Have you ever experienced a full blown panic attack?
It can be an utterly terrifying experience.
Anyone who has suffered a full blown panic attack will be familiar with how the fear of having another attack can trap them in a permanent state of vigilance, looking out for the next bad thing.
When it happens again and again and again, your life starts to unravel. You do anything you can to avoid situations that might trigger another attack, and your world starts to shrink.
Understanding panic attacks
It doesn’t have to be like this. Understanding what triggers and fuels a panic attack can, and does, make all the difference. It can take away the fear almost completely. With this understanding you can learn how to prevent future panic attacks completely or stop a future panic attack from escalating.
The first thing to know is that a panic attack will not kill us, even though it can feel like it might at the time.
It is the result of our brain perceiving we are facing a threat (real or imagined) and triggering the ‘fight or flight’ stress response. All of the symptoms of a panic attack are those we commonly experience when we’re stressed, such as:
- Fast shallow breathing
- Palpitations or sensation of a pounding heart.
- Sudden feeling of nausea
- Dry mouth
- A sense of desperately needing to use the loo
But why does our brain think we’re under threat, when in the case of a panic attack, we’re simply doing routine, safe activities like the weekly shopping, waiting for a bus, working in our garden? Where’s the clear and present danger in these innocuous situations?
Our inbuilt, natural survival system has made a mistake.
A useful analogy is that a panic attack that occurs when there’s no actual threat is rather like a smoke alarm that is so sensitive that it sometimes goes off even when there is no fire.
With a faulty fire alarm everyone wonders what is happening for a moment or two but then they realise they can just safely turn it off. We can do this with panic attack attacks too, once we know how (see below).
What fuels a panic attack, and escalates it, is hyperventilation – sustained shallow breathing. When you breathe in short breaths or gasps but don’t take any physical action, you take in more oxygen than you can use and it gets breathed out again, taking carbon dioxide with it.
Normally we breathe in the right amount of oxygen, and with the aid of carbon dioxide, this gets transferred to our body tissues, and the carbon dioxide is exhaled. But when oxygen is breathed out almost immediately, as a result of hyperventilation, it takes precious carbon dioxide with it, causing the levels of carbon dioxide in our blood to fall. We then feel we are oxygen starved and experience the terrifying feeling of choking or suffocating, even though we are actually breathing plenty of air in.
The hyperventilation may also cause:
- Chest pains as a result of the strain on our chest muscles as we hyperventilate
- Trembling and shaking. The more we hyperventilate the more uncontrollable the trembling and shaking becomes.
- Dizziness or faintness
- Weakness – hyperventilation is tiring.
Our mind interprets the escalating physical sensations as evidence that we are:
- losing control. Our body is screaming ‘RUN!’ yet there is no clear and present threat to run away from?
and we say/think to ourselves:
“I can’t breathe!”
“I’m having a heart attack!”
All of these physical sensations and catastrophic thoughts are the result of hyperventilation.
Remember, a panic attack is just your body’s normal response to a perceived threat.
Therefore the intensity of the stress symptoms would normally start to abate within two or three minutes if the stress process was left to follow its natural course. The only reason stress symptoms don’t abate quickly when we’re experiencing a panic attack is because our catastrophic thoughts and imaginings, triggered by our hyperventilating, keep activating the fight or flight response.
Ways to stop a panic attack as soon as it starts.
Some people find that this information about how what they’re experiencing during a panic attack are normal stress symptoms fuelled by unhelpful thoughts, is all they need to enable them to begin to gain control over their panic attacks.
However, there are some practical and effective ways you can stop a panic attack as soon as it starts. When you do this, the reaction only has to last for three minutes.
Here are some hyperventilation stopping techniques for you to try:
- Hold your breath and count to 10.
- Start 7/11 breathing. As soon as your out-breath is longer than your in-breath, you are stopping yourself from hyperventilating. As soon as you start to breathe in slowly through your nose, you’ll find you lose the sensation of suffocation.
- Do something active. Engaging in physical activity when you’re struggling to breathe sounds crazy but it works. Almost miraculously, the panicky feelings subside. This is because you are putting your rapid breathing to the purpose it was originally intended to help you fight or flee. So run up and down the stairs a few times, run to the next bus stop, jog on the spot, dance to the radio, do some press-ups. You’ll not only feel better, you’ll have proof that you’re not experiencing a heart attack or dying.
Once you’ve got your breathing under control:
- Distance yourself from the experience by naming what you’re experiencing. This can be an extremely powerful way of regaining control. Tune into what’s going on in your body and then name it, ideally out loud: “My heart is beating like a drum. I’m having a panic attack.” “I’m panicking. This isn’t going to help me.”
- Stop catastrophic thinking. Often people having a panic attack get stuck in an endless loop repeating the same catastrophic thoughts over and over in their head. Interrupting this endless loop gives you the opportunity to replace the scary message with a calming one. You can interrupt your catastrophic thinking by shouting the word “STOP!!!” either out loud or really loud inside your head. By shouting the word “STOP” you are interrupting the stream of thoughts that are repeatedly triggering your stress response. Then distract yourself by naming all the red/green/blue etc objects in the environment around you. Do this for two minutes, by that point you will have broken the catastraphic loop.
NB. If you’re concerned about the possible causes of your panic attacks consult your doctor.
How to Master Anxiety by Joe Griffin and Ivan Tyrell (HG Publishing 2011)
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