Avoid Panic Attacks

A panic attack is a physiological and psychological occurrence in which an individual suddenly and unexpectedly experiences some or all of the following symptoms: rapidly increased heart rate, pain in the chest, sweating, nausea, dizziness, cold chills/hot flashes, numbness, difficulty catching breath, feeling of choking, shakiness, disassociation or fear of death. In order to prevent future attacks, you may benefit from: getting outside assistance, altering your thinking about panic attacks, using anxiety-reducing techniques, and focusing on your physical health.

Steps

Getting Help with Panic Attacks

1. Contact your doctor. Panic attacks are not something you should simply try to treat on your own. It is very important to make sure the panic attack is not a medical issue before attempting to treat it.
   • If you do in fact experience panic attacks and not a medical condition, you can begin treatment with a general practitioner or psychiatrist (recommended) who can prescribe medication or suggest natural remedies and nutritional supplements. Early treatment is key to preventing panic attacks.
   • Contact a general practitioner (medical doctor) or psychiatrist to discuss possible medications. Sertraline (a Selective Serotonin Reuptake Inhibitor-SSRI, brand name: Zoloft), Escitalopram (also an SSRI, brand name: Lexapro), and other medications have been indicated in reducing panic attacks.
2. Consider psychological treatment. If your anxiety disrupts your daily life in that you have trouble completing your obligations or interacting socially, it may benefit you to seek professional help. A therapist or psychologist can outline a treatment plan specific to your needs that can include coping methods and techniques.
   • Contact a therapist, social worker, or psychologist for therapy in order to help you learn new techniques to treat your panic attacks. Cognitive Behavioral Therapy (CBT) has been indicated as a useful modality for treating panic attacks. CBT is associated with changing your thoughts in order to change your feelings and behaviors.
3. Join a support group. Talking with others who have attacks may help you to feel in control of your condition and lead to helpful panic attack management resources. Group members can share strategies for facing and managing fear and their successes. Professionals with expertise in panic attacks may also be available to speak with you at meetings.
   • Request a list of local support groups from your doctor. Or, locate panic attack support groups in your area by contacting the Anxiety and Depression Association of America via their website or by phone at 1-240-485-1001.
   • There are even internet based treatments for panic attacks that have been shown to be effective.
4. Look for support from family. Ask your family to help you face your fears instead of avoiding them, stay positive with you as you work through your anxiety, and be patient while you confront your disorder.
   • Start by letting your family members know that you suffer from panic attacks and that you would appreciate their support in your recovery.
   • Try being assertive and straight-forward about your panic attacks. You could say something like, "I want to talk to you about a problem I've been having. I have been experiencing panic attacks that are very scary for me. I would appreciate any help you can offer me. I need your support in my treatment of this problem."

Changing Your Thinking about Panic Attacks

1. Realize that trying to avoid the attack is part of the problem. Panic attacks are the result of your body responding to a perceived trauma or threat. However, a pattern of panic attacks occurs due to the individual’s anxiety related to the actual panic attack and his fear that the attack will be painful or harmful. This fear leads to increased anxiety, which can trigger another panic attack.
2. Understand that the panic attack will pass and it will not kill you. Cognitive Behavioral Therapy (CBT), an evidence-based treatment for panic attacks, focuses on changing thoughts in order to alter your feelings (both physiological and psychological) and actions. Ironically, the fear of having a panic attack can lead to more panic attacks. Your fear of having a panic attack is directly related to your thoughts about having an attack. If you change your thoughts to more realistic evaluations, then you can prevent or lessen future attacks by reducing your anxiety and fear.
   • It is important to de-catastrophize the effects of a panic attack. Instead of thinking, “I’m having a heart attack, or I feel like I’m going to die,” change this thought to, “I am okay, I’m just having a panic attack, and it will pass.”
   • Use a panic attack thought record sheet in order to track your thoughts and actively change them in order to reduce future panic. Go to www.getselfhelp.co.uk/docs/PanicThoughtRecord.pdf.
3. Face your fears. Allowing fears (especially worries about having a panic attack) to build up can increase the severity and frequency of panic attacks. Thus, reducing your fears by facing them head-on could alleviate panic because instead of avoiding the issue you are dealing with it appropriately. This helps to alleviate some of the anxiety that usually builds up and causes an attack. Instead of suppressing your fears or hoping they will go away, deal with them in a straight-forward manner.
   • Label your fear. As you feel fear coming on assign a number to it from 1 to 10. Your fear likely won't stay at a high number for long, so as the number decreases you can feel more relieved.
   • When you fear failure, try new things you've been afraid to do in the past.
   • If you fear social situations, meet new people and accept invitations to parties and gatherings you may have declined in the past.
4. Accept emotions in general. Individuals who experience panic attacks may avoid emotions more often and not accept their feelings as often as those who do not experience panic attacks. Learning to accept your emotions instead of avoiding them could help to decrease the incidence of panic attacks because the more acceptance you have the less fear you might have about getting a panic attack. Since more fear and worry is associated with more panic attacks, less fear (and more acceptance) may help to reduce panic.
   • When you feel a negative emotion - say to yourself, “This emotion is natural, and it gives me important information about how I am doing. It is okay to feel this emotion and I can get through it.”
   • Attempt to be in tune with your emotions (anxiety, panic) instead of avoiding them. Sit with the emotion and experience how it feels in your body and what thoughts you are thinking when you have that emotion.
5. Focus on what you can control. Sometimes we may worry about things we cannot control such as what others say or do, and what might happen in the future. However, thinking about what we cannot control is futile. Worrying about what you cannot control can increase anxiety, so avoiding this can help to decrease the fear and worry that may produce an attack. Observe your surroundings and situation and examine what is actually happening as opposed to what might happen or what you fear might happen. For example:
   • Accept constructive criticism and praise for a job well done rather than worrying about how you could have performed better.
   • Prepare for things that may be out of your control, whether it's a possible illness or a potential disaster.
   • Build positive relationships with others. Let go of what others may think of you and embrace those who spend time with you.

