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Health & Fitness

Coping with Panic Attacks

Coping with Panic Attacks. Learn about panic and what you can do to cope with and reduce the frequency and duration of the panic attacks.

 A panic attack is a sudden surge of mounting physiological arousal that can occur “out of the blue” or in response to encountering or even thinking about a phobic situation. The bodily symptoms that occur with the onset of panic often include heart palpitations, tightening in the chest or shortness of breath, choking sensations, dizziness, sweating, shaking, faintness, trembling, and tingling in the feet or hands. Physiological reactions that often accompany these bodily changes often include an intense desire to run away, feelings of unreality, fears that the person is going crazy, dying or doing something uncontrollable.

Any one who has ever had a panic attack knows that it is one of the most intensely uncomfortable states that a person can experience. The very first panic attack often leaves the person feeling helpless, terrified and very anxious about the possible reoccurrence of another one. Researchers still don’t know why some people have only one, others once every few years and others may have them as a chronic condition.

The good news is that you can learn to cope with panic attacks so well that panic attacks won’t frighten you any longer.  Over time you can learn to diminish the intensity and the frequency of panic attacks if you are willing to make some lifestyle changes. I will tell you that making changes initially is tough. Most of us want a particular result, but we are unwilling to make necessary changes. I hope that those of you who suffer with panic attacks will try these changes out and you will probably find that you are doing much better as a result. The life style changes include: regular practice of deep relaxation, a regular exercise program, elimination of stimulants (caffeine, sugar and nicotine), learning to acknowledge and express your feelings, especially anger and sadness, and adopting positive self-talk and “core beliefs” which promote a calmer and more accepting attitude toward life.

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Some times people need medication to help them deal with their panic attacks. That may be the case if your panic is interfering with school, work, close relationships, sleep or if they are so frequent that you feel you are losing your grip. See your doctor about this. Otherwise, most people will not need medication and can find good results from following some of these suggestions.

A panic attack is frightening but it is not dangerous. Panic is an entirely natural bodily reaction that simply occurs out of context. It is related to the fight- or- flight reaction. It is instinctual when faced with a threat. It serves to protect us. Our heart rate and respiratory rate increases, our muscles tense, our arteries constrict and there is reduced blood flow to hands and feet, there is increased blood flow to muscles, a release of stored sugar from your liver into bloodstream and increased production of sweat.  So during a panic attack, the body goes through exactly the same physiological flight reaction that it does in a real life-threatening situation. The panic that wakes you from sleep or that happens out of nowhere is physiologically indistinguishable from your response to such experiences as a vicious dog chasing you. What makes panic attacks challenging is that there is no apparent danger. No one fully knows why this happens, which makes it more unsettling. We do know that when a person has been undergoing prolonged stress or has recently undergone a significant loss, there is a greater tendency for such attacks to occur. Yet, many have had great loss and dealt with prolonged stress and never experience panic attacks.

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Please remember that panic attacks are not dangerous.  It is important to break the cycle between bodily symptoms and your catastrophic thoughts. Please know that: A panic attack can’t cause heart failure or cardiac arrest. During a panic attack there are no EKG abnormalities, only rapid heartbeat. So know that you won’t have a heart attack.  A panic attack won’t cause you to stop breathing or suffocate. Your brain has a built in reflex mechanism that will eventually force you to breathe if you don’t have enough oxygen. A panic attack can’t cause you to faint.  Feeling lightheaded during panic isn’t dangerous and can be helped by breathing slowly and regularly from your abdomen, through your nose.

Don’t’ fight the panic! Resisting or fighting the initial panic symptoms often makes it worse. It is important not to tense up or try to make the symptoms go away by suppressing them. It is better to act than be passive, yet do not fight it. Claire Weeks, author of Hope for Your Nerves, describes a four-step approach to cope with panic:

 

  1. Face the symptoms- don’t run from them.  Running away from symptoms tells yourself that you can’t handle a situation. This often only creates more panic. It helps instead to say to yourself, “Okay, here it is again. I can allow my body to go through its reactions and I can handle this. “I’ve done it before.”  
  2. Accept what your body is doing- don’t fight against it.  When you try to fight panic, you simply tense up which makes you more anxious. Adopt an attitude of letting go and allowing your body to have its reactions will enable you to move through the panic more quickly and easily. The key is to learn to watch or observe your body’s state of physiological arousal- no matter how unusual or uncomfortable it feels.
  3. Float with the wave of a panic attack rather than try to force your way through it.  The initial fear is due to the bodily reactions, and then the second fear is due to scaring ourselves about those reactions. We may say, “I can’t handle this” or “I’ve got to get out right now!” or “What if people see this is happening to me?” The truth is that you can’t do much about your bodily reactions but you can learn to flow with the rising and falling of your body’s state of arousal rather than fighting or reacting fearfully to it.  Say to yourself, “This too shall pass,” “I’ll let my body do its things and move through this,” or “I’ve handled this before and I can handle it now.”
  4. Allow time to pass. Panic is caused by a sudden surge of adrenaline. It you can allow and float with your bodily reactions caused by this surge, much of the adrenaline will metabolize and be reabsorbed within 3-5 minutes. Then you will start to feel better. Panic attacks are time limited. Most will peak and begin to subside within only minutes.  Drinking water helps as well to metabolize the chemicals that are produced by the body during panic.

