How to deal with a panic attack

I’m pretty sure I’ve already written something along these lines before, you know? I think we can agree this means I must be out of ideas, since I’m now resorting to a 2020 remake of something that was probably better the first time around. Ah well, I can justify the existence of this blog post with two excuses:

  1.  I’m bored
  2. I’ve learned a fair bit about my mental health since 2018, and I can hopefully offer more advice for someone looking to manage their panic attacks

This one is going to be quite specific, yes. I’ve noticed in previous posts that I can spread myself too thin trying to address as much as possible in my posts. This post is just about panic attacks and how I manage them. If the title didn’t tell you that already, then this certainly does. If this doesn’t then I’m afraid all hope is lost for you. 

If I do discuss having panic attacks, it’s purely to establish some context. If you’re here reading this then I presume you’ve had a panic attack before and absolutely don’t need a reminder of what they feel like. 

Accept that it’s happening

As humans we are pretty much hardwired to resist anything negative that’s happening to us.  After all, you wouldn’t put your hands down in a fight and happily let the other person beat you up would you? Having a panic attack is quite different to having some external shitness imposed on you in that it’s quite outside of your control for the most part. Your natural response when this happens is to get worked up because no matter what you do you can’t stop the rush in your chest, you can’t stop the trembling, nor the sweats or the feeling of impending death when shit really hits the fan. The thing is though- and you probably already know this- but getting angry and worked up at the fact it won’t stop is just going to make it worse. Panic is cyclical. It begins with anxiety, then physical symptoms, then worry about those physical symptoms comes and before you know it, you’re locked in a very deadly cycle. Stress, anger, and resistance towards what is happening to you will keep you in that cycle for much longer. These emotions can lead to your heart rate staying up, they keep your breathing deep and strained, keep your jaw clenched and generally do a good job of keeping you in a state of tension. 

It sounds almost weird to say but the most immediate thing you should do when having a panic attack is to stop resisting it and just let it happen. It’s not your fault that it’s happening, unfortunately it just is what it is. No amount of added stress is going to make it go away, so be aware of any anger you’re feeling at yourself or towards the situation and try to let that go. The key I think to getting through a bout of panic is to eventually get to a place in your mind where you can become a spectator of your own thoughts. It becomes less about fixating on all that’s going on in your head and more towards watching thoughts pass by like clouds in the sky. That doesn’t mean you don’t still feel the panic, but you’re not as sucked up into it. This all starts with accepting that this is happening to you and that it’s okay that it is. 

Focus on your breathing

When you have a panic attack, 9/10 times you’ll be breathing quite deeply and irregularly. By doing this you’re going to keep some of the physical symptoms of panic going. When you take those big deep breaths you’re giving your heart a lot of work to do. Your heart rate will absolutely stay sky high, and that’s not a nice feeling at all. Not only that but taking deep breaths puts a lot of strain on the intercostal muscles between your ribs. That’s often where the bulk of the chest pain comes from during a panic attack. Myself personally I’ve found chest pain and an elevated heart rate to be the two most alarming symptoms. Their presence often leads to me catastrophise the situation, so there’s a strong case for working around them. 

It’s quite weird, but physical symptoms actually have quite a significant impact on your state of mind and vice-versa. Understanding this psycho-somatic relationship is quite important for managing panic attacks. Imagine how you might start to feel if your chest pain were to slowly diminish, and your heart rate gradually slow? Managing the physical symptoms can actually begin to temper the panicking in your mind. 

As soon as you become aware of your breathing, it’s time to make sure it isn’t so deep and/or irregular. I like to practice rhythmic breathing. It ensures that your breathing is steady and shallow. It also gives your mind something else to focus on. I would really recommend looking it up, but I tend to breathe in slowly for 3 seconds, and then breathe out for 5 seconds. Do this for as long as you need to. Over time, you’ll notice your heart rate beginning to slow down. Breathing rhythmically will relax the pressure on your intercostal muscles and ease those feelings of tightness or any aching going on. The process does take time, but it can help you to slowly release yourself from the panic cycle. If your body is in that fight or flight state, then surely your mind will be. However, if your body begins to relax then so the mind will begin to follow.  

Do a body scan

Now this one does apply more to when you’re indoors perhaps. Nonetheless, I find doing a body scan quite useful. During a bout of panic, you might notice that you seize up in some areas. For me, I notice that my jaw clenches down quite hard. Your body reacts in a similar way to how it does when you’re stressed, really. Areas become quite tense because you’re in the fight or flight state. Your body is ready for action even though you might be lay down trying to get some sleep. Doing a body scan involves actively thinking about each part of your body from head to toe, making yourself aware of any aches, pains, seizures, really any feeling at all. It’s just making yourself aware of it that is important. Often in the heat of it all you don’t realise just how tense you are. You’re likely more rigid than a wooden ruler, but that’s an afterthought when you’re focusing on not losing your mind really! All the same, it’s important to become aware of how your body is reacting to your panic state. Again, it’s worth doing some research into this, I think. By scanning your body, you can consciously relax areas that are stressed. For me this involves relaxing my jaw, and near enough instantly sometimes this can bring you some ease. By focusing just on the physical sensations, you’re also distracting yourself from what’s going on in your mind. Of course, you won’t always get this right. I often get to my shoulders and then get right back to business wondering if that adrenaline rush was the beginning of cardiac arrest or not. You just have to keep bringing yourself back to it when you can. Again, a large part of dealing with a panic attack is simply accepting what’s happening rather than becoming stressed that it won’t just go away. 

Anyway I hope those do help. Panic attacks are horrible, and even quite debilitating at their worst. There will be many times when the above tips or any other strategies you know of just don’t work at all and that’s okay. They definitely don’t always work for me either, because at the end of the day a panic attack is difficult to manage. Just be kind to yourself by trying to accept that this is just the way it has to be for a short while, and that it’s not your fault it won’t go away. 

-Nick

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