I know I said last week we’d return to the topic of singlehandedly improving any relationship, but I’ve spoken with a couple of people this week that are struggling with Anxiety and Panic Attacks, what they are and how to manage them. In the midst of all of the changes with Covid-19 and anxieties flying high, I thought we should pause and talk about this today. We’ll get back on track with creating change in our relationships next week.
So, what is a panic attack? If you or someone you’ve loved have experienced panic attacks read on.
When panic comes on you might literally think you are having a heart attack or dying, since it’s such a scary and visceral experience. The heart races, the body sweats, the face gets flushed, and thoughts dart around causing obsessive worry or flood in and seem out of your control. It can feel extremely overwhelming in thoughts and body sensations and one tends to get frozen by the fear just hoping the panic will soon end.
Panic attacks are deluges of anxiety and overwhelming fear that last for several minutes. They are unpredictable and cause heart-pounding, sweating, and the feeling that you can’t think straight or breathe. They can be situationally cued or come out of the blue.
First, please know that if you feel you need medical attention, please get it immediately. There’s a lot of overlap in symptoms between heart and panic attacks, symptoms of heart attacks in women differ from those in men, and I DO NOT want you trying to meditate and deep breathe your way through a major cardiac event!
However, once you’ve been through a panic attack and gotten evaluated by a doctor and/or your psychotherapist, you can use certain techniques to help. Panic attacks are something you can gain control over especially when you are getting the right professional help. Ideally, you will be in therapy and have the guidance and help of your therapist to determine if you need adjunct treatment to help such as medication or other forms of treatment to rule out any contributing problems or medical conditions.
Panic is definitely something that can be managed with the right help. So, preparing yourself and having a plan if panic shows up are important. Some panic comes at certain times, it can be in a specific social situation, a specific trigger, or upon waking in the morning for example, and other panic can be experienced completely unexpected. But it’s ok—you can be better prepared to manage panic attacks if/when they come.
Here are my top 10 coping tips for panic attacks:
Name the Panic Attack
Simply naming the panic can help. Say, out loud if you can or to yourself, “I am having Panic, or “I am having Anxiety.”
You don’t need to fear the panic and resist it because although that is our natural instinct it usually makes the panic greater. Many of my clients have felt significant relief when they stop worrying about the panic and instead remind themselves that they have the tools to help themselves.
In essence, observe if you are panicking about panicking. This just increases your intense negative emotion.
So just talk to yourself in a calming manner. “I am having panic.” “I know how to navigate this and take the best care of myself I can.” “I can enlist help from others if I need it.” “I can use the techniques I have (listed below) to help me cope.” “This will pass. It’s temporary.” “I appreciate myself and care about my well being.” “I have tools.” “I will practice my tools.” “If I panic about the panic, I will not panic more.” I will allow the feelings and they will begin to dissipate.” “These are waves of emotion that will calm soon.”
Deep Breathing
Regulating your breath can help you focus on something other than your symptoms, and it can lessen their severity—and keep you from hyperventilating.
Focus your attention on your breath, slow it down and take deep breaths in and out of your mouth, focusing on your belling expanding on the inhale and pulling back towards your spine on the exhale.
Placing your hand on your belly so you can actually feel the rise and fall of your belly can be a helpful focusing technique to help calm instead of excite you further.
Sing EIEIO
You can’t not breathe when you sing, so use the end of this old nursery rhyme to get you breathing when you feel it may not be possible. It is possible. It just takes practice. EIEIO.
Practice all of these skills when you are not in panic or anxiety to prove to yourself that they can and will help you soothe.
Progressive Relaxation
You can counter your tense muscles by tensing and relaxing different muscle groups one-by-one, which (again) gives you something to focus on and helps lower your heart rate.
Start by flexing your feet up towards your heart. Hold for five seconds and then let go. Feel the tension leaving that part of your body. Then repeat moving to calves and thighs and so forth all the way up the body until you get to the top of your head.
Don’t forget to tense and release your facial muscles. That can feel amazing! You got this!
Walk it Out
Engaging in light exercise can refocus your body and get endorphins flowing. You can ask a friend to come along if you prefer.
