- Retreat from the situation if possible, with the intention of returning to assure you have self-control. Talk to someone, and tell them you are feeling anxiety, which may help you feel more safe in the situation. Stay outward focused to prevent obsessing on physical symptoms. Splash cold water on your face.
- Engage in repetitive activity to distract your attention. Count backwards from 100 by 7’s, count the number of people waiting in line, practice thought stopping techniques, practice focused abdominal breathing or muscle relaxation exercises, do push-ups, do a crossword puzzle, run in place, play a musical instrument. swing a baseball bat as if practicing, chop wood, hammer nails, do a hard run or swim, cry hard, or do wind mills. Engage in pleasurable activities, such as hugging a loved one, taking a hot shower, etc.
- Express your feelings through catharsis. Punch a punching bag or pillow and scream, hit a baseball with a bat, run in place.
- State coping affirmations (e.g., “let go,” “I feel calmer and calmer,” “I can get through this,” etc.)
- After the panic attack is over, try to identify the particular initiating circumstances that may have precipitated the attack. Don’t let the symptoms scare you, but learn how to discriminate them early on. Prepare a treatment program to reduce the likelihood of their recurrence, and retrain your body to relax through stress management. Also prepare a strategy that you can use if another panic attack should occur. Be prepared! Lastly, Prepare your body and mind to heal and prevent excessive anxiety at any time.
Long-Term Healing Strategies:
- Have a medical check-up with your physician to rule out any medical conditions other than a simple panic attack, as well as any conditions which a panic attack might exacerbate (i.e., heart problems, etc.).
- Explore your lifestyle, emotions, life stressors, or any possible precipitants that may be causing your panic attacks. Develop a plan to eliminate or reduce as much of those factors as possible.
- If you have been suffering from ongoing stress, seek counseling and learn some effective stress management strategies. Cognitive therapy can help change maladaptive beliefs and diminish anxious self-talk to promote a calmer and more accepting attitude toward life. Biofeedback can help you explore how your body reacts to stress, increase your self-awareness and self-control, and help you to learn effective stress management strategies. Learn to express your feelings, and to be aware of and seek to change tendencies toward overwhelming yourself with negative emotional habits (rage, type A hostility, anger, fear, guilt, sadness, impatience, etc.). Counseling may be beneficial for working through any repressed traumas or withheld emotions.
- Maintain a healthy diet, and eliminate any stimulants (i.e., caffeine, amphetamines, nicotine, sugar, etc.).
- Develop and maintain a regular exercise program with aerobic, flexibility, and weight bearing exercises.
- Practice deep relaxation strategies and stress management exercises regularly.
- Certain medications are very effective for many people with panic attacks (see your physician). Also, there are many alternative treatments to explore, which may also help reduce the onset of or precondition to panic attacks.
Dr. Ben Allen has a treatment program that includes the following ways to help to alleviate panic attacks.
- Bottom-up Approaches: Build hardiness and stress resilience from the inside out. Learn biofeedback and interoception, along with physical and self-awareness strategies that lower threat response in real time, and practice these strategies frequently to condition your body to cope and be hardy against stress and adversity. Chi Gung and mindfulness approaches train the mind to stay in the present and attend for longer periods of time, while keeping the body in a steady and health state, thus reducing stress-induced thinking and reinforcing of negative behaviors. In addition, exercise, good diet, and other wellness skills help.
- Top-down Approaches: Learn how to mentally reframe and resolve the fears, change the anxiety narrative and reinforce behaviors to ones that support healing and resolve. Thoughts are powerful, and the imagination can exacerbate fears, justifiably real or not. learn how to identify and address issues contributing to the panic episodes, and change the power of the triggering thoughts, and learn how to reframe issues and build mental hardiness and coping skills under stress.
- Desensitization Approaches: If the panic episodes become a pattern leading to avoidance and significant triggering episodes that may be a conditioned response, consider the following different healing strategies, designed to diminish the conditioned response as well as to provide deeper healing: EMDR, EFT, Timeline Therapy, Clinical Hypnosis, Exposure and Desensitization, and NLP. These protocols often help in dissolving the energy that reinforces intrusive thoughts, panic episodes, and recurring symptoms.
- Psychotherapy: Sometimes the solution toward panic episodes is to better understand the deeper concerns and perhaps unresolved issues triggering anxiety. Therapy may help to discuss and work through such issues, and ideally bring some resolve, renewal of spirit, and confidence in dealing with related challenges.