Tips for managing panic attacks

A panic attack is a sudden and intense feeling which can be scary and, often, can occur with no obvious reason.

Firstly, it’s important to understand what panic attacks are before looking at how to manage them. Panic, or anxiety attacks, occur when the body releases stress hormones and cortisol.

This can be helpful to us in times of danger, such as when crossing the road and suddenly a fast car approaches. Your anxiety gets to work immediately by giving you an adrenaline rush to run to the other side of the road automatically. However, there are other times you may experience these same symptoms, which are not helpful at all, such as during work, studying or in a social gathering.

The impact of panic attacks 

Panic attacks can be overwhelming and affect daily life in several ways. Moreover, the fear of having another panic attack can be debilitating. People might start changing their behaviour, avoiding things they love or need to do, just to feel safe. This can then affect daily life in the following ways;

• avoiding particular situations or places that might trigger attacks
• difficulty sleeping or feeling constantly on edge
• strained relationships
• problems concentrating
• feeling like you're losing control

Signs of a panic attack

If you’re having a panic attack, you may experience some of the following signs. Please note this can change from person to person:

• irregular or racing heartbeat (palpitations)
• sweating/hot flushes
• dread
• shortness of breath (hyperventilation)
• a choking sensation
• nausea
• dizziness
• tingling/numbness
• feeling disorientated
• dry mouth
• intense feelings like you're having a heart attack or stroke
• catastrophic thoughts

Causes of a panic attack

There are many different causes of panic or anxiety attacks, such as: 

• work: unemployment, retirement or workload
• family: divorce, caring for someone or relationship challenges
• financial problems: debt or unexpected bills
• health: illness or injury
• past experiences: bullying, abuse or neglect
• big life events: buying a house, planning a wedding or having a baby
• bereavement: loss, grief

Please note this is also different from person to person.

How to manage panic attacks

It’s important to look at grounding techniques in the role of managing panic/anxiety attacks. This is especially important as it calms the nervous system, which can then reduce racing thoughts and provide a sense of safety immediately.

Here’s a list of quick suggestions that can help you with managing panic/anxiety attacks: 

Grounding statements

This can be helpful by remaining present and focusing on the here and now. Phases like ‘I am safe. I am not going to die. I will get through this,’ can help with reducing catastrophic thoughts and symptoms of panic, which play an important role in panic attacks.

Breathing

Controlled breathing helps one feel safe and calm. This regulates the sympathetic nervous system, which is responsible for feeling safe, helping to restore a sense of control in the body from the physical symptoms of a panic attack.

Smell

Smelling salts, peppermint, clove, eucalyptus, ginger, essential oils, perfume, decongestant sprays and sticks can be especially useful as smells direct the brain's emotion centres. As a result, it can break the panic spiral and bring one to the present moment.

Taste

Taste, whether it's peppermint, strong mints, gum, cough sweets, popping candy, fruity sweets or sour sherbert, can help ground you during a panic attack. This grounding method diverts the brain's focus from fear to the sudden, strong sensations in the mouth.

Sight

Looking at art on the wall, calendars, pictures, fairy lights, a mirror or night lights can help change the focus from the feeling to the present moment.

Touch

Touch can help break the fight or flight cycle in panic attacks and gain a sense of safety. This can be achieved through many different objects, such as stress balls, play-dough, putty, marbles, velvet, feathers, pebbles, shells, astroturf, hot or cold compresses, elastic bands, bubble wrap, a piece of cloth or even a TENS machine for example.

Sound

Listen to a loud ticking clock, recordable motion sensors or any noise you can focus in on. Similar to touch, this can break the brain's fight or flight cycle in panic.

Additional ways to support yourself

The techniques mentioned above are ways of managing and regulating emotions during panic or anxiety attacks. These are quick, short methods which can be implemented straight away to gain relief from panic attacks. These techniques can also be used when struggling with symptoms of PTSD, such as flashbacks, as they focus on bringing one's attention back to the present, which can help a person feel safe. 

Further to the exhaustive list mentioned above, things like reading a self-help book for anxiety based on the principles of cognitive behavioural therapy (CBT) can help manage anxiety or panic attacks. Activities like yoga and Pilates can help regulate your emotions and feel relaxed; doing regular exercise is a great method for releasing stress and easing symptoms. Furthermore, avoiding caffeinated drinks can help manage panic and anxiety attacks.

Therapy for panic attacks

CBT (Cognitive Behavioural Therapy) is an effective way to treat panic attacks in line with NICE Guidelines. The aim is to change how you think, feel, and respond to panic attacks, so you can manage the attacks. It's not about eliminating panic completely, but learning to manage it at a suitable level. CBT looks at understanding your thoughts, feelings and behaviours in the role of panic attacks. 

EMDR, on the other hand, looks at processing traumatic memories that might be triggering panic attacks, reducing their distress. By reprocessing these memories, EMDR can decrease the intensity of triggers that lead to panic attacks. EMDR is often used alongside other therapies like CBT.

If you're looking for support for panic/anxiety, reach out to a qualified therapist.