10 ways to stop a panic attack

In the last blog, we looked at the symptoms of a panic attack. Today, let’s talk about 10 tips for helping to stop the panic.

1. Realize that you are going to be ok

Often having a panic attack can feel like you’re about to die. It is common to have impending feelings of doom or to mistake them for a heart attack. If panic attacks are a new experience for you, you should consult with your doctor to rule out medical conditions. If it’s determined to be panic attacks you are dealing with, when they start to happen remind yourself “I’m going to be ok.” Repeat that in your head as a mantra. Panic attacks are physically uncomfortable, but not dangerous. And they always end. Typically the worst of a panic attack will peak after 5-20 minutes.

2. Be kind to yourself

Panic attacks are nothing to be ashamed of. They do not mean you are weak or over-dramatic. The symptoms show that actually, your body is working hard to try and keep you safe from something it perceives as a threat. So be kind to yourself. Many people feel embarrassed by experiencing these, but if you can turn your attention toward kindness, that will help soothe the panic. Be kind to yourself like a comforting and safe adult would be to a child. In the moment, repeating a mantra like “it’s going to be ok,” or “I can get through this,” or “this will end,” can help. Turn on a comforting song, wrap yourself in a weighted blanket if that helps you, and when it’s over, give yourself some extra comfort.

3. Ride the wave

Treat panic attacks as a wave to surf rather than something to resist. In surfing, if you try to resist a cresting wave, you are just going to get pounded by that wave and taken under. Don’t resist the symptoms. Don’t focus on how you want them to stop. Do you remember those finger-trap toys we played with as kids? The ones that would trap your fingers at either end if you pulled to escape them? The more forcefully you try to pull out of those, the more stuck you become. The trick is to lean into the symptoms. Let them run their course without resisting them. That means letting the rapid heartbeat, the shaking, the derealization, etc. happen without trying to stop it or overly fixate on it. If you do this, the symptoms will alleviate much faster.

4. Try box breathing

When you’re having a panic attack your system is in fight or flight. Regulating our breathing is a powerful way to help the brain shift back into the parasympathetic nervous system, which helps to relax your body. During a panic attack, we are often breathing shallowly and possibly hyperventilating. Try box breathing instead. To do this, you inhale for a count of 4, hold your breath for 4, breathe out for 4, and then pause for 4. Then you inhale for 4 and keep repeating the cycle. Here’s a video on youtube that lets you breathe along with a calming visual to make box breathing easy.

5. Use grounding techniques

In addition to box breathing, grounding techniques are something you can do in the moment to help alleviate your symptoms of a panic attack. Grounding here refers to grounding yourself in the present moment using your 5 senses. Most often when we have panic attacks, our bodies are responding to a perceived threat that might not be happening at the moment. Our threat detection system is overly sensitive, and it’s like a car alarm going off with a firework—no one is actually breaking in, but the system went off by mistake. If that’s the case, then getting into our 5 sense and the present moment helps our body see that we are actually safe right now. To do this, focus on physical sensations. What can you hear? See? Touch? Taste? Smell?

A helpful exercise to practice this is the 5-4-3-2-1 Grounding Exercise. To do this, look around your room and say out loud 5 things you can see. I like to name 5 things that are the same color, like 5 blue things in my room. Then 4 things you can touch and as you touch them, describe the texture and allow yourself to focus on what it actually feels like. Then 3 things you can hear, really tune into those sounds. Then 2 things you can smell, maybe an essential oil, some lotion, a scented candle, an orange. Let the smell fill your sense. Then one thing you can taste. Eat a piece of chocolate, a hard candy, some orange, whatever you have. Focus on the sensation of taste you are experiencing. The more you focus on your physical experience the less you are focusing on the anxious thoughts and allowing yourself to reconnect to the present moment. Here’s a video to walk you through this exercise.

6. Use visual imagery

Another thing you can try in a moment of anxiety is to imagine a peaceful place and try to inhabit that vision in your imagination as much as possible. Maybe you imagine sitting by a mountain stream, or walking on the beach. Pay attention to the physical details. Can you feel the wind on your face? The sound of waves crashing? The feeling of sand between your toes? Choose a location that is calming for you. Try to get into the sensory details of the experience as much as possible. This is another way to take the focus off your symptoms and help you ride the wave of panic safely to the shore.

7. Go for a walk

When you are in fight or flight, your body systems are on alert to try and protect you from a threat. One way our body does this is preparing your body to run from a threat. Blood literally goes into your arms and legs so you can run, which is why you may have a tingling sensation in your hands and feet. Blood is channeled away from your abdomen and head, which is why you may feel sick to your stomach or light-headed. Going for a walk is doing what your body wants to do—to move! So try walking around the block, or doing some pushups, or doing a short sprint. This one won’t be for everyone, but some people find this immensely helpful. Plus, if it’s safe to go outside, the change in environment can be calming.

8. Ask for support

This is a big one! Don’t go it alone! If you have a friend, family member or pet that you can be with while you are experiencing a panic attack, that can help comfort you. They can be a loving presence with you helping you know that you are going to be ok. If you’re alone when you’re having one, think about if there is anyone you can call or text for support. Do be careful with this one though as some people don’t know how to respond when you’re having a panic attack. It’s best if you talk to your support people before a panic attack comes on. Let them know this is something you experience sometime and ask if they’d be willing to support you if you are having an episode. Then tell them how to support you. Generally, that means that they just are a loving and kind presence with you. Let them know there’s nothing to fix and that it’s not a medical emergency, just something that you have to let run its course.

9. Be careful with medications

If you are experiencing panic attacks, it’s a good idea to talk to your doctor. It used to be a practice in the past that a class of medications called benzodiazapines would be prescribed for panic attacks. That includes medications like Klonipin, Valium, Xanax, and others. These meds work as gentle tranquilizers and slow down messages between your brain and body. These medications have their place, but are generally only safe for very occasional use, like before a surgery. If they are taken frequently, they can be addictive. When the body habituates to them and then you try to come off of them, many people experience rebound anxiety. Sometimes the rebound anxiety can be worse than the initial anxiety that drove them to start the medication in the first place. These are not often prescribed for panic attacks anymore, but it’s good for you to be aware of and stay away from these medications if possible unless monitored closely by an experienced psychiatric medication prescriber.

10. Counseling can help

Panic attacks can be very scary, especially if they come on out of the blue or often. Just know you don’t have to go through this alone. Panic attacks are highly treatable, and working with a therapist can help you practice these techniques to get through them more easily. A counselor can also help you identify what is triggering your anxiety, help you process and heal past trauma that may be contributing, and help you create a plan for wellness to minimize the impact of panic attacks. If you’d like to see if you and I might be a good fit to help you decrease panic attacks and find your peace again, give me a call today for a free phone consultation.