Get Rid of Panic Attacks

A panic attack can strike suddenly and without warning, sending your heart and mind racing and filling you with dread. It may be a single event or a recurrent pattern; in certain people, it might part of a chronic psychiatric problem called panic disorder. Anxiety attacks result from basic, primal reactions in the human body – fight or flight mechanisms responding to a perceived threat. Usually, the panic-causing situation is one that makes you feel in danger and unable to escape, like being in an enclosed space or having to speak in public. Panic attacks are manageable, however, and with some coping strategies, you should be able to overcome your symptoms.

Steps

Finding Coping Strategies for Attacks

1. Learn about the root causes of panic. Panic attacks start in the central nervous system, which controls everything from your breathing and heartbeat to your perspiration and respiration. When your brain senses danger, it sends signals to the body through the cerebral cortex to mobilize a response. This happens automatically with the release of chemicals like adrenaline. The heart beats faster. Your breathing becomes rapid. You start to sweat. This “fight or flight” response is not always accurate, though.
   • Learn more about anxiety, panic disorder, and the fight or flight response in books, articles, or online. You will discover that what you feel during a panic attack is very real and that you are not simply imagining things.
2. Don't be reactive. Some therapists advocate “accepting” a panic attack. Your fight or flight mechanism is powerful but not always right, and you are almost certainly in no real danger during an attack. Try to keep calm and assured if you feel an attack approaching. Don't give in to your fear. In fact, “phobic” or negative thoughts – i.e. “I'm going to die” or “I'm going crazy” – can not only overwhelm you but exacerbate the attack. Consciously force yourself to recognize that there is no threat to you. Hold this in your mind and repeat it for several minutes.
   • You may try to avoid situations that make you anxious. This is natural, but not helpful. Evasion can actually exacerbate your fears.
3. Practice relaxation techniques. Learn to control your breathing. Draw slow, regular breaths through your nose and exhale out through puckered lips, inhaling to the count of five, holding for five seconds, and then exhaling to the count of five. This deep breathing can help to relieve symptoms of panic, especially hyperventilation, which causes giddiness and lightheadedness.
   • Another effective strategy is progressive muscle relaxation. To do this, tense and release various muscles working your way from your head to your toes. Tighten each muscle while breathing in, hold for several seconds, and then release. This relaxation technique should reduce your tension and overall stress level.
   • Practicing yoga or meditation every day are also good ways to reduce your stress and tension.
4. Minimize stress. Take care to avoid things that increase your overall levels of stress, anxiety, and tension. Avoid caffeine and other stimulants, for example, like coffee, caffeinated tea, sodas, and cigarettes. These can provoke panic attacks in susceptible persons. Likewise, try have some fun every day and to get adequate sleep each night. Making lifestyle changes is important.
5. Be physically active. According to a recent study, a regimen of at least three workouts per week can curb panic attacks and related symptoms. Although the exact mechanism is not clear, physical activity increases heart-rate variability and has a positive impact on the brain and on mood. Try some form of vigorous aerobic exercise like jogging, riding a bike, swimming, or playing a sport. Go for a walk. Do something active.

Using Medication

1. Don't self-medicate. You might be tempted to cope with your panic episodes through self-medication with drugs or alcohol. This is always a bad idea. For one thing, it fails to address the underlying problem. You are merely masking it by temporarily altering your brain chemistry and putting yourself at risk for alcoholism, drug dependency, and a host of other health problems. For another thing, it is counter-productive. Once the sedating effects of the drugs or alcohol wear off, the panic often comes back more strongly because you have lowered your defenses.
2. Talk to your doctor. There are safe medications that you can use to temporarily control or reduce symptoms of panic disorder. This will not “cure” the problem or resolve it entirely, but it may prove helpful. Talk to your doctor about this option. Most often, meds will work best when paired with other treatments like therapy and changes to lifestyle that get at the root causes.
3. Ask your physician about antidepressants. One possible option is to take a serotonin reuptake inhibitor antidepressant, like fluoxetine (Prozac), paroxetine (Paxil, Pexeva), or sertraline (Zoloft). These work by changing the levels of the hormone serotonin in your brain, boosting your mood, relieving mild to severe depression, and decreasing the frequency of panic attacks.
   • Antidepressants are generally safe and cause fewer side effects than other types of antidepressants.
   • Keep in mind that antidepressants can take several weeks before they begin to work properly. You have to take them continuously, not just during an isolated attack.
4. Ask your doctor about benzodiazepine. Benzodiazepines are central nervous system depressants that are useful in treating anxiety, insomnia, seizures, and other problems. Generally they act quickly, usually within 30 minutes to an hour, and give rapid relief of symptoms of anxiety or panic.
   • Benzos are habit-forming when taken long-term or in high dosages. You can develop a serious physical or psychological dependence on them and experience withdrawal symptoms. They should usually only be used for a short period.

Using Cognitive Behavioral Therapy

1. Talk to a mental health professional. Medicine is not a cure-all for your panic attacks. Instead, one of the most common treatments is cognitive behavioral therapy (CBT), administered with the help of a mental health professional like a psychologist. CBT challenges your fear. It teaches you to replace your false, unfounded fears with more rational beliefs and to develop an inner voice to cope while the fight or flight response runs its course. When feeling panicked, your response with CBT should be reassuring: “I'm in no danger.”
   • Talk to a professional. See what sort of treatment options are available for you. There are in fact a number of different approaches that can be taken separately or at the same time.
2. Try practicing mindfulness. Mindfulness is an acceptance strategy and form of CBT, addressing aspects of your emotional experience that can't be directly changed. As someone who suffers from panic attacks, you likely have feelings of anxiety, fear, doubt, and urges to escape. With mindfulness you will learn that there is no “off switch” for these feelings and that the attempt to control them will only increase your distress. Mindfulness teaches you strategies to live with the sensations, to soften and accept them while letting them run their course.
3. Try exposure therapy. Exposure therapy reverses our normal response to fears. Our natural reaction is to avoid anxiety-inducing situations. But while avoidance gives immediate relief, it is actually counter-productive and can ultimately worsen your fears or create mental paralysis. Exposure therapy will systematically confront you with your fears or whatever might be inducing your panic.
   • Most therapists do this slowly, in a graded fashion, so that high-level exposure is not attempted until you successfully face lower-levels. With each step, then, you will build up more emotional “muscle.”
   • The confrontation can be real (“in-vivo”) or simulated, where you are guided through an imaginary scenario. Once your brain learns that these feelings are not dangerous, it will stop triggering your panic. Exposure therapy has been found to be effective in treating anxiety disorders.

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Sources and Citations

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