Using Tools to Reduce Anxiety

1. Do deep breathing exercises. Deep breathing techniques are crucial to coping with anxiety and reducing panic attacks. When you breathe deeply it can help you reduce feelings of tension, anxiety, and jitters; this is because controlling your breathing reduces your heart rate, blood pressure, and resets your autonomic nervous system. This causes a physiological reaction which makes you feel relaxed.
   • Place yourself in a quiet and safe space. Begin by closing your eyes and breathing in through your nose and out through your mouth, slowly and deeply. Pay attention to how it feels in different parts of your body each time you let your breath out. Continue this exercise until you feel relaxed.
2. Practice progressive muscle relaxation. Progressive muscle relaxation (PMR) is a very useful technique to reduce anxiety and promote relaxation. PMR reduces feelings of anxiety by lowering cortisol (stress hormone) levels in the brain. PMR is associated with contracting and relaxing different muscle groups throughout your body in a strategic manner.
   • Begin by putting yourself in a safe place. Tense your muscles in your toes for 5 seconds, and then relax the muscles for approximately 15 seconds. Continue tensing and relaxing all the way up your body from your toes to your face muscles.
3. Engage in mindfulness. Mindfulness is being in the here-and-now by focusing your attention on your current feelings, sensations, experiences, and surroundings. Mindfulness helps to reduce anxiety because we are concerned with what is happening right now instead of regretting the past or worrying about possible future events that have not happened yet. Mindfulness relieves anxiety in individuals who experience panic attacks.
   • Start by being in a relaxing environment and trying a basic mindfulness exercise. One exercise is to slowly and very intentionally eat a small piece of fruit; Pay attention to how it looks, feels, and tastes.
   • You can do a mindfulness exercise with any object in the room you are in. Simply look at the object, note its colors, shapes, and your feelings about it. Then touch it and feel its texture. Focus on the object and make any observations you can about it.
4. Utilize grounding techniques. Grounding is called grounding because it helps “ground” us, meaning we can momentarily detach from painful emotions. It is especially useful when we have tried other relaxation techniques that may not have worked as well as we had hoped. Thus, we can healthfully avoid the emotion in the meantime, and come back to it later when it is more appropriate to deal with.
   • One mental grounding exercise it to name all of the states or colors you can think of. A physical grounding exercise is to run cold water over your hands, or take a shower/bath and simply focus on how the water feels over your body.
   • Find other grounding exercises online.

Focusing on Your Physical Health

1. Reduce your caffeine and cigarette intake. These stimulant substances may increase the frequency of panic attacks.
   • Instead of drinking something that increases anxiety and can produce panic, try drinking chamomile tea.
   • If you are used to drinking coffee or other caffeinated beverages on a daily basis, you can slowly taper your use of caffeine over time instead of quitting cold-turkey.
2. Avoid alcohol and other substances. Substance use disorders are very common in individuals with anxiety or depression. While using substances may seem to relieve your anxiety symptoms in the short term, it does not help to reduce panic attacks in the long term. In fact, some studies suggest that abstinence from alcohol can reduce anxiety.
   • If you have a problem with alcohol or drug use, speak to your doctor. Make sure you discuss the specific drug you use and ask about the possible risks or withdrawal symptoms associated with cutting down your use. Some drugs can be very difficult or deadly to quit (including alcohol, benzodiazepine, and opiates), but a medical professional can prescribe you medication or help you through the detoxification process.
3. Exercise. Consistent aerobic exercise can reduce symptoms of panic. Exercise is one of the best ways to reduce anxiety because it releases endorphins in your brain which make you feel happy. If aerobic exercise is not your thing, try other cardiovascular workouts such as dance, running, swimming, or jumping rope.
   • Yoga combines stretching, stationary poses and deep breathing exercise. This practice aims to create balance in your body, and is believed to be relaxing and stress-reducing.
4. Ensure you get plenty of sleep. Sleep issues and insomnia commonly occur in individuals who suffer from panic attacks. Being excessively tired can increase anxiety because you need the adrenaline to keep you awake during the day. Additionally, sleep deprivation is associated with high blood pressure.
   • Set a time to go to bed at night and a time to wake up. Make sure you are sleeping a minimum of 8 hours per night. If you have trouble falling asleep, try the relaxation techniques and breathing exercises detailed above.

Related Articles

• Manage Anxiety and Panic Disorder
• Stop Panic Attacks
• Overcome Panic Attacks
• Overcome a Panic Attack at Work

Sources and Citations

See also

• Help Someone Having a Panic Attack
• Cope With Panic Attacks
• Stop Panic Attacks
• Manage Anxiety and Panic Disorder
• Calm Yourself During an Anxiety Attack
• Get Rid of Panic Attacks
• Use Self Hypnosis to Stop Anxiety Attacks
• Treat Panic Attacks Naturally

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