Living with panic can leave you feeling lost and confused about which direction to go for help. Perhaps your efforts to stop panic from happening have not worked, and the medications have given you some relief, but are not the solution. I want to provide you with what I call a “Survival Guide”. This guide will serve as a road map for finding your way out of the grip of panic. This will be a long term solution.
In my first infographic, Anatomy of a Panic Attack, I covered key information about panic attacks, including important factors that cause and maintain them. Several of these factors are not in your control, like your history and your genetics. However, some factors are in your control.
If you read the first article or watched my video, you may recall that these four factors are your actions, thoughts, emotions, and beliefs. Learning more about how these areas play a role in panic is the first step. I will also explain how you can start addressing these areas in your life starting today.
But first I want to introduce you to two concepts that are at the core of HelloPanic. They are so central that they are, in fact, the keys to overcoming panic.
The first major concept simply involves noticing. As you may have guessed, noticing means observing and paying attention to something. We can notice anything in our environment or inside of ourselves, but for HelloPanic the goal is to focus on noticing your actions, thoughts, emotions, and beliefs.
Simple enough, right? But because of their important role in panic, we can not underestimate the power that comes from noticing these aspects of our experience as they are happening. As you will see, your best chance of changing them is to first see them as they occur. Start with noticing.
The second major concept, accepting, is equally important. Accepting means having an attitude that is open and non-judgmental. It involves allowing and making room for parts of our experience that we normally don’t like, such as anxiety.
When we are accepting anxiety we can say something like, “I may not like you, but I can let you be there.”. What we usually might say may sound like, “I can’t tolerate you and I must get rid of you.”.
Because it often goes against our nature, acceptance can be a challenge. The good news is that you can cultivate it over time.
As we now turn to see how actions, thoughts, emotions, and beliefs impact the experience of panic, you will begin to see how the concepts of noticing and accepting are woven in throughout the road to relief.
Before Panic Attacks
The period before a panic attack is a time to implement all of the preventative measures that will help you to decrease the severity and frequency of the panic symptoms.
Just as you must practice and prepare for running a marathon, it is possible to practice skills that improve your ability to deal with anxiety. We can’t be ready for the real thing unless we have been practicing.
In regard to actions, you want to be engaging in more actions that are healthy for you and that are supportive. Eating healthy, getting sleep, and exercising are all things that we know are good for us. Doing these things will give you a solid foundation that will improve your ability to handle anxiety. It sounds very basic, but ask yourself how you are doing in these areas right now.
Other actions that can be taken include journaling, getting a massage, a warm bath, or reading a good book. You may have heard the term “self-care”. Well, this is exactly what I am talking about. Try to build on these and make them part of a routine.
Regarding activity level, it is healthy to be active and to pursue things that are important and meaningful, but you don’t want to be so busy that you don’t have time to just be still. It’s important to find a balance in how active you are.
Thoughts are central when it comes to anxiety and panic, but it is important to realize that you can’t prevent yourself from having thoughts or from having undesired thoughts. Instead, you can practice noticing your thoughts and then identifying thoughts that are increasing your anxiety. For instance, if you thought, “What if I have another panic attack, that would be terrible!”, you would likely feel more anxious. Not helpful.
When you notice thoughts like this, one positive response is to practice reframing. By this, I mean coming up with a new idea about what is happening, one that is more helpful than harmful.
The new idea is typically more accurate than many of the thoughts that commonly accompany anxiety. Good examples include:
If I do have a panic attack it will be ok, I can get through it.
Other people have panic attacks and they would probably not judge me.
We can not overlook emotions when it comes to panic. Overwhelming emotions or unexpressed emotions can trigger panic attacks. To address this, I recommend checking in with your emotions on a regular basis. Just as we can notice our thoughts, you can notice your emotions by simply asking yourself how you are feeling at the moment.
After you notice your emotions, a good option is to try expressing them in healthy ways. For example, if you are feeling sadness about changes in your life, note that you are feeling sad and perhaps talk to a friend about it. If you are inclined, you might also express your emotions through journaling, artwork, or music.
Beliefs lie deeper than thoughts and typically consist of several connected thoughts. They represent how we view ourselves, our internal experience, and our world. Our experience is filtered through our beliefs in important and profound ways. If we can get better at identifying our current beliefs about panic, we can learn to shift toward beliefs that are more helpful.
Typically anxiety gets worse because we believe certain things about it. For instance, we believe that it means we are messed up or not good enough. We want to get closer to believing that anxiety is an acceptable and normal part of life. When we believe that anxiety is bad and that it is to be ashamed of, the problem gets worse.
During Panic Attacks
Believe me, I get it. You want to know what to do when you are having a panic attack. You just want it to stop. It is so uncomfortable that you want to do whatever it takes to make it stop. I’ve been there. But the catch is that expecting to stop your anxious feelings doesn’t work. In fact, this expectation can create the opposite effect.
While you can’t make panic stop, you can work at preventing yourself from entering what I call the “Panic Feedback Loop”. This loop, which I covered in my article, “Anatomy of a Panic Attack”, is the mechanism that makes the panic intensify.
Essentially, your mind tells you that the symptoms of anxiety represent a dangerous problem, which in turn causes the stronger activation of your brain’s threat detection system, resulting in more discomfort.
