Recognise the symptoms of panic attacks

To manage a panic attack effectively the first and most important step is being able to recognise the symptoms. Knowledge is power. To learn more about the symptoms of panic attacks take a read through our blog What are the Symptoms of Panic Attacks?

Keep in mind that panic unfolds differently for everyone. Get to know the unique way that panic attacks work for you.

Develop a barometer for your panic symptoms

As you become more aware of your panic, it’s useful to get a sense of how these symptoms vary as your panic increases. Think of this as developing a barometer for your panic symptoms. When you’re experiencing mild levels of panic what sort of physical sensations do you notice? What thoughts come up? What do you tend to want to do? How does this compare to when your panic is at a moderate or strong levels?

Knowing the subtle changes that happen as your panic increases is essential. The sooner you recognise panic arising, the sooner you can start taking action to manage the symptoms (keep reading for more details about to create a plan for coping during a panic attack).

Develop a specific and concrete plan for managing panic attacks

After you have a better idea of what panic attacks are, the next step is creating a specific and concrete plan for coping when you notice panic symptoms popping up.

During a panic attack the parts of a brain responsible for problem-solving and complex decision-making are not very active (because we are in fight-flight mode). Your mind is momentarily robbed of the ability to think straight. This means that it will be nearly impossible for you to come up with a plan for coping on the spot. This is why you need to create a plan ahead of time.

Ideally have this plan written down somewhere. Many of my clients have a summary plan stored on their phone or in a card in their wallet.

The goal of a plan for panic attacks is not to get rid of or even reduce panic symptoms. Your plan gives you tools to ride out the panic attack without making it more intense or prolonged. Essentially you are aiming to “wait-out” the panic. In the midst of a panic attack it can feel like you are never going to escape the horrifying physical physical sensations and catastrophic thoughts, but you will. Panic attacks eventually end regardless of what you do. Although there are individual differences, in general panic tends to reach its peak at about 10 minutes and then gradually subsides within about 30 minutes.

As a clinical psychologist I work with my clients to tailor an individual plan for coping with panic attacks. Typically the plan will include the following components:

Step #1 Develop a list of your unique panic symptoms

We usually refer to these as “red flags” or “warning signs” that a panic attack is about to happen or is happening. Once you recognise any of your unique warning signs it’s time to put your plan into action. The sooner, the better.

Step #2 Don’t fight the panic

This step might sound counterintuitive, but research has consistently shown that struggling against panic symptoms makes them more intense and leads them to last longer. It can help to think of your panic like a wave. Go with it (even though every bone in your body will be screaming not to!) and eventually you will get to shore.

Step #3 Shift your attention away from the physical sensations you are experiencing using distraction

Your body goes into over-drive during panic. Your mind tries to make sense of the chaos by frantically searching for explanations for the physical changes you are experiencing. If your heart is racing, your mind might tell you it’s because you’re having a heart attack. Or if you feel detached from your surroundings, your mind might start throwing out thoughts about you “going crazy” or “totally losing it”. The problem is these thoughts only increase your focus on the physical sensations you are experiencing!

Although the symptoms of panic feel overwhelming and at times terrifying, they are not dangerous. Your mind is unlikely to be convinced of this in the moment though. This is because while the fight-flight response is still triggered, your mind is  on the lookout for threat, danger and impending doom.

To counterattack this tendency to become fixated on the physical symptoms of panic it’s important to distract your mind by filling your short-term memory with unrelated thoughts. Keep in mind that none of the suggestions below are a “cure” for getting rid of the panic symptoms. They are simple, everyday activities designed to help you to ride out the panic.

Here are some tried and tested ideas that you might like to try:

1. Describe in detail five things you can see, hear and touch. For example, I can see a tree…it’s tall and green, with large leaves and a soft grey trunk. I can hear the sounds of the air-conditioner. I can feel the cold wind against my skin.

2. Become aware of your body as you stand or sit. Tune into the feeling of your feet making contact with the ground. Notice the points where your body makes contact with your clothes. Notice the subtle sensations of your hair resting on your face.

3. Move your body – go for a short walk, rub your hands together, do star jumps, stamp your feet, clap your hands.

4. Ask yourself questions to bring you back into the here-and-now:

  • Where am I?
  • What time is it?
  • What’s the date?
  • How old am I?
  • What’s my address?

5. Carry a grounding object around with you. It might be a rock or a shell, or a photo of someone you love, or a phrase that has personal meaning for you.

6. Call a friend or family member and ask them to distract you by speaking about unrelated topics (it can be good to give this person a heads up if you plan to do this and to have a back-up person in mind too, in case they aren’t available when you call).

7. Counting things around you (for example count cars, trees, people, houses, leaves, clouds).

8. Splashing water on your face and/or sipping water.

Step #4 Write down reassuring coping statements that you can say to yourself when you are panicking

Some useful examples of things you might say to yourself include (these are all based on facts about panic):

  • It feels terrible to be panicking right now but I know that this will pass eventually. It is literally impossible for me to feel panic forever.
  • Panic attacks make me feel like there is something to be scared of or that I am in danger in some way, but this is just the way my mind thinks when I am in the midst of a panic attack. Despite what my body and mind are saying I am safe right now.
  • In order to get through this panic attack I need to accept that it is happening. This doesn’t mean that I like, want or welcome the panic. It simply means that I acknowledge that it is here and that fighting against it will only make it worse.
  • I have a plan for coping with panic that is going to help me “ride it out”.
  • I don’t need to get rid of these symptoms, I can just wait for them to pass.
  • The sensations that I am experiencing feel harmful, but I know that panic symptoms are not dangerous to me in any way.
  • By acknowledging that these physical sensations are just a panic attack I can slow down the cycle of panic and prevent this attack from getting worse.

Step #5 Use your breath to calm your mind

When we panic our breathing usually changes. We might breath more rapidly, take shallow breaths or even hold our breath. These changes in breathing disrupt the balance of oxygen and carbon dioxide. This imbalance causes a series of physiological changes that increase anxiety. The dizziness, tingling, choking sensations, chest pain and unsteadiness felt during panic is directly related to your breath. As you work to try to take slow and deep breaths you will be breaking the cycle of panic. You’ll notice the physical symptoms of panic gradually subsiding.

Most of my clients find that in order to really feel that they have mastered breathing exercises it is not enough to just use them when they feel panicky. They also need to try these exercises when they are feeling calm or experiencing mild to moderate anxiety levels. It can sometimes feel hard to motivate ourselves to practise breathing exercises when we don’t feel particularly anxious, but learning to master this skill in the midst of a panic attack often isn’t all that realistic.

Give yourself the best chance of getting a grasp of this skill by practising regularly, ideally for ten minutes daily. To get started today, try one of our audio files below which walk you through different techniques for calming your breathing.

Although it’s essential to try to get your breathing back to a normal rate and rhythm, for some people focusing on the breath actually increases their anxiety levels. If this is the case for you start with distraction (and then come back to trying breathing exercises).

If you are experiencing panic symptoms and would like to speak to a psychologist about more in-depth strategies or the reasons why you might be experiencing panic attacks, call us on (03) 9376 1958 or email us at info@innermelbpsychology.com.au