Free Self-Help Course for Panic Attacks

Have you ever changed or canceled plans because you were afraid of having a panic attack? Do you catch yourself worrying about when the next one will hit?

Panic attacks usually don’t last that long, but the fear of having one can stick around and start to control how we live our lives. In this video, we’ll learn how to break this cycle.

We’ll look at what panic attacks are, why they happen, and how to manage them, and what panic disorder is, and what we can do to reduce the frequency of panic attacks in the long run.

What is a panic attack?

A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes. It usually starts in one of two ways.

An external stressor triggers anxiety which then brings on distressing physical sensations. For example, we might be in a social situation and worry, what if I say something stupid and embarrass myself? This leads to a wave of anxiety and we begin feeling dizzy.

The intense feelings in our bodies seem to come out of nowhere. We’re just sitting minding our own business when suddenly we notice our hearts starting to race.

And these physical sensations bring on the panic and we start having catastrophic thoughts about what’s happening in our bodies. I’m losing control. I’m going to pass out. I’m going to embarrass myself in front of everyone. Or, I’m having a heart attack. I’m going to die.

And these thoughts set off our sympathetic nervous systems fight orflight response. The body’s automatic reaction whenever it senses danger.

Our heart rate and blood pressure increase. Muscles tense and breathing speeds up as we get a rush of adrenaline. These processes help protect us from dangerous threats.

But in panic, they backfire because they make our physical symptoms more intense, feeding into our panic.

Why panic attacks happen

So why do we have panic attacks? We might be particularly sensitive to anxiety and changes in our bodies due to genetics, the environment we grew up in, or stressful or unpredictable experiences we’ve gone through.

And we’re more likely to have panic attacks if we’re already in a heightened state of stress or anxiety.

And once we’ve gone through one panic attack recently, we can be more likely to have another in the future because we start being on the lookout for them, worried it might happen again.

And so we start paying closer attention to how we’re feeling and what’s going on in our bodies, which makes it more likely we notice some feeling or body sensation that then triggers a panic attack.

And the fear of having another attack can make panic escalate more quickly and can lead to panic disorder, which we’ll talk about in a minute.

How to manage a panic attack

So what can we do when we start having a panic attack?

The first step is to respond to catastrophic thoughts with more reassuring ones. Instead of I’m losing control or I’m going to die, we remind ourselves this is a panic attack. It’s just anxiety.

These physical feelings are intense, but they’re not dangerous. And eventually they’ll pass and I’ll be okay or whatever we can believe about what we’re going through that’s a little more reassuring so we don’t add more fear on top of our panic.

And then we calm our physiological arousal by slowing down our breathing. Breathing in through our nostrils for a count of two, pausing, and then breathing out through our mouths for a count of four through pursed or puckered lips, which adds some resistance that naturally slows down our breathing.

This quiets the sympathetic nervous system and the fight orflight response and activates the parasympathetic nervous system and the rest and digest response, which signals to our bodies it’s okay to relax. And we keep breathing like this for as long as we need until the panic starts to subside.

Now, during a panic attack, we get caught up in catastrophic thoughts and intense body sensations.

Grounding exercises help shift our attention away from these internal experiences and onto the world around us. A simple grounding technique is 5 4 3 2 1, where we name five things we can see, four we can touch, three we can hear, two we can smell, and one we can taste.

Going through this exercise helps divert our attention away from the panic attack and gives our mind something external to concentrate on. And once we’re no longer focused on our panic, we often start to calm down.

What not to do during a panic attack

One thing we don’t want to do during a panic attack is try to escape the situation or rely on what’s known as safety behaviors.

Things like always calling someone for reassurance or constantly scanning the environment to make sure we have a way out. These might help us feel better in the moment, but they reinforce the idea that panic is dangerous or unmanageable.

And over time, avoiding situations or relying on these behaviors can make us more anxious, more likely to have future panic attacks, and can contribute to panic disorder.

What is panic disorder

Panic disorder refers to recurring unexpected panic attacks, meaning they happen without a clear trigger or warning, as opposed to attacks that occur in specific situations we can predict, like public speaking or flying or phobias in general.

Unexpected panic attacks can arise at any time, leaving us constantly worrying and on edge, wondering when the next one will hit.

We might even start to fear the physical sensations themselves like a racing heart or shortness of breath because they become so strongly linked to panic which can make us want to stay away from anything that can ring those feelings on like exercise.

Frequent unexpected panic attacks can lead us to start avoiding situations to try to prevent these attacks.

Unlike avoiding specific triggers like flying or public speaking, avoidance from panic disorder becomes much broader and significantly impacts and limits how we live our lives.

Exposure therapy

So, how do we manage panic disorder? And what can we do to make panic attacks in general less frequent and severe?

The first step is to stop avoiding things we’re afraid will bring on a panic attack.

And we willingly go into these situations without trying to control or prevent panic and just see what happens. This is called exposure.

It gives us a chance to learn that sometimes in these situations we may not even have a panic attack. Sometimes it’s milder than we expected. And even when it’s intense, eventually it passes and we’re okay.

This helps us form a more accurate understanding of the things that make us anxious and learn that things aren’t always as bad as we fear. And even when they are, we get through them and survive, which builds more confidence about our ability to handle these situations.

And as a result, our anxiety about future attacks along with our day-to-day anxiety starts to decrease, lowering the chances that we’ll start to panic. And we look at how to do exposure along with everything else we cover in this video in more detail in my free self-help for panic course.

Interoceptive exposure

We can also use interoceptive exposure, which means intentionally bringing on some of the physical sensations we fear, like a racing heart, shortness of breath, or dizziness in a controlled way to learn that they’re not dangerous.

We might do some exercise until our hearts start beating faster and we’re a little out of breath. Or gently spin around on a chair until we’re a little dizzy.

This helps us learn that these feelings can be uncomfortable, but they’re not dangerous. And so we stop interpreting these body sensations as a threat and automatically assuming that a racing heart or some dizziness means that something seriously wrong.

And so we don’t feel the need to avoid them at all cost. And they’re less likely to trigger a panic attack.

Summary

Panic attacks can be overwhelming, but we can learn to respond to them effectively by understanding how they start and what’s happening in our minds and bodies.

Reassuring ourselves about uncomfortable body sensations and using our breathing to calm physiological reactions.

And when panic becomes a recurring problem, rather than avoiding things to try to prevent panic attacks, exposure can reduce how often these attacks happen and how much they control our lives.