Panic Attack Survival Guide

Every time that you’ve had a panic attack you’ve probably felt like you were going to die. Maybe you’ve also thought that your panic attacks were going to cause insanity but, it hasn’t happened. And, it never will.

However, that doesn’t stop you from thinking that it will every time panic strikes. The fear that you won’t be able to resist your next panic attack seems to linger on, no matter what you do.

Given that this is the case, I decided to create a short podcast to help you get through panic attacks, and feelings of intense anxiety. I wanted to make you feel as if I were sitting right next to you, and guiding you through your panic.

In this podcast I discuss:

1. What panic is
2. How to relax in the face of fear and anxiety
3. Why anxiety can’t hurt you

Hit the play button below to listen now…

How to Stop Panic

PUSH! to openPanic almost killed me one night.

At least that’s how I felt at the time. That was more than ten years ago now, but man did that night change my life.

You see, way back before I met my beautiful wife I had started dating this other nice young lady. This charming damsel had invited me to a small get together, and like a sucker, I went. By now I was already fully engulfed by nervous illness, but I went anyway because well… what can I say, I was blinded by the potential of it all.

So off we went in a small yellow hatchback car that was driven by some guy I can’t remember anymore.

After a short drive we arrived at  a small house located on the corner of any empty looking neighborhood. Up to this point I was more excited to be with my date than I was nervous or scared, so things weren’t that bad, yet.

That is until we walked up to the front door. A smiling girl opened the door widely and asked us to come in, and then I saw something that made my heart sink into my stomach. I saw what looked like 100 or so people crammed into that tuna can of a house.

The only person I knew was my date, so right away I got tense and apprehensive. We made our way through the crowd and I could feel 100 pairs of eyeballs laser beaming into my body, but I held it together and took a seat at the kitchen table.

About an hour later, it happened. I started to have a panic attack. The onset was sudden and I could feel myself breathing faster, and faster. At the same time my skin started to crawl with chills and my eyes began darting around the room because I became desperate for an exit.

But I didn’t have a point of reference because it was a strange house, filled with strange people. Outwardly I looked normal, but inside I was being tormented by the urge to run.

And right when I thought I was going to lose all control I caught a flickering light from the corner of my eye. I turned my head to the right and noticed a few people gathered around a small t.v. They were watching a movie called Cliffhanger, of all things. And even though I wasn’t a huge fan of the movie before that day, I was for sure afterward.

Cliffhanger distracted me from my palpitations and my chest pain. It took my mind off the sweating and trembling. I could still feel the panic clawing at my body, but watching that dorky movie was helping me out. I was scared as hell.

Then something amazing happened. My date got bored and decided that she wanted to leave, so I sprang up from my chair filled with eager anticipation and the kind of joy that I can’t even begin to describe. And as we walked out the front door and my foot hit the other side of the threshold my panic stopped; it disappeared as soon as the cool night air hit my lungs, but why?

Well, the obvious reason was that the threat was gone. I didn’t have anything to fear anymore. But later that night, and in the days to follow, I kept asking myself, how could I make my panic turnoff instantly like that? And could it even be done?

The answer is yes it can. You can shut off the fear response even if you’re still in a situation that is causing you to panic or feel intense nervousness.

After much trial and error I discovered that for me to calm my panic I needed to do three things.

1. Control my breathing: When your body is in a state of fight or flight being able to bring your breathing under control as soon as possible is critical. This is because when your breathing rate gets away from you you’re more likely to have the stress response ramp up.

Not only that, but the longer the panic or intense anxiety is allowed to develop the harder it is to bring yourself back to normal. So, turn to your breath and slow it down. Take deep breaths, focus on your belly, and try to breath in through the nose and out of your mouth. Deep Breathing is a panic killer.

2. Self-Talk: When panic strikes you have to jump in the captain’s chair fast. One of the first things the fight or flight response will do is turn off, or at least diminishes, your ability to think normally. Your normal way of thinking is temporarily stunned and this confusion leads to more panic.

It’s important to recognize panic and severe anxiety quickly because if you do then you’ll be able to use self-talk and statements of logic to calm yourself down. For example, “I’m panicking, this is a stress response, it’s normal, I’m going to be OK.”

3. A tight belly: By squeezing your stomach muscles tightly this will put pressure on a group of nerves that will signal your heart to slow down.

After that, you wait. Give it a few minutes and your body will return to normal quickly.

In the end, this horrible panic attack taught me two big lessons. One, panic attacks are almost never as bad as you think they are and two, you can do something to help yourself when it’s happening.

You simply don’t have to put up with this and suffer in silence.

Side-note:

Here is a link to an awesome article by Dr. Carrie Demers that breaks down the root of chronic stress, panic, and how to get it under control.

