Important Information For Overcoming Panic

Before describing some of the more effective panic prevention strategies, it’s important to discuss some of the issues that stand in the way of recovery. You need to be aware of these issues before you can expect your panic attacks to stop.

Make sure you’re aware of the following:

  • Hypersensitivity – A major problem in decreasing panic attacks is hypersensitivity. It’s actually a symptom of panic attacks, and it comes from becoming overly aware of how your body feels. The body experiences weird sensations, aches, and pains, that otherwise are meaningless. Most people ignore them or don’t even notice them. But those with panic attacks notice every single sensation, and their brain translates that sensation into something much worse – like another panic attack, or the symptom of a health condition. Hypersensitivity is one of the reasons panic attack patterns are hard to break.
  • Hyperventilation – It’s also important to understand what causes many of the symptoms of panic attacks, and that’s hyperventilation. Hyperventilation usually occurs when you breathe too quickly, but may also occur because you take deeper breaths than you need to – something that’s actually a symptom of hyperventilation. Hyperventilation causes rapid heartbeat, lightheadedness, tingling in the hands and feet, trouble thinking, chest pains, and more. Anxiety changes breathing habits to lead to constant hyperventilation, so how you breathe needs to change to stop panic.
  • Fear of Panic Attacks – Fear of panic attacks is also something contributes to future panic attacks. In fact, it’s actually a symptom of panic disorder. So if you find yourself fearing your panic attacks often, or you allow yourself to fall victim to that fear, the chances of your panic attacks returning becomes more likely.

Panic Attack Prevention Tips

  • Control Your Breathing – Start by learning how to control your breathing when you’re hyperventilating. The key to controlling your breathing is slow deliberate breaths and fighting the urge to breathe too fast or too full. Try to take 14 to 15 seconds total, with 5 breathing in, holding for 2 or 3, and then breathing out for 7. Do this any time you feel like you might be “panicky” and while you may not be able to stop the attack, you should be able to reduce its severity.
  • Visit the Doctor – Even though panic attacks are rarely caused by any type of health issue, visiting a doctor is an important part of getting the reassurance you need to move forward with your panic attack treatments. When health problems are ruled out, you’ll have an easier time maintaining that your panic attacks are the problem. But be warned: Rarely does hearing from a doctor cure that little voice in the back of your mind that worries about your health. So don’t think visiting a doctor will stop you from being concerned.
  • Start Talking About It – There is a tendency to feel embarrassed about your panic attacks and try to fight them. When you’re out in public – or even sitting there alone – and you start to feel like something is wrong, the tendency is to try to push it away and fix it yourself. But those with anxiety struggle within being too much “in their own head.” You need to get out of your own thoughts as much as possible. So be okay talking to those around you about it, or calling someone you trust and letting them know how you’re feeling.
  • Exercise – Exercise can actually cause panic attacks in some people because of the way they interpret heart rate and fatigue. But exercise is also a powerful anxiety reduction tool, one that mimics the mental health benefits of several anxiety medications. Talk to your doctor about exercising more, because it is an important addition to any anxiety reduction plan.
  • Healthy Lifestyles – Maintaining a healthy lifestyle is also a crucial part of overcoming your anxiety. Diet plays a big role, and you need to make sure you’re getting enough vitamins since vitamin deficiencies can cause some discomforts that may trigger panic attacks. But sleep is perhaps most important. Sleep debt causes a host of problems that tend to trigger panic attacks, like headaches, weak muscles, and trouble focusing. Healthy living really is an important part of overcoming panic.
  • Adapt to Triggers – You can also try something known as desensitization. While this is best done in the presence of a therapist or trained expert, desensitization is the act of getting used to your triggers until they no longer cause anxiety. For example, if you find that dizziness tends to trigger your attacks, you can try to get used to dizziness on purpose by spinning around in a chair or circle. You can hyperventilate on purpose, you can get your heartbeat up by running in place – there are many different strategies you can use to get used to each physical trigger of your panic attacks so they cause less fear when they occur.
  • Let Yourself Have the Attack – One of the toughest things you can do is also one of the most important. You need to be okay with having panic attacks. That means if you find that you get panic attacks when you go to the mall, for example, then you have to still go to the mall when you need to without avoiding it just because you get panic attacks there. Be okay with the idea that a panic attack will happen. When/if it does, wait it out, and then immediately go on with your day.

1) Let the panic know who’s boss

“Stopping panic attacks is all about taking back control. To help beat panic attacks, I want you to think about them in a very specific way,” I told Kathy.

Panic is powerful but stupid. We’re all born with the capacity to panic, but panic is ‘blind’. That means it doesn’t know what to fear, so it takes its lead from you. If you avoid or run from something (say, the library in which the panic attack happens), then your panic response will tag that place as threatening.

If the panic gets just one hint that a situation is really not dangerous, it will ‘call back’ its big investment of energy. Breathing will slow down again, blood pressure will return to normal, the sweat response will calm down, and clear thought will return. Like fire fighters returning to their depot after discovering that it was a false alarm.