This process happens so quickly, and it is often outside of our conscious awareness. This is where the practice of noticing comes in. If we can notice how we are responding more readily, we can practice shifting our response. If you can do this, the panic will subside. Guaranteed.
Our actions during the panic attack are important. Of course, we always want to focus on what we can do to feel better. But, remember, we can not “do” something that will shut off anxiety. Instead, we can rely on actions that help us to keep our focus in the present moment, instead of on thoughts about how bad the anxiety is. This will you out of the feedback loop.
Grounding techniques involve directing focus toward the senses, especially those that are on the outside of the body. Some examples include:
paying attention to your feet touching the ground
paying attention to the sensation of your body sitting
splashing cool water on your face or drinking a cold drink
petting an animal or touching something soft
All of these things actions keep the focus on present moment sensations that aren’t related to the panic, and that keeps you from dwelling on worried thoughts.
During the panic attack, our thoughts about what is happening can be like adding fuel to the fire of the panic. If we practice noticing them and reframing them during the panic attack, the result is helpful rather than harmful.
A typical thought during a panic attack could be, “Oh no, this feels weird, maybe there is something horribly wrong!”. Try replacing this thought with something like, “It’s just my anxiety and it will soon pass.”. Try writing down alternative thoughts and carrying them with you so that you can rehearse them when you start to feel the panicky feelings.
Anxiety is just an emotion. When it comes, you want to recognize that it is there, and see it for what it is. It is a natural emotion, and it is actually not dangerous. Practice letting yourself be anxious instead of focusing on trying to not feel anxious. This will take time, but you will get there.
While beliefs are not often apparent during the panic attack, you can address them with your surface-level thoughts. Most importantly, you do not want to buy into the belief that you are somehow weak or defective because you are struggling with panic.
After Panic Attacks
After a panic attack refers to the time frame immediately after the attack and for the rest of the day going forward. This is an important time because it involves how you process the panic attack in terms of thoughts, beliefs, emotions, and actions.
For many of my clients, once they have had a panic attack, their assessment of its meaning about them and about their life tends to have a direct impact on symptoms of anxiety.
But perhaps, even more importantly, it starts to affect their choice of actions. Following a panic attack, it is my recommendation that you go about your day as planned. There is a misconception that you need to avoid going to places or to stop activities as a result of the panic attack.
It makes sense that you might want to. After all, you’ve just been through something very upsetting. You may also fear having another attack, so staying home and lying in bed or not doing anything could seem like a way to prevent another one.
However, when you pull back on your activities because of panic, the problem gets worse. So go on with your day. Encourage yourself to keep going.
After your panic attack, you might be aware of having many thoughts about it as the day goes on. These thoughts are often geared toward making sense of why it happened, but also about when or where the next one might be.
There is likely a tone of worry in the thoughts, worry about whether you will ever get better or about what you might need to do to avoid another attack. These thoughts also reinforce the anxiety and panic pattern.
Try reframing these thoughts. Instead of saying, “Oh no, that was really bad, what if it happens again during class?”, try, “It was just my anxiety. While uncomfortable, it will always pass.”.
It takes time to work with thoughts, so be patient with yourself.
Just as it is before and during, after the panic attack is an important time to be aware of your emotions and to accept what you are feeling. It's ok if it makes you angry or sad, just acknowledge the feelings when you notice them.
You may also want to identify what the triggers were for your anxiety in the first place. Was it a difficult interaction with a spouse or partner that led to an increase in anxiety? Was it thoughts about finances? Triggers are thoughts, situations, people, or places that bring about our anxiety. Many times we are aware of what these are. For example, someone who struggles socially is well aware that being in groups at a party is a major trigger.
However, we are sometimes less aware of triggers. For instance, it might be that when we go to a certain place we are reminded of something that our brain connects with danger or threat. Triggers are important because they are part of the chain reaction between what we experience and how we react. If we notice that something is a trigger for our anxiety, we can be ready to respond to it in the best way possible.
After the panic attack, it is easy for us to make meaning of it through our underlying beliefs. Often times the beliefs are not easily identified. Examples of common beliefs about panic are:
There must be something really wrong about me if I have panic attacks
I am weak because I can’t handle life
It’s not ok to feel anxious
I won’t be able to live a normal life if I have panic
These are problematic beliefs because they lead to more anxiety, as well as to shame and low self-esteem. Notice if any thoughts related to such beliefs pop up. Also, remind yourself of healthier beliefs such as:
I can live with feeling anxious
Anxiety does not mean anything about how strong I am
I can go on with my life despite feeling anxious
While this article overviewed some major ideas about the roadmap for surviving panic, understand that I do not assume any of these things are easy. Many of these skills do not come naturally and must be practiced and developed over time. Please be kind to yourself through this process. You may also consider the help of a therapist to guide you along the way.
Best wishes and I truly believe you can release yourself from the grip of panic!
In my online community, Hello Panic, I focus on educating people about panic so it is no longer the monster in the dark. In a twist that goes against instinct and much of our medical model, I believe that what actually changes panic for good is to stop fighting it. Rather, we can benefit from getting to know it, and by saying “hello” to panic.
If this information has been helpful, you can download the full infographic. I also have a 27-minute long video on Facebook and YouTube (below) where I will walk you through this infographic and others like it.
Best wishes to you on your panic journey, and I hope to hear from you soon!