Creative Commons License photo credit: dylancantwell

So, I Had a Panic Attack

No, really, I had a panic attack. After a couple of years of not having a major one, here is what I learned.

The first thing that struck me about this particular panic attack was the ferocity – I mean this thing was big. Like a tsunami wave looming over me, I could feel it coming. But, despite it’s rapid onset, I never had the feeling that I would die or go crazy.

In the past death and insanity were the two main things I was waiting for. In this case, I was just waiting for it to die down and that took about ten minutes. In a  strange way I was kind of glad that I had this panic attack because I was able to experience it from a completely different perespective than before.

I was able to objectively experience it, flow with it, and use my head and not my gut reactions to cope.

Now, I won’t lie to you, for about 10 seconds I thought oh crap! Then, just as suddenly I said to myself, “ok, been here before, let’s dance!”

My head was being filled with all I knew… namely that panic, anxiety, fast heart rates, fast breathing, vertigo and so on are damn annoying, but not dangerous. So, with this firm knowledge I rode the wave of panic, looking for the exit. But as I searched I walked and didn’t try to run to the end of it.

I’m also glad this happened because it proved what I’ve been telling you for so long. And that is that anxiety, in all it’s forms, will not harm you and that it can be tamed with knowledge, acceptance and patience. It also proves that you can manage it to the point of mastery. By the end of it I was sitting on top of this thing like an MMA fighter pounding it with the truth.

It was a hell of a way to prove a point to myself, but it’s good to know that I am where I think I am. Had I fallen apart it would have made me feel like a dance instructor that can’t dance, but this guy was doing the cha cha with skill.

I’m back to normal and don’t expect anymore panic attacks for now, but of course anxiety is unpredictable so anything is possible. That being said, if I do panic again it better not take more than ten minutes because I got things to do.

Side note:

For the past year I’ve been thinking about whether or not to up the ante at Anxietyguru.net. That is, should I expand the website, podcast, and even extend my message into the world of video? Should this site try to reach more people? Does this website help you? That is the question.  I thought the best way to gauge this is to ask you since you are the one that uses the site. So, to that end, I added a poll to get a snap shot of what you think.

Because if this website it truly helping people I need to know so that I can do the right thing and send this thing into orbit!

And remember, even if you don’t normally comment, I really need your input on this one. It’s a game changing decision. So please vote and send me a word or two if you can. Thanks.

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Panic Disorder: Stories of Hope (1994)

This is a 20 minute documentary video that follows the story of three people with panic disorder. The video is a little dated and somewhat cheesy, but the information it contains is up to date and useful.

It’s kind of hard to find good media about anxiety disorders, so I was glad to find this video and make it available to you. The bottom line of this short video is that panic disorder can be crippling, but it is also highly treatable.

If you can’t see the video CLICK HERE.

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How to Stop the Mind Shift

The mind shift is the switch from normal thinking to saying to yourself something like, “oh no!” or “I’m going to die!”

It’s the dividing line between regular thoughts and panicked thoughts.

It’s easy to recognize this shift in thinking, and once you do it well, it can help you to reduce and shorten your bouts of anxiety and panic.

This mind shift happens fast, and many times it happens so fast that you seem to fall into a panic state without even knowing how it happened.

That’s why you’ll often hear people say that they were doing something mundane when all of a sudden they became overwhelmed with panic.

It’s also why the phrase “It came out of the blue” gets thrown around so much by anxiety sufferers when trying to explain how their panic started.

I was first introduced to the idea of the mind shift by Dr. Claire Weekes .  She correctly pointed out that people tend to talk or think their way into panic without knowing it.

Dr. Weekes never spoke of a “mind shift” per se, but she hammered the idea that anxiety is set off by  phrases or thoughts that signal some kind of disaster.

So then, if you find yourself having anxiety symptoms or even if panic just flashes for no reason, keep your mind clear, listen to yourself.  If you think or say things like, “oh my God,” “get me out of here” or really anything that screams emergency in your mind just before the panic strikes, then you can tell yourself that this is anxiety at work.

You can use this recognition to calm yourself and think your way out of panic.  Usually when panic grips you the ability to think clearly gets tossed out the window.  But this is why it’s important for you to reel in the logical part of your brain as quickly as possible.

This happened to me the other night.  I was roaring down the interstate at a staggering 55 mph because I had noticed that I couldn’t take in a deep breath.  I guess I had slowed down without knowing it, and in what seemed like 2 seconds, figured I was going to die because I couldn’t catch my breath.

And just as I thought that I was about to veer off the road, I just as quickly thought of Dr. Weekes.  I thought about her because just before I began to panic, I thought, “oh no!”  Literally, those were the exact words that ran through my mind.

