Dealing with panic attacks: What works

What Are Panic Attacks? Understanding Panic Attacks

Panic attacks occur when a combination of symptoms suddenly appear, often without an identifiable trigger. They can cause physical symptoms so intense that sufferers may believe they are dying or experiencing a medical emergency. 

Panic attack symptoms can consist of but are not limited to:

• Shortness of breath
• Racing heart
• Feelings of doom or dread
• Chest pain
• Tightness in the body, especially in the hands and/or chest
• Shakes 
• Chills or sweats
• Headaches
• Feelings of dizziness or vertigo
• Nausea
• Body cramps
• Body feels numb

Panic attacks often feel debilitating, and fear of another panic attack can actually worsen anxiety over time. Whether or not there is a clear trigger, the right treatment and coping skills can lower the likelihood of repeated panic attacks.

How Long Do Panic Attacks Last?

Panic attacks can last anywhere from 10 minutes to 30 minutes. It is possible to experience multiple panic attacks in succession within an hour of the initial attack.

Why Do Panic Attacks Occur?

Biologically, panic attacks happen because the sympathetic nervous system (our fight or flight response) becomes activated. There are numerous reasons why people experience panic attacks. Some of the top causes include:

• Anxiety disorders 
• High stress levels
• Alcohol or other substances 
• Experiencing a traumatic event
• Phobias of certain things, animals, or situations
• Family history of panic attacks
• Depression 

Though you don’t need to have anxiety to experience a panic attack, panic attacks are more common in people with anxiety disorders, such as panic disorder. If you are experiencing panic attacks, talk to a mental health professional about your symptoms. 

Common Triggers of Panic Attacks

Because panic attacks escalate so quickly, it can be difficult to determine their cause or trigger. Their onset can often be traced to either an internal stimulus, like a negative thought, or an external stimulus, like a physical sensation or encounter. 

Common triggers include:

• Stressful situations, such as a test or going to the doctor
• Thoughts about difficult situations, perhaps regarding a life event like a birth, death, or job loss
• Thoughts about or difficult situations involving finances
• Seeing something adverse, such as a phobia or a friend/family member getting injured
• Environmental situations, such as crowded places
• An experience that is very similar to a previous difficult/traumatic situation

Triggers for panic attacks might not be immediately apparent or make sense right away. This is why the help of a mental health professional is often needed to unearth the trigger or stress point and process the negative association within it.

How to Ease a Panic Attack

Panic attacks escalate so quickly that they can be difficult to stop before their peak. However, there are many useful strategies that you can use to de-escalate your anxiety and, even at the peak, calm yourself down. 

Here are some strategies you may find useful:

• Grounding: There are multiple grounding techniques—such as the 333 rule, the 54321 technique, or simply holding an ice cube and focusing on the sensation—that are aimed at focusing on the details of your surroundings to take you out of the sensations in your mind and body.
• Breathing techniques: Square breathing (inhale to 4, hold to 4, exhale to 4, hold to 4), combat breathing (inhale to 4, hold to 7, exhale to 8, hold to 4), and many other techniques help steady the breath and calm the nervous system. Repeat these 3-5 times or until calm.
• Coping thoughts: This involves telling yourself something to help you weather the anxiety. Try repeating affirmations like “This will pass,” “I can take all the time I need to relax,” “This doesn’t feel comfortable and it will not kill me,” and “I’ve survived similar situations and I will be okay.”
• Progressive muscle relaxation: Find a quiet spot. Then, take a moment to tense and release each muscle group throughout your body, one at a time, going from toes to head. 

What Is the 333 Rule for Panic Attacks?

The 333 rule is a type of grounding technique. To practice it, name three things that you can see, three things you can hear, and three things you can touch. While you do this, note that you are only naming or identifying things—you don’t have to focus on your thoughts or judgments about the object or the sound. The purpose of this exercise is to shift your focus to the here and now, taking emotional reasoning out of the equation at this time.

Coping Strategies for Panic Attacks

As noted above, there are multiple ways to manage panic attacks. Additional things you can do to help manage anxiety and prevent panic attacks include:

• Learning to effectively manage stress levels
• Getting good sleep
• Taking medications as prescribed (if appropriate)
• Learning your warning signs and triggers
• Making sure your diet has necessary nutrients
• Talk therapy
• Doing physical activity such as weight lifting, yoga, and walking/running
• Mindfulness skills 

It’s important to try multiple coping strategies to find the ones that work best for you and your symptoms. Though they are all effective in their own way, not all of them will work well for everyone, so keep that in mind as you use them.

However, talk therapy is one of the most effective ways to decrease the frequency of panic attacks. If you are experiencing regular panic attacks, consider reaching out to a mental health professional. They can help you identify the cause, provide knowledgeable solutions, and give you tools to help you manage your symptoms on your own.