 

Some helpful coping skills:

Coping Statements: “This feeling isn’t comfortable, but I can accept it.”

“I can be anxious and still deal with the situation.” “I can handle theses symptoms.” 

“This isn’t an emergency. It’s okay to think slowly about what I need to do.”

“ I will ride through this, I don’t need to let this get to me.”

Make up your own to practice saying during a panic attack.

 

Explore what may be the underlying cause of your panic attacks:

Were you under stress?  Were you by yourself or with someone?

Who were you with? What kind of mood were you in for several hours before the panic came on? (Anxious, depressed, angry, depressed, sad?)

Were you engaging in negative or fearful thoughts just before the panic attack?

Did you feel tired or rested?

Were you experiencing some kind of loss?

Were you feeling hot or cold?

Were you feeling restless or calm?

Had you had caffeine or sugar just before the panic came on?

Are there any other circumstances that correlate to you’re your panic reactions?

Keeping a journal has helped many in finding clues to some of the underlying causes of their panic attacks or anxiety. 

Learn to Discriminate Early Symptoms of Panic and then Use Coping Skills:

Some will start to feel a sudden quickening of their heartbeat. Some will feel tightening in their chest or sweaty hands or queasiness. With practice you can learn to catch yourself in the early stages of a panic attack before it gets worse. When you notice the early signs, begin to slowly do some abdominal breathing, while breathing through your nose, which can reduce hyperventilation, which can often cause or aggravate a panic attack.  

Some coping skills include:  Repeating positive coping statements. Talk to a supportive person on the phone or in person. Talking about what may be on your mind can help a lot. Talking through a panic attack can also help even if it feels uncomfortable.  Move around and get some physical activity. Stay in the moment as much as you can. Focus on your immediate surroundings and the details around you. Use simple distraction techniques. Counting backward, count the people that you see or the books that you see, count change in your purse, count the bumps on the steering wheel, snap a rubber band on your wrist to jar your mind out of your anxious thoughts. Sing, take a cold shower.  (Distraction is helpful at the sudden onset but don’t let distraction be a way of avoiding or running away from anxiety. Best thing is to learn to experience the surge of anxiety and allow it to pass without trying to get away from it.)

Get angry at the anxiety:  Did you know that anger and anxiety are incompatible responses? It is not possible to experience both at the same time. Sometimes anxiety stands if for deeper feelings of anger, frustration or rage.  If you get angry at the anxiety at the moment you feel it, you may be able to stop it. You can get angry verbally or physically. You can say, “Get out of my way. I have things to do!”  “This is ridiculous. I’m doing what I have to do anyway. You can’t stop me!” Physical ways that help many: Pound a pillow with both fists, Scream into a pillow or in your car, hitting a bed or couch with a pillow. Sometimes writing about your anger helps too. Write an angry letter, just don't mail it. You may want to rip it up or shred it after you are done writing. 

Physical Exercise: One of the most powerful and effective methods for reducing anxiety and overcoming a predisposition to panic attacks is a program of regular, vigorous exercise. Exercise is a natural outlet for your body when it is in the fight or flight mode of arousal. Many people who have panic attacks find that after undertaking a regular exercise program, that their panic attacks are much less severe and that they occur less frequently. Regular exercise also diminishes the tendency to experience anticipatory anxiety as well as recovery from phobias such as public speaking or the fear of being alone.  Determine your fitness level. You may need to visit your doctor first. If you are out of shape you may begin with walking at least 30 minutes 4 times per week. Then slowly you can build up to running, cycling, swimming etc. This lifestyle change will help your health in many ways including coping with anxiety.

In summary:

1. Accept your symptoms.

2. Practice Abdominal Breathing.

3. Use a coping strategy.

For more help please check out the book: The Anxiety and Phobia Workbook, 5th Edition by Edmond J. Bourne. One of the best books I know on Anxiety.

We can endure much more than we thing we can; all human experience testifies to that. All we need to do is learn not to be afraid of pain. Grit your teeth and let it hurt. Don't deny it, don't be overwhelmed by it. It will not last forever." ~ Harold Kushner

Take care of yourselves and take care of each other. For information on grief, loss and healthy coping please visit my website: www.griefspeaks.com

Like 'Grief Speaks' and 'Grief Speaks 4 Teens' on Facebook. Follow Griefspeaks on Twitter.  Watch helpful videos on grief, loss and coping on YouTube on my channel: Griefspeaker 

Take care,

Lisa

 

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