Dealing With Panic Attacks ~ And How to Regain Control

If you have ever experienced a panic attack, you know how frightening it can be. Your heart begins racing, your breathing becomes rapid, and you may feel dizzy or shaky. Suddenly, it can seem as though something is terribly wrong. Many people experiencing a panic attack fear they are having a heart attack and may seek emergency medical care.

One of the most important things to understand about a panic attack is that although the feelings are very real and can be incredibly intense, they will pass. Panic attacks often reach their peak within approximately 20 minutes, although some symptoms may last longer.

Understanding what is happening in your body can be an important first step toward feeling more in control.

A panic attack is a sudden surge of intense fear or discomfort that can come on quickly, sometimes without an obvious reason. The body essentially sounds an alarm. It's like flipping a switch. Remember, the thought creates the feeling.

Our bodies have a natural survival system commonly known as the fight-or-flight response. When the brain senses danger, the body prepares us to respond. Our heart rate increases, our breathing changes, our muscles tense, and stress hormones are released.

During a panic attack, breathing may become rapid and shallow, sometimes leading to hyperventilation. These physical sensations can make a person feel as though they are losing control or are in danger. The problem is that sometimes our internal alarm system goes off when there is no immediate threat.

As a psychotherapist, I have found that simply understanding what is happening inside the body can sometimes make these experiences feel a little less frightening.

Learning breathing techniques can help tremendously. But these techniques are not always easy to use for the first time in the middle of panic. That is why they should be practiced regularly when you are calm, so they become second-nature, familiar and easier to use when you need them.

Instead of thinking, "Something terrible is happening to me", you can begin to recognize, your body's alarm system has been activated.

Once you have experienced a panic attack, the fear of having another one can sometimes become part of the cycle. You begin worrying about when or where another attack might happen—and that fear itself can increase anxiety.

Regaining control is about learning what to do when panic begins and becoming confident that you can ride it out until it passes.

Panic attacks can feel different from person to person. Some common symptoms include a racing or pounding heart, shortness of breath, trembling, sweating, dizziness, chest discomfort, nausea, tingling sensations, or feeling disconnected from yourself or your surroundings.

There may also be an overwhelming fear that you are going to lose control, faint, or that something terrible is about to happen. And that is part of what makes panic so powerful: we can become frightened by the sensations themselves.

The heart starts racing. We notice it. We become afraid because our heart is racing. That fear causes the body's alarm system to become even more activated, which can intensify the physical sensations. It becomes a vicious cycle.

Rather than fighting against every sensation and desperately trying to make the panic stop, which will make the symptoms even more intense. Remind yourself that you have practiced what to do. You have to become your own cheerleader.

Focus on your breathing, in for the count of 4, hold for the count of 4, and release for the count of 4. Allow yourself to ride through the wave of panic. It is important to notice the time you initiate breathing techniques, remembering that 10 minutes into your symptoms you are half-way through and symptoms should start to subside.

I often think of a panic attack like a roller coaster going up a hill. The symptoms get a bit stronger, then reach the peak and start to ease up. Gradually, they begin to disappear and your breathing returns to normal. Once the symptoms have passed, return to what you were doing before the panic attack began. Try not to allow the experience disrupt the rest of your day. Avoiding an activity because of the panic attack occurred can reinforce the fear surrounding it.

Instead, you are teaching yourself something very important:

I experienced panic. I got through it. And I can keep going.

There are several types of breathing exercises you can practice. One technique you may want to try is called 4-4-7 breathing:

1. Breathe in gently through your nose for a count of 4.
2. Hold your breath for a count of 4.
3. Slowly breathe out through your mouth for a count of 7.
4. Repeat at a comfortable pace.

Don't worry about performing the technique perfectly. The goal isn't to pass a breathing test!

The idea is to slow things down, focus your attention, and give your mind something steady to concentrate on instead of the frightening sensations.

If holding your breath for seven counts feels uncomfortable, don't force it. Gentle, slow breathing is more important than hitting an exact number.

And remember: breathing techniques are skills. Practice them when you are not anxious. The more familiar the technique becomes, the easier it will be to call upon it when you are experiencing panic.

When we are frightened, our thoughts can quickly move toward the worst possible explanation.

Try replacing:

"What if something terrible is happening?"

with something more grounded:

"I've felt this before. I know what this is. I can breathe through it. It will pass."

The goal is simply to remind yourself that what you are feeling right now is temporary.

Having a panic attack does not necessarily mean you have panic disorder. However, if panic attacks are recurring, you are constantly worried about having another one, or you have begun avoiding places or activities because you are afraid an attack might occur, it may be time to talk with a qualified mental health professional.

If you experience new, severe, or unexplained symptoms—particularly chest pain, difficulty breathing, fainting, or symptoms that are different from panic attacks you have experienced before—seek medical attention rather than assuming the symptoms are caused by anxiety.

Panic attacks are treatable. Learning to understand the connection between our thoughts, our body's physical reactions, and our fear can help us feel less powerless when panic strikes.

And perhaps that is the most important thing to remember:

A panic attack can make you feel as though you have lost control. But there are skills you can learn that can help you regain it—one breath at a time.