Movement can help tremendously, and offers somewhere for the energy created by the emotions of panic to dissipate. If you can’t get outside walk around your apartment or house. Get creative.
Block Out the World and Get Mindful
Sometimes panic attacks can be caused by excess external stimuli, so closing your eyes and getting somewhere quiet can help reduce those triggers.
Mindfully focus on the physical sensations you’re familiar with. Feel your bare feet on the wood floor, or inside your shoe, or whatever is your situation.
Name what you see around you. I see a tree. I see my desk. I see … fill in the blank. Name what you know. Today is August 14th. I am at home. I am writing. My name is ….
Run your hand over your jeans, “I feel the jean material under my hand, etc, etc. By naming these sensations and facts you are grounding yourself firmly in reality and giving yourself something objective to focus on.
These techniques are particularly helpful when panic attacks create feelings of detachment and separation from reality. All of these techniques can combat panic either as it is approaching or when it’s actually happening. So, give it a try ahead of time when you’re feeling good! Gain practice and confidence!
Imagine Your Safe Place
If you haven’t visualized one yet, do it now. Maybe it’s a serene beach and you can feel the cool breeze on your skin, and the warmth of the sun at the same time. Imagine yourself without a care in the world, relaxed with nothing to do but be. Imagine what those happy feelings feel like coursing through your body. Be there.
Get creative. You can imagine being at the top of a mountain looking out at the beautiful landscape. Or in a villa on the French Riviera, looking out from your terrace at the expansive majestic Cote d’ Azure, with your veggie garden below full of fresh and nourishing vegetables alongside an assortment of beautiful flowers. Maybe you can even smell the fresh herb garden?
The key here is to use all of your senses to tune into that calm and peace and get grounded and focused.
Repeat a Mantra
Repeating a mantra internally or out loud if possible can be relaxing and reassuring. Of course, here again, you are also staying focused on something other than your symptoms and by doing so not giving yourself more worry fuel to get scared and panic about the panic, which of course makes you feel calmer and the panic dissipate more quickly.
A mantra can be just about anything that resonates with you. Whether it’s, “This is temporary,” or something more personal for you
Lavender
Keep essential oils and lavender in particular around or on your person. Make sure you can use it on your skin and ensure you’re not sensitive first. Dab a little under your nose, or on your wrists, or on the top of your head, or between your eyes, or on the souls of your feet or on your belly or just over your heart. (Don’t forget to use a carrier oil.) This has a calming effect. In addition, your focus is taken away from the panic and focused on an act of self-care. Alternatively, you can just take off the cap and smell it too or diffuse if you have a diffuser. Enjoy the smell and effects.
Lavender should not be combined with medications such as benzodiazepine, since it can make you extremely drowsy.
Alternatively, try drinking soothing and relaxing lavender or chamomile tea.
Calming medi-herbs can be used as well, please consult with a qualified professional and your Medical Doctor to ensure you are a candidate and you are not taking anything else, or have another condition that will constitute a contraindication.
Antianxiety medication/ such as Benzodiazepines May be Needed
In many cases, if you’ve tried the above and still experience Panic Attacks, medication can help you calm down the nervous system while you talk through a treatment plan with your therapist to get the panic under control. Benzodiazepines can be habit-forming, and are generally used for short term or temporary relief and can be prescribed by your Psychiatrist.
To Wrap Up:
Don’t go it alone if you experience distressing anxiety or panic. Please get the help you need in a therapist who can help you navigate what other treatment or evaluations you may need and help you get these symptoms under control.
Knowing the difference between a panic attack and a life-threatening emergency is key. Being prepared to use the tips above can help you or someone close to you navigate these scary experiences.
And if you find that you have had or are having panic attacks regularly, please see a doctor, preferably a psychiatrist, and get yourself into talk therapy with a mental health professional immediately. There’s a possibility that you could have panic disorder, or another anxiety disorder and/or mood issue and you may benefit greatly from both medication (such as benzodiazepines) and talk therapy.
You can do this. There is never any shame in getting help. It is the opposite actually, a show of strength and intelligence.
