How can you prevent or manage a panic attack?

Author and Medical Reviewer
Dr. Jose Toledo

How can you prevent or manage a panic attack

Panic attacks are “an abrupt surge of intense fear or discomfort,” according to the definition given by The Diagnostic and Statistical Manual of Mental Health Disorders.

People experiencing them have overwhelming and intense mental and often physical symptoms. If you have a panic attack, you might experience:

  • rapid heart rate
  • chest pain or discomfort
  • sweating
  • difficulty breathing
  • nausea or stomach upset
  • dizziness
  • shaking or trembling
  • chills or feeling hot
  • numbness or tingling
  • feeling detached from yourself or reality
  • fear of losing control
  • fear of dying

These symptoms tend to start without warning and reach a peak within minutes.

In severe cases, panic attacks are even sometimes confused with heart attacks or strokes.

What causes panic attacks?

Panic attacks can happen for various reasons. Often, though, they occur for no apparent reason.

In most cases, a panic attack happens when you’re exposed to a specific trigger. These vary widely. Some people find that social events, public speaking, conflict or situations that remind them of past or current stress can be a trigger.

Managing panic attacks

Managing panic attacks

Having a panic attack can be terrifying. Here are some strategies you can use to try to prevent or manage panic attacks, either in the moment or in the long term.

1. Learn to recognize when you’re having a panic attack

By learning to recognize that you’re having a panic attack (instead of a heart attack, for example), you are reminded that it’s only temporary and it will pass. You can therefore focus on other techniques to reduce your symptoms.

An important element of this is knowing what your triggers are. Though it’s not always possible to avoid them, knowing the triggers can help you understand that you’re having a panic attack and not something much more serious.

2. Close your eyes

If you’re in an environment with a lot of visual stimuli, this can feed your panic attack.

To reduce the impact of these, close your eyes and block out the extra stimuli that are stopping you from focusing on your breathing.

3. Practice deep breathing

Hyperventilating during a panic attack can increase your fear levels. Practicing deep breathing can therefore reduce symptoms during an attack.

Studies show that those who practice deep breathing have lower cortisol levels (a stress indicator) and have improved attention levels and emotional well-being.

Therefore, focus on taking deep breaths – in and out through your mouth. Concentrate and feel the air slowly fill your chest for four seconds, hold for a second, and then breathe out for another four seconds.

Similarly, slow breathing can also improve feelings of relaxation, comfort and alertness and reduce symptoms of arousal anxiety, depression, anger and confusion.

Ultimately, if you’re able to stay in control of your breathing, you’re less likely to experience hyperventilating and make panic attacks worse.

4. Practice mindfulness

As panic attacks can cause a feeling of detachment from reality, practicing mindfulness can help ground you in your surroundings.

Generally speaking, mindfulness involves focusing on the present, recognizing the emotional state you’re in and meditating to reduce stress and help you relax.

If you’re having a panic attack, try to focus on familiar physical sensations. For example, tap your feet on the ground or feel the texture of the clothes you’re wearing. These specific sensations ground you in reality.

5. Find a focus object

Another technique some people adopt is to pick an object in clear sight and note everything possible about it. These sensations can also give you something objective to focus on.

Describe the shapes, patterns, colors and size of the object to yourself. Focus all your energy on this and your panic symptoms should subside.

6. Visualize your ‘happy place’

Using guided imagery techniques can help reduce stress and anxiety during a panic attack.

Try to visualize the most relaxing place in the world that you can think of. Place yourself there and try to focus on the details as much as possible and imagine yourself interacting with them.

Forget cities. This place should be quiet, calm and relaxing – preferably in nature.

7. Repeat a mantra internally

Repeating a mantra internally, especially one that speaks to you personally, can be reassuring and give you something to grasp onto during a panic attack.

You should try to repeat it on loop in your head until you feel the panic attack start to subside.

8. Do light exercise

Expert research shows that exercising for 20 minutes three times a week at between 60 and 90 per cent of your maximum heart rate can help reduce anxiety.

Aerobic exercise, including running on a treadmill, is especially effective but if you’re not used to exercising, you have to build up gradually to help your body adjust and avoid breathing problems or triggering additional anxiety.

If this causes stress, try a more leisurely option such as walking or yoga.

9. Keep lavender close by

Research shows that lavender has a calming effect and helps to reduce stress. It also has the added benefit of not leading to dependence or causing withdrawal symptoms.

Traditional remedies that contain diluted lavender oil may help reduce or manage symptoms of anxiety.

However, lavender essential oil is not regulated so be sure to get your oil from a reputable source, such as a pharmacy. Be sure to always follow the instructions for use and avoid applying concentrated oil directly to the skin.

10. Seek counseling

People who have panic attacks or panic disorders often benefit from cognitive-behavioral therapy (CBT) and other types of counseling. The aim of CBT is to help you change the way you see challenging or frightening situations and find new ways to approach them.

In exposure-based CBT, a therapist will expose you to something that can trigger a panic attack and they will help you work your way through it.

In addition to changing behavior, there is some evidence that CBT might affect structures in your brain that are responsible for panic symptoms.

11. Consult a doctor about medication

When taking medication for panic attacks, it’s advisable to consult a doctor first. Doctors tend to only recommend medication for short-term use during a crisis.

Benzodiazepines, such as alprazolam, are often prescribed to treat the symptoms of panic when they occur. For a more long-term solution, a doctor may prescribe anti-depressants.

Generally speaking, you should consider consulting a doctor, especially if you have one or more panic attacks, your behavior changes after an attack or your concerns or feelings are affecting your daily life.


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