Panic attack: how to help your body

Panic attack is an “emergency” mode which is turned on by the person’s psyche. It is a reaction to danger – real or (most often) imaginary. And you need to learn how to get out of this regime, preferably with minimal losses.

Of course, what we describe here will not address the root cause: for now, we are treating symptoms rather than the disease. But the “disease” itself needs to be treated with the help of a psychotherapist. It will take some time, and this process begins with a search for the reasons for the “strike” declared by the autonomic nervous system. But you are not going to suffer from a runny nose until the allergy ends: you need to take urgent measures and make your life easier. Even more so in the case of a panic attack – it is much more painful than a cold…

Now we know the very essence of the process of formation of a panic reaction, and this gives us an important understanding: in order for PA to stop, we need to reduce the existing tension (in the thoughts, in the body, in the emotions) and switch off the reaction that has already begun. This is what all the coping strategies are aimed at. If panic attacks still happen to you then you probably already know some ways that help you when you get overwhelmed.  And you can also probably list of certain techniques that do not work for you, so it’s time to expand your arsenal.

The general rules of self-help during a PA are the following:

– get grounded. Literally, feel the ground under your feet, every square inch of your feet touching the floor. Note your sensations, focus on them. 

– try to bring yourself to reality: who am I, where am I, what’s the time, where am I standing or sitting, what is going on around me, what do I see and hear, what are the sensations on my skin.

– get warm: if you can, wrap yourself in a blanket or in a large sweater. Get a heating pad. This will help you get your blood moving through your limbs and around the whole body. 

– manage your breathing, focus on it. Breathe in the corners of an imaginary square: inhale on the count of four while looking at one corner, look at the next corner and hold your breath, exhale in the next corner on the count of eight, hold your breath and move your eyes to the next corner. Breathe into a paper bag. 

– choose any object. Look at it very attentively, mentally (or aloud) note all the little details of it. 

– try convincing yourself that this is just a panic attack, you are not going crazy, you will not get sick nor die. It is unpleasant, but not dangerous. It will be over soon. 

Now, let’s consider these methods in more detail.

Let us start from the key aspect. What is always affected during a PA? Breathing, of course. Recall any instance when you experienced nervousness or anxiety. Your breathing becomes shallow and fast. Just noticing this change makes you even more nervous. Any changes to our psychological or emotional state affect our breathing.

The good news is that we can influence our breathing, especially if we practice a little bit.

• Shall we learn how to do it?

If you need to lessen the symptoms of stress that were caused by anxiety or fear, you need to do certain breathing exercises. They will help you get back to reality.

The general principles of managing breathing are simple and can be easily memorized: 1) slow down the breathing rate, 2) make longer exhales as compared to inhales, 3) distraction. 

• Breathing on the count of 6: 1-2 inhale, 3 hold, 4-5-6 long exhale, emptying your lungs.
• “Breathing into a square”. Find any rectangular shape. Look in the upper-left corner and inhale, slowly counting to 4. Then look at the upper-right corner and hold your breath, slowly counting to 4. Move your eyes to the lower-right corner and exhale, slowly counting to 4. Look at the lower left corner and try to smile. Do this exercise for 2-3 minutes.
• The “4-7-8” method can be used to lower the stress level. Sit straight, put the tip of your tongue to the back side of your upper teeth and keep it there during the whole exercise. Inhale through your nose on the count of 4. Hold your breath on the count of 7. Exhale making audible sound through your mouth on the count of 8. This is one full breath. Repeat this cycle three more times – making four breaths total.
• Rhythmic breathing: inhale through the nose – one nostril at a time, exhale through the mouth in three bursts. Inhale through one nostril on the count of one, exhale with both nostrils while counting 2-3-4 in three bursts. One inhale through the right nostril, exhale through both, next inhale through the left nostril. Try it several times, gradually increasing the number of cycles. 

As soon as you notice that panic is reaching out to you with its tentacles, start controlling your breath, consciously slowing it down and making is deeper. Select one of the techniques above, the one that you like the most – and do it!

When our brain notices fast breathing it reacts by sending SOS signals to the body. “Fast breathing – means something is wrong, something is happening, you need to release the stress hormones!” And here they are – raising the adrenaline level in your whole body. It works in the other direction too: the stress hormones make you breathe faster. But if you breathe slowly and evenly, the same mechanism will help you move in the opposite direction: “Oh, slow breathing, therefore it is not dangerous, false alarm, at ease guys!”

Do not forget about the grounding techniques. When everything around you is trembling (a PA can make you believe that something terrible is going on), it is very important to feel support under your feet. You can use the grounding methods to help you return to reality. 

• Find a small object in your pocket that will be “grounding” for you. It may be a little stone, a piece of sea glass, a small statue, or even a coin. Focus on it and mentally describe every little detail of this object while touching it and noticing your sensations through your fingers. 
• Wrap yourself in a blanket. Tightly hug yourself or ask someone to hug you. You can rub your arms from your shoulders to your wrists, and legs from your feet to your thighs. Focus on your bodily sensations. 
• Stand firmly and “attach” your feet to the floor. It is better to take off your shoes, if possible. Feel your feet on the ground or on the floor, as if your feet are the foundation of a sturdy house or the roots of a big tree that is securely attached to the ground. Feel the floor under your feet, feel the force of gravity. You can do this exercise while sitting or while laying down too.  
• Lay down on the floor. Scan your body from top to bottom, noticing where your body touches the floor, what parts of your body feel it. Focus on this sensation of pressure, texture, and temperature. 
  
   

In the next article, we will continue studying quick methods of coming back to reality. We would want you to create a small toolbox of coping strategies in the case of PA.