How To Stop Panic Attacks

Having a panic attack can be terrifying. And if panic attacks leave you feeling scared, overwhelmed, and powerless, you’re not alone. In this video, we’ll learn strategies to help you have fewer panic attacks and manage them more effectively when they do occur.

How panic attacks happen

Panic attacks arise when we feel so anxious that our sympathetic nervous systems kick in and set off the fight-or-flight response. This brings on a wave of intense physiological reactions. We get a rush of adrenaline. Our heart rates and breathing speed up, our pupils dilate, and our muscles become tense. We start to produce more sweat, and so on.

This is a great way for our bodies to react if we’re in a life-threatening situation. But during a panic attack, our bodies misinterpret our anxiety as a life-threatening situation, setting off this fight-or-flight response as if our lives were in danger, leading to these distressing physiological reactions, some of which you’ve probably experienced.

Physical sensations of panic

These sensations can include a feeling of tightness or tension in your chest, an increased heart rate or a racing heart, heart palpitations, or feeling like your heart is skipping a beat.

Breathing issues are also common. You might start breathing faster or even hyperventilating. Or you might feel a tightness or lump or choking feeling in your throat, and it can start to seem like you can’t breathe.

Or you might start feeling dizzy and lightheaded and like you’re going to pass out.

The panic cycle

So that’s the first part of the panic cycle: anxiety leading to intense physical reactions in our bodies.

The second part is we start having catastrophic thoughts about these physical reactions and misinterpreting them as symptoms of a medical emergency. We might think, “I’m having a heart attack. I’m going to die,” or, “I can’t breathe. I’m going to suffocate,” or, “I’m going to pass out,” or, “I’m having a stroke.”

These thoughts feed into the panic cycle and increase our anxiety. As a result, our physical reactions become more intense, leading to even more catastrophic thoughts and initiating a vicious cycle between our anxiety, our physical reactions, and our thoughts. And we start to panic.

To break this panic cycle, we need to come up with alternate and more accurate explanations for what’s going on in our bodies that reassure ourselves rather than feed into our panic.

Reassuring thoughts

If we’re having a thought like, “I’m having a heart attack and I think I’m going to die,” first, if you ever believe you’re experiencing a heart attack, stroke, or other medical emergency, please seek immediate medical assistance. But if you know there’s nothing wrong with your heart, have had panic attacks before, and recognize this as a panic attack, you can remind yourself that these physical reactions are linked to anxiety and the fight-or-flight response.

They don’t mean you’re having a heart attack and you’re not in any danger. These reassuring thoughts help you feel a little less anxious, and so the intensity of your physical reactions decreases, which can lead to more reassuring thoughts like, “I know this is going to be over and I’m going to be okay,” which further reduce your anxiety.

It’s also good to remember that these physiological responses like a racing heart aren’t dangerous. They won’t cause a heart attack or damage your heart.

And a panic attack almost never leads to passing out because the fight-or-flight response raises blood pressure, which prevents fainting. Feeling dizzy or weak during a panic attack is caused by anxiety and won’t make us pass out or fall over.

And we won’t go crazy during a panic attack. Symptoms like feeling detached, dreamlike, or as if we’re floating outside our bodies are simply physiological responses to anxiety. While they can feel strange and frightening, they’ll pass as panic subsides.

Breathing during panic attacks

If we feel like we’re choking, can’t breathe, or are starting to suffocate, we need to remind ourselves that this isn’t dangerous. These sensations are triggered by the fight-or-flight response, and it’s not physically possible to suffocate ourselves. When our bodies need oxygen, they will reflexively breathe, and these are typical symptoms of a panic attack.

But we can start to hyperventilate, which can lower carbon dioxide levels in our blood and cause many of the symptoms we experience during a panic attack. So one of the most effective ways to calm a panic attack is to slow down our breathing.

A simple technique is to breathe in through your nose for a count of two, pause for a count of two, and then exhale through your mouth for a count of four through pursed or puckered lips, which naturally slows down the exhale. And just keep repeating the cycle until you start to feel calmer. It can really help a lot.

When we slow down our breathing like this, not only does it become easier and more comfortable to breathe, we also activate the parasympathetic nervous system. And instead of triggering a fight-or-flight response, the parasympathetic nervous system initiates the rest-and-digest response, which helps our bodies recover and return to a calm state after a stressful situation. And the rest-and-digest response settles our stomachs, which can be helpful if we’re feeling nauseous or like we’re going to be sick. Both of which are common during a panic attack.

Anxious thoughts

Along with worrying about what’s going on in our bodies, we can also have anxious thoughts related to our overall situation like, “I’m so scared. I can’t stand this. This is never going to end.” These thoughts increase our anxiety, so we need to try to shift our perspective to something more calming.

This is really scary and uncomfortable, but I know it’s just a panic attack and it’s not going to last forever. And the worst-case scenario is I’m going to feel really terrible for 20 to 30 minutes and maybe still shaken up for a while after that, but it’s going to pass and everything will return to normal, or any similar perspective that calms our anxiety, which can make it less likely that our panic will escalate.

For thoughts like, “I need to get out of here. What if I can’t escape? I’m losing control. I’m going to make a scene,” we can reassure ourselves that this is a panic attack. It feels overwhelming, but it’s not dangerous. It’s just my body reacting to fear. “I don’t have to leave right now. Panic always subsides eventually. In the meantime, I can slow down my breathing and let the feeling pass.” And, “I won’t lose control during a panic attack. It can feel like I’m losing control, but that doesn’t translate into acting out of control.”

And if we’re having thoughts like, “I’m going to embarrass myself, what will people think of me?” it’s unlikely we’ll embarrass ourselves during a panic attack. Most people won’t even notice we’re having one. And even if someone does notice, generally, people will feel empathy or sympathy. And having a panic attack isn’t something others will judge us for.

Acceptance

If we do find ourselves in the middle of a full-blown panic attack and slowing down our breathing and modifying our thoughts isn’t helping, the best thing we can do is to accept we’re having a panic attack. Not because we want the panic attack, but because at this point it’s already happening, so there’s nothing we can do to prevent it.

And if we simply accept that we’re having a panic attack and allow it to happen, it loses some of its power. Because once we stop fighting it or trying to escape, there’s no longer any need for the fight-or-flight response, so our physiological reactions start to calm, and as a result, our panic starts to subside.