So I stopped this thought from repeating, and replaced it with information I knew to be true.  I thought, “I can breathe”, “I’m not dying”, “just anxiety”.  After about 2 to 3 minutes I was able to get it back together again.  The “oh no!” thought was my clue that anxiety was working its voodoo.

It happens.  You can not have a panic attack for a long time, or any anxiety for that matter, and have it come back occasionally for no reason.  But it’s important to not dwell on the fact that it comes back.  It’s more important to know that many times you can slow down anxiety so it doesn’t mount and get out of control.

I know that this probably sounds too simple to work,  but trust me on this one.  Knowing that you’re panicking, versus thinking that you’re dying, is not the same thing.  It’s not even the same sport.

At least when you know it’s panic or anxiety you can reason with yourself, and most critically, not feed your fears.

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How To Cope With A Panic Attack

Now when you read the title of this post you might have thought “cope with a panic attack? Is that even possible?” It is kinda hard to understand how one could cope or negotiate with such a stressful and seemingly out of control event but it can be done.

Let’s start by looking at the word cope. To cope means to manage a taxing circumstance. The operative term being manage, not defeat, conquer, vanquish, etc. We have to start out with the understanding that we cope with anxiety and panic we don’t and cannot will it away or destroy it.

However although we can’t blink our eyes and have it disappear we can master the skill of anxiety management. With respect to panic attacks this is a skill that is crucial to helping us live with our daily angst.

There are a few things you can do to help calm yourself when panic does overwhelm you.

1. Recognize and pay attention to your thoughts.

Sometimes panic attacks can come out of the blue and have no trigger. You might even be in bed when one strikes. However much of the time it could be a certain type of situation or event that gets you anxious. When our anxiety levels go past a certain threshold, which varies for all of us, we go into panic mode.

In other words, your thoughts can lead to a panic attack after you allow them to go there. And when our thoughts are allowed to slip away into anxiety, panic can follow swiftly. You have to recognize the nervous thought when it comes, but you have to take it a step further and not just recognize it but negotiate this occurrence carefully.

When the thought arises and the nervous feelings follow – you have to intervene on your own behalf. You have to literally do something to calm yourself and not allow the nervous thought to pass your threshold. If your at home this can be done by lying down and resting.

If in public the calming response can vary but can include sitting, breathing slowly, playing with a napkin, excusing yourself to the rest room for some quiet time, be creative but suppress the desire to overreact.

A panic attack will peak in about 10 minutes and will gradually deescalate after this time frame. You need to tell yourself that although you feel bad it won’t last forever – you are o.k.

2. Knowing the facts about panic attacks and accepting it.

When panic overtakes us we get all goofy and scared and lose control of our normal rationale selves. But believe me when I tell you that even in the midst of a panic attack you can do a lot to slow it’s escalation.

When a panic attack occurs you will have strong physical symptoms. Sweaty hands, pounding/racing heart (palpitations), racing thoughts, trouble breathing, and so on. You feel like your going to drop dead at any moment. O.k. clearly panic attacks feel bad on a lot of levels but they don’t kill.

Knowing this before a panic attack is a definite perk since it can be used as a self talk mantra. Your heart will not stop, your lungs will continue to function, and you will not lose your mind.

3. Distraction

Although it’s difficult to think of anything but panic when you are in fact panicking you have to take positive action. During a panic attack you can’t run out of a meeting because you have bad nerves so you’ll have to find creative and subtle ways to occupy your mind.

You have to do the opposite of what your mind is telling you to do and engage the activity that is going on in front of you or engage in some creative napkin origami while the panic dies down.

Counter intuitive I know but a must if you want to regain control. Although a panic attack can peak in ten minutes it can also last only 3 minutes or 7 minutes. You have to actively manage this fear event and use the above information in tandem – all together as it were to make good on calming your nerves.

Having anxiety is like living at the top of a slippery slope because you never know when you’ll lose your footing and slide down the anxiety superhighway. Mind tingling fear notwithstanding you can cope with panic attacks when they happen.

Panic has a way of making you feel and act vulnerable, but that’s because when you’re in a state of panic you are. You are afraid and suggestible because you’ll do anything to be free from those feelings. So don’t feel bad about feeling this way. And above all understand that you can learn to cope if you practice anxiety management. Panic is sweeping mental and physical feeling but it’s not the end of you – it will not harm you.

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Anatomy Of A Panic Attack

“In panic attacks feeling follows thought so swiftly it is as if thought and feeling are one

- Dr. Claire Weekes

So there you are lying in bed when all of a sudden your heart starts to pound and feels like it’s going to leap from your chest. You stop thinking and become overwhelmed by the physical sensations that started in your gut, back or chest. And in what seems like seconds you become convinced that you’re about to die.