So you can let your panic know it’s not needed by practicing the next tip:

2) Stop running to stop panic attacks

If you panic in a supermarket and flee the scene, then your panic response will conclude that the supermarket holds life-threatening horrors because you ran away from it. It will try to be ‘more helpful’ by spreading the fear to perhaps allsupermarkets or even all situations that have lots of people in them, a bit like supermarkets.

If you panic but stay in the situation until you calm down, your panic response will learn that it’s not the situation causing the panic. In nature, we avoid what is dangerous. And the more you avoid something, the bigger the fear builds.

The more ‘normal’ you act, the more panic gets the message it’s not needed. By imagining being in a situation in which you fear you might panic whilst you are relaxed, you teach your mind and body to feel relaxed about being in the situation for real. See the free audio that comes with this article.

The next tip shows you how to control breathing – often the fist physical change before a panic attack starts.

3) A breath of fresh air

When we panic, we breathe quickly and high in the chest. This is because your body wrongly assumes it needs to exercise and so breathes as if you were running hard. When we breathe in this way when we are not exercising, we may call this hyperventilation.

Hyperventilation is not serious, but it feels dramatic. Symptoms of hyperventilation include light-headedness, giddiness, shortness of breath, heart palpitations, and feelings of weakness.

“Yes,” said Kathy, “I feel like I can’t breathe!” It may feel as if you haven’t got enough air, but this feeling actually occurs because you have been taking in too much.

To ‘switch off’ hyperventilation you can:

  • Hold your breath. Really? Am I kidding? Seriously, holding the breath for as long as you comfortably can will prevent the dissipation of carbon dioxide. The feeling of not having enough air isn’t caused by not breathing in enough oxygen but by breathing out too much; so holding your breath prevents this happening. A period of ten to fifteen seconds, repeated a few times, is sufficient. This will ‘re-set’ your breathing to normal.
  • Then do deep diaphragmatic breathing: slow, deep breathing right down to the bottom of the lungs. Breathing should be through the nose, with the out-breath taking longer than the in-breath. You can quick count in your mind to 7 as you breathe in and 11 as you breathe out (the 7-11 technique). Practice this everyday to get very good at relaxed breathing – because it’s impossible to breath like this and panic at the same time.

4) Stop panic attacks by ‘acting normal’

“So Kathy, if you do have another panic attack, I want you to make a conscious effort to carry on as if nothing out of the ordinary is happening. Pretty soon the panic will ‘get bored’, realize it’s not actually needed, and drift away.”

You wouldn’t carry on talking if a hungry lion was about to pounce on you. So keep talking – keep acting as if nothing untoward is happening. You may not feel like ‘acting normal’, but remember your panic is pretty dumb (even if you have a PhD in astrophysics) and is looking for cues from you as to whether it’s needed or not.

With that in mind, on to the next tip.

5) Keep thinking

Keep thinking or doing something that is methodical. During times when panic is really required (a hungry, fractious lion coming right at you), the thinking part of the brain becomes much less active. This happens because we need to become purely physical – to run or to fight.

But if you purposefully start counting backwards from one hundred in jumps of three – ‘100, 97, 94, 91…etc.’ – you force your thinking brain to work, which actually dilutes the panic response. Making yourself do a crossword or read the paper, even grading your own anxiety from one to ten (see: Overcome Fear and Anxiety) – all force your thinking brain to work, which again sends the message: “This is not a real emergency, so butt out!”

Kathy actually did this. She thought she might panic (again when driving), so she started to count backwards and very soon found that she felt normal again.

6) Use the AWARE technique

I gave Kathy a little card we call the AWARE card. (Make one for yourself.) She was to carry it around with her and, if she started to feel panicky, to take it out, read it, and follow the simple instructions:

A: Accept the anxiety. Don’t try to fight it.

W: Watch the anxiety. Imagine it is outside of you and you are just observing it.

A: ‘Act normal’. Carry on as if nothing is happening. Panic will soon ‘get bored’.

R: Repeat the above steps until you start to relax again.

E: Expect the best – it will pass quicker and quicker the more times you do this.

Write these steps down on a card and if you ever feel you might panic, take them out, follow them, and you’ll soon calm down.

Now the last tip is perhaps the most powerful.

7) Prepare not to panic

“This is all good advice!” said Kathy. “And I do feel a bit better. But in the heat of the moment, I’ll know I’ll forget it all!”

This is why I worked hypnotically with Kathy. Sure she could use all the above (and she did), but we wanted her mind and body to naturally feel calm again.

Mental rehearsal whilst very relaxed helps automatically re-jig your responses so that calm naturally starts to replace panic. You just start to find you naturally feel more relaxed.

The best way to do this is to relax deeply with your eyes closed, imagine being in a situation in which you fear you might panic, and just see yourself controlling it; even enjoying the situation and forgetting to think about panic.

Published by Dr.Adel Serag

Dr. Adel Serag is a senior consultant psychiatrist , working clinical psychiatry over 30 years.

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