Coping for Panic
COPING FOR PANIC
Panic feelings, panic attacks and anxiety attacks that feel like panic… can be very scary, even feel life threatening sometimes. The physical and mental symptoms of panic aren’t actually dangerous - but our brains pick up the message that we are ‘in danger’ when panic sets in and the body somatically responds to that ‘threat’ by releasing stress hormones and chemicals that make us feel very, very uncomfortable.
Some of the symptoms of panic are below:
racing heartbeat
shortness of breath / breathlessness
throat tightness / sensation of choking
lightheadedness
dizziness
nausea
sweating or chills
shaking or trembling
thoughts that you are “going crazy”
fear of fainting
numbness and tingling in hands or feet
fear of dying / feelings of doom
fight / flight / freeze responses
feeling that ‘things don’t seem real’
It’s not uncommon at all for people to make ER trips when panic attacks happen - they physically feel like something is terrible wrong. It’s always important to ensure that there isn’t an underlying medical issue by checking with your doctor if panic attacks start occurring suddenly. Once you've determined there’s no physical reasoning for the symptoms, it’s time to figure out coping.
COPING FOR PANIC FALLS INTO TWO CATEGORIES:
1) Recognizing the triggers of panic and starting coping routines before full panic sets in.
2) Coping during the actual panic attack.
(see more below)
1) RECOGNIZING WARNING SIGNS OF PANIC:
Start tracking when anxiety escalates and you start to feel panicky. Identify what are the situations, events, activities and/or stressors that occur prior to anxiety/panic starting. Know these triggers well and prepare even before they occur.
2) COPING DURING THE ACTUAL PANIC ATTACK :
When panic starts, the subcortical and lower brain areas take over - our PFC (Prefrontal Cortex - the upper brain where logic, reasoning, rationality, language, etc, happen) goes offline - as in it’s not fully operational. This is a ‘survival’ reflex in our brain that sends us into immediate action to protect ourselves… for example - when we touch a hot stove, our brains don’t stop to think about why the stove is hot or what temperature it is - our hand just immediately jerks away from the stovetop to keep from getting burned. The same ‘survival’ response can occur when the brain senses any kind of ‘danger’ even if the danger isn’t real. Our brains are wired for survival - not for accuracy. It’s part of what keeps the human race going!
This means that coping for panic needs to be easy to remember once the symptoms start. When our brain senses ‘danger’ and our PFC goes ‘offline’ … our ability to think about or remember details is limited. We need ‘simple & basic to recall’ coping at these times.
To make the coping routine easier to remember, here is an acronym - BAMMM - to help remember coping:
-more details below-
B - BREATHE:
4-7-8 BREATHING: Inhale 4-counts; Hold for 7-counts; Exhale for 8-counts; Keep repeating.
Just make sure you exhale longer than you inhale… this signals to your brain that you are no longer hyperventilating which represents “safety” and “things are okay now”.
‘OCEAN BREATHING’: Inhale through your nose; Hold briefly; Exhale through your mouth with a long ‘whooshing sound’ like an ocean wave.
Put one hand on your tummy and one hand on your heart when breathing (this hands-on addition helps to soothe).
A - ACTIVITY / DISTRACTION:
Find a distraction - walk outside, wash your hands, listen to / play or dance to music, phone a friend, take a shower/bath, do something with your hands, find a crossword or word/number puzzle, run cold water over your hands / hold an ice cube or a cold water bottle (cold air and water regulate the nervous system), drink water, vacuum, call a friend, leave your desk or chair if you’re at work or a meeting, etc.
Engage the 5 Senses - find 5 things you can see, 4 things you can hear, 3 things you can smell, 2 things you can touch and 1 things you can taste; (this 5-4-3-2-1 grounding practice can be done in any order as long as you’re engaging the senses).
M - MOVE YOUR BODY:
Walk, dance, sing, talk out loud, wash your hands, go outside, yoga, run, do jumping jacks, walk up and down stairs ….. get up and move wherever you are and however you can at the time. (Panic can often happen in the car or in a meeting, airplane, etc….. if so - press your feet into the ground, hands into the chair or your lap - focus literally on the ground beneath you - which helps to get you out of your head … and your attention shifted toward the ground).
M - MUSCLE RELAXATION:
Starting with your head or feet, tense up one group of muscles at a time. Tense for a 5-10 seconds and then release, relaxing for 10-15 seconds. You can start with your forehead - tense by ‘scrunching’ for a few seconds and then release; move to eyes and repeat; cheeks and repeat…. tense/scrunch muscle groups one-by-one all the way down to your feet. (You can also start with feet and work your way up to your forehead). This teaches the body it can relax after it tenses.
You can prepare for this coping ahead of time by practicing PMR’s - Progress Muscle Relaxation exercises. (More info on this in the ‘Active Mindfulness Practices’ post.)
M - MENTALLY RECOGNIZE IT’S ONLY PANIC:
Remind yourself that what you are experiencing is anxiety… and not real danger.
Use some of the following thoughts… you can also write these down in your journal or on your phone as reminders:
“My brain is giving me the wrong signals - I’m safe”
“I know how to cope - I can trust myself to get through this”
“These panic feelings won’t last forever - I can get through them”
“Thanks for the warning, brain - but I’ve got this”
“I’ve felt this way before and nothing bad actually happened - I made it through”
“I’m not dying, I’m not going crazy - this feeling will pass”
“I’m safe right now and this will fade away”
“I’m getting enough air and I’m going to be okay”
Hope these reminders and coping practices will help you or a loved one cope better with panic, should it occur. They also work well during any type of increased anxiety episodes or ‘anxiety attacks’… which are similar, but less severe, than panic.
It’s also important not to shame yourself (or anyone) for panic issues… our brains are simply built this way. Sometimes the ‘wiring’ is just off in a particular moment. Once it’s over and the panic dissipates - you can “resume calm and carry on”.
Best, Jenn
*The information presented in this blog is intended for general knowledge and use only. It should not take the place of medical, clinical advice or licensed therapy. To find a licensed practitioner in your area, the Psychology Today Directory is an excellent resource.