Having a panic attack is analogous to a drag race. It starts fast, reaches climax in a flash and winds down gradually. But unlike a drag racing car there seems to be no obvious fuel since Panic attacks are not triggered by any particular thing. In fact almost all the panic attacks I’ve ever had were experienced at home when everything seemed o.k.

During this frenzy of thought and feeling you may experience some of the following symptoms:

  • Palpitations
  • Slow heart beat
  • dizziness
  • difficulty breathing
  • shaking
  • fear of losing control or dying
  • Sweating, chills, hot flashes
  • racing thoughts
  • stomach pain
  • numbness in limbs

You may think that you’re having a heart attack because of pain in your arms, you might even pace the room and constantly run your hands over your face and hair in an effort to stabilize yourself. And worst of all you feel like the 5-10 minute panic attack will never end.

After its all over the fear does not stop. You then turn your attention to the next time that this horrible sensation is going to hit you again.

You fear it because you know a panic attack can strike in the morning, during the day or even while you sleep. Basically there is no time or place that a panic attack cannot occur.

Researchers don’t know what causes panic attacks but some believe that they are related to the same things that cause anxiety disorders, namely heredity, brain chemistry and environment.

So we don’t know the exact cause but we definitely know what is going on physiologically. At the root of all this is our bodies fight or flight response.

The bloodstream is pumped with adrenaline and cortisol. The pupils get dilated, you sweat, the heart beats faster and faster to increase oxygen to your muscles and you’re basically reverted back to an animal state.

Way back in prehistory when our proverbial uncle Joe was walking around the untamed wilderness he needed this heightened awareness and lightening fast reaction to stay alive.

We still have this mechanism inside us and could use it to run a little faster, listen a bit more carefully and have just a little more strength to ensure survival in a crisis situation.

But for unknown reasons this safety switch is broken in us and gets set off without warning or cause. It can be frightening but you should also know that it will not kill you.

In fact having a panic attack, or several, does not mean that you will get sick as a direct result. There are long term health issues related to anxiety disorder, but that is tied more to stress and related hormones.

Panic attacks are not dangerous in and of themselves. In other words your not going to have a panic attack and drop dead. You can however develop heart disease over the long term if you do nothing to curb your stress levels.

To cope with panic attacks you must do all you can to do nothing. That is you should sit down and slow your breathing (see diaphragmatic breathing ) and not add to the mounting fear and anxiety.

When we get this scared we tend to want to run (this is the flight response in action) but you have to do the best you can to realize that there is no danger. This is not to suggest that it’s all in your head, believe me I know the fear is real, but you must slow down and not add to the excitement.

Hopefully one day there will be some safe means of counteracting the effects of a panic attack but until then we’ll have to try to reduce stress when things are normal and not overreact when you do get a visit from the anxiety bogeyman.

My First Panic Attack

My first panic attack happened in the fall of 1999. I was 19 yrs old and having the time of my life. I was in school, had lots of friends, and partied all the time. On this particular night however, I was with two friends and we were having a few drinks. I went to the john and while I was sitting on the porcelain throne it came. It felt like someone poured hot water down my back, I then became disorientated. My heart rate increased dramatically and my palms became sweaty. I thought it was the alcohol so I jumped in the shower hoping that I could shake it off. Three hours later I was still on the roller coaster ride from hell, I really thought I was losing my mind.

I jumped out of the shower and told my buddies that I was turning in early, but I didn’t mention, oh by the way guys I am freaking out right now! I went to my room and laid down and stared at the 13 inch t.v. near my bed and just prayed for this ‘thing’ to go away. I experienced anxiety and panic symptoms off and on for the next 6 months. I never knew exactly what was wrong. I was afraid to tell someone because I thought I was experiencing this because of prior drug use. I just tried to deal with it by myself. I didn’t get diagnosed with Anxiety Disorder until 2003. I spent at least three years completely lost and confused about what was happening to me. Up until that time I had never heard of Anxiety Disorder or anything related to nervous breakdowns. I was truly lost and afraid.

Eventually I sought help through my university counseling center. I was assigned to a wonderful psychologist that began to educate me over the next 6 months about what Anxiety Disorder was and how I could learn to manage it. After a while I stopped going because I appeared to be doing so well. But as soon as I stopped going I started having panic attacks again. So then I started to do research and learned as much as I could about Anxiety Disorder and all of it’s variations. That night was the start of almost a decade of panic attacks, palpitations, racing thoughts, mood swings, so on and so on. If you learn anything from reading this post, you should know that getting help is always a good idea. Don’t be afraid of the label or anything for that matter. It can save you years of wondering and suffering unnecessarily. That was my first time so to speak – what was your first anxiety or panic attack like?