If you've ever had a panic attack, you know how terrifying they can be. If you have never had the experience, consider yourself lucky.
Panic attacks typically are self-limiting and short in duration. The usually develop and peak suddenly, their intensity reaching the highest level within ten minutes and then abating. Someone experiencing a panic attack may feel their heart bouncing around in their chest (palpitations); may feel sweaty or shaky; might feel like they are choking or can't breathe; and may feel disoriented or dizzy as well as an intense amount of fear1.
Today a friend of mine had a panic attack unexpectedly (as they usually are "out-of-the-blue") and I happened to catch it and help them calm down. I want to offer some tips to those of you who experience panic attacks or have loved ones who do.
Generally the first thing you want to do is control your breathing, as calming your physical self down will help to short-circuit any of the "fight-or-flight" responses occurring in your body. If you are having a panic attack (or your friend or family member is), get into a comfortable position and relax the body and focus on proper breathing. I quickly knelt by my friend and got them to a chair. I told them to focus on their breathing and breathe in through their nose and out their mouth using only their belly. I kept eye contact with them and held their hand and breathed with them. It is hard to think during a panic attack so if you can be the guide for breathing, it is much easier for the other person to follow; also, if you are helping someone else, it is important to keep calm yourself.
If you are alone when panicking, it may help you to call a friend/family member to help you breathe or talk through what you are feeling while focusing on breathing (but be safe! If you are panicking while driving, pull over and make the call or use a hands-free device). If you can't call anyone find a comfortable spot and begin your breathing exercise. Distraction works well in this case - video games, movie, music, writing. Anything to get your mind off the feeling of fear or the physical symptoms you're experiencing. If you continue to breathe correctly your anxiety should subside. If it doesn't, there are help-lines to call and the operators will be able to assist you.
Once you've regained control of your breathing and are in a safe place to relax, you can work on progressive muscle relaxation (PMR) exercises (especially if you are prone to panicking before bedtime). This will bring the anxiety level down even farther. The slow and controlled breathing is an important first step and might help you come completely out of an attack or might just bring you back to a manageable level of anxiety; but the PMR exercises can really help you get centered again, especially after a panic attack. It all depends on your base-line anxiety levels.
If you are noticing that you are having many anxiety attacks in a short period of time or that they are getting worse or your work/school/relationships are suffering you should speak with your doctor. There are many helpful therapy programs (CBT especially) as well as medications that can help you manage your anxiety. It is not a weakness to reach out for help when you need it.
List of crisis lines*:
National Suicide Prevention Lifeline toll-free at 800-273-8255. (USA)
*if your country is not listed, a quick Google search should help you find one in your area.
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1 Kessler RC, Chiu WT, Jin R, Ruscio AM, Shear K, Walters EE: The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication.
Arch Gen Psychiatry 2006, 63:415-424. PubMed Abstract | Publisher Full Text | PubMed Central Full Text