Understanding Panic Attacks and What to Do About Them
Your guide to negotiating anxiety in the form of panic
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Warning: I’m going to discuss in some detail what I experienced during a panic attack. This might be helpful, or it might be triggering. I just wanted to let you know it’s coming.
Recently, I had my first panic attack in years.
Luckily for me, I haven’t had a lot of panic attacks in the last years, so when one comes, it stands out sharply on the calendar. The fact that I’d been panic attack-free for so long made this one particularly stark.
I had mistakenly thought that doing my time in therapy, learning the tools and techniques, would always shield me from panic. Where did this come from, after all that time, and all the work I had done to prevent them?
What is a panic attack like?
It’s different for different people. But here is what I experienced this time…
I had my panic attack in circumstances that don’t generally stress me out: I was sitting across from my partner in our favourite local pizza place, sitting in front of a very delicious margarita pizza. I had had about one bite when the feeling began. I started to lose feeling in my fingers, and had to put down my slice. Black was edging into the sides of my vision; I could hear my heart beating loud in my ears, the breath coming short in my throat, and I felt myself start sweating, even though moments earlier, I’d felt cold. I had the overwhelming feeling of my body tightening up — like I would choke soon, or have a heart attack.
I had to shut down, stop talking, and be entirely still, until I regained enough calm over my body to drink some water. While the panic was happening, I tried to recite breathing strategies in my head, and my partner knew what was happening and did his best to help. It probably wasn’t happening for more than 5 minutes, but it felt like hours in that moment.
A list of things you might experience according to the NHS:
- Feeling that you’re losing control
- Sweating, trembling or shaking
- Shortness of breath or breathing very quickly
- Feeling sick or nauseous
What causes a panic attack?
There are lots of reasons we can experience a panic attack. The Priory Group suggests that causes can include:
- Chronic stress
- Chronic physical illnesses
- Low self-esteem, anxious/negative self-talk, dysfunctional beliefs, and withheld feelings
- Alcohol, drug or medication withdrawal or side effects
- Excessive caffeine consumption
- Big life changes, like experiencing a loss, the breakdown of a relationship, losing a job or moving house.
- Any existing phobias, or underlying mental health conditions you might have — like anxiety, depression, obsessive compulsive disorder (OCD) or post-traumatic stress disorder (PTSD).
There is more recent evidence to suggest that if you struggle with assertive communication, you might be more susceptible to panic attacks as well.
The Priory Group also suggests that avoiding panic-provoking situations to too far of a degree can mean that when you are exposed to some distress, you might find your body overreacting — it’s about being able to handle some levels of anxiety, without your body responding this drastically.
How can I prevent a panic attack?
The NHS has this list of ways to ‘treat’ or ‘manage’ panic attacks. I don’t personally want to rely on medication, so I’m going to list some non-medical approaches that I have found to help — particularly when I was in the midst of a panic attack myself.
Learning the mindfulness of breathing
Comes from the Buddhist tradition, there are lots of excellent breathing and meditation-based exercises that you can integrate into your daily life (or in the moment of panic). I particularly love the mindfulness of breathing — this is where the focus is on the breath.
If you’re experiencing panic, take a moment to close your eyes, and find your breath. Count in batches, on each exhale, up to 10. Start again from 1. Count in time with your natural breath, and you will find that it starts to slow and become more regular. Do this for as long as you need, really focusing on the unique way you breath — each breath is usually very slightly different. Try to pay attention.
If you want some guidance or a place to start, I always recommend Headspace, or you can start with a free guided meditation here.
Repeat a strong mantra
Reminding yourself that you are having a panic attack — not actually dying — will help ease the panic faster. This can take the form of a simple mantra that you gently repeat in your own mind. It should be something with a positive flavour, and which you learn to say to yourself in a kind and compassionate manner.
Healthline suggests:
Whether it’s simply “This too shall pass,” or a mantra that speaks to you personally, repeat it on loop in your head until you feel the panic attack start to subside.
Personally, I have even just used “Everything is okay” in moments where I really couldn’t think of anything more fancy or interesting — and that still worked just fine!
Create helpful routines
We all know by now the many benefits of regular exercise, but they are especially vital to ensuring we maintain the kind of balance that will help us deal with long-term anxiety.
Create a routine that works for you and helps release stress and tension day to day, rather than allowing it to build up and boil over. Depending how anxious or over-stimulated you feel, it might be wise to start reducing caffeine, alcohol, or other substances that amp you up or start affecting your mood. Drink chamomile instead when you want to create extra moments of calm.
Learning to take things more slowly, too, has been part of my journey.
Find moments of joy and gratitude
Give yourself the opportunity to experience some joy. It might seem weird to ‘organise’ joyful moments, but the fact is that in a stressful modern life, we can become hamsters in a wheel. We just keep on pushing through all the stressful items on our to-do lists without taking the time to reflect, express gratitude, or have a good laugh.
Give yourself the opportunity to care for yourself. Self-care, after all, is a huge part of good mental health.
Find regular ways to give yourself compassionate moments — it might be a regular catch up with a friend you love chatting with, or a class where you can explore your creativity freely, or even simply taking a few moments at the end of your day to write down the things you are grateful for.
So, where did my panic come from?
When I took the time to reflect, I realised that actually, the circumstances of my panic attack weren’t so simple after all. I’d been ignoring the slow build up of several factors. At the time I was working a challenging job, with people who were less than supportive. I’d had a meeting with a manager where she had treated me less than well. I had had my first glass of wine in quite a while, and I was battling over making a really difficult decision about my life. The fact that I was working my butt off had meant that I’d let go of all my good routines — I wasn’t meditating, or taking much time for myself. All these things combined, the pressure got too much.
Dealing with anxiety will always be part of my journey. But learning to recognise the factors building up, and learning to prioritise the things that really do make a big difference to my health, make it much more likely that I’ll manage my panic better in the future.
