Panic attacks are often a terrifying experience. Most people who have had one never want to suffer through another one and often live in fear of a repeat.

Many people are surprised when they experience their first panic attack and let me tell you, it feels like you are dying or losing your mind. People experience heart pounding, chest pain, difficulty breathing, dizziness and unsteadiness, feeling as though they are going to die, have a heart attack or go crazy. Terrifying. Usually a panic attack occurs when you are going through a stressful period in your life (like a pandemic and lockdown in Malaysia) and are overwhelmed with your current situation. However, a direct correlation to the source of your panic attack may not be obvious. Sometimes a panic attack is your body’s way of telling you that you are under stress and not managing your stress properly.

It not uncommon to feel emotionally and physically exhausted.after a panic attack. Some people cry, some people feel numb, it can differ. What is common is that people may feel “aftershocks” of their panic attack and experience heightened anxiety for the week after. Sometimes this furthers peoples fears that something is terrifyingly wrong. The reality is that your body has been through a huge ordeal including a surge of chemicals. It needs rest and recovery.

Unfortunately, panic attacks frequently involve the mistaken belief that there is no way to prevent or reduce the symptoms. This is why panic attacks are one of the most frequent reasons for emergency room visits. After an emergency room visit, many visit their GP’s and are prescribed medication without learning the triggers to their panic attacks and how to manage anxiety effectively. This is a common mistake because, with adequate therapy and education around copings skills, panic attack symptoms can be reduced and even completely eliminated. You do not have to live in fear of your panic attacks.

What Causes Panic Attacks?

People experience panic attacks for a variety of reasons and sometimes there is no way to tell when you will next be in the triggering situation. Often someone will naturally experience an increased heart rate, or start sweating and this will trigger your mind scanning for signs that something is wrong. It is easy to feel like it is difficult to breathe when you are focusing your breath. Focusing on possible symptoms and symptom scanning leads to increased anxiety, triggering a panic attack.

In other situations, there are clear indicators of triggers to your panic attacks. The trigger may be public speaking, anxiety when thinking about a certain topic or reminders of a trauma you have experienced. In these situations, it is important to trace the origins of your panic attacks and identify your triggers to best prepare you.

The best way to prepare yourself for a panic attack is to focus on your coping skills. Work with a psychologist to understand when you are experiencing anxiety at a lower and more manageable level. Often anxiety is rated on a scale of Subjective Units of Distress (SUD). Anything under a 4 you can quite comfortably manage with copings skills. As your anxiety rises above 4, the more your capacity for rational thinking is impaired and the less effective coping skills are. This is why psychologists recommend practicing coping skills even when you are not anxious. This builds confidence in the power of coping skills and ensures that if the time comes, you are able to escalate your anxiety before it gets near to panic attack territory. If you have not been to therapy before, learn all about what to expect here.

What Happens During a Panic Attack?

Your body was designed to physiologically respond to danger. It responds in certain ways when it senses a threat, whether you’re aware of it or not. Some of us know this response as fight or flight. When you begin to feel anxious, your body will send signals to your brain. These signals release adrenaline that result in increased heart rate, blood pressure, nausea, dizziness, tingling hands and feet, difficulty breathing, or feelings that you’re going crazy or having a heart attack. Your attention and concentration is hyper focused on the situation and escaping the threat. While these symptoms might be disconcerting and cause you to feel your anxiety increase, they are a normal result of your body’s reaction to perceived danger.

The problem here is that your body is preparing to flee, fight or freeze. It believes that there is a predator or lion waiting to pounce. Meanwhile you are confused because there isn’t a danger you perceive. You may be completely unaware of how this panic attack started or of any threat at all.

The good new is that a panic attack will end, and usually only lasts 10 minutes. You are waiting for the adrenaline to finish coursing through your body. You will not die. You will be ok. Ride the wave of panic and let yourself know, you will be ok.

What are the Coping Skills for Panic Attacks?

Grounding Techniques and More

Grounding techniques utilise your senses to reduce anxiety before or during a panic attacks. They anchor you and quite literally “ground” you. People who have experienced a panic attack are familiar with that unsettling feeling of dizziness, and feeling like the world is spinning or unreal. Grounding skills will help you counteract that feeling.

1. Counting backwards from ten. You start by counting one and then move to counting backwards from 9, then 8 and so on.
2. Drink some cold water. You are combining senses here which is even more effective.
3. Find an interesting object. Describe it in painstaking detail to yourself. What does it look like? How many parts does it have? What would it feel like? What is it made of?
4. Find 4 red objects in a room. Describe them.
5. Push your feet into the ground. Feel where your body touches the chair you sit on.
6. Rub your hands together, rub your arms
7. Ask someone you trust to hold you.
8. Hold a warm mug of tea. Feel the warmth and comforting weight of the mug. Both the smell and taste will help to further ground you.
9. Take a cold shower or a warm bath
10. Call a friend. You don’t have to talk about the panic attack if you don’t want to.

Plan Ahead:

1. Wet a washcloth and scrunch it up. Keep it in the freezer for when you feel anxious. Take it out and slowly unfold the now frozen wash cloth.
2. Keep teas or essential oils that provide a comforting and stimulating smell. Keep some next to your bed if you experience panic attacks at night.
3. Keep ice packs in your freezer for quick relief.
4. Carry instant cold packs like these that do not require freezing and activate when you need them.
5. Bring a bottle of cold water to stressful situations like interviews.
6. Carry a grounding object in your pocket or bag. When you start to feel anxious, feel the edges and shape of this object.

Breathing Techniques:

Breathing techniques directly affect they physiology of your body to manage a panic attack. When experiencing a panic attack, the best thing you can do is to focus on a breathing technique that works and to focus on repeating a statement such as “This is just a panic attack, I am ok.”

When using the following breathing techniques, always inhale through your nose and exhale through your mouth. Always engage in diaphragmatic breathing which allows you to take deep breaths bringing oxygen to your blood stream. In diaphragmatic breathing, you focus on breathing with your belly, feeling it expand and contract. It can help to place your hand on your stomach. Try the following breathing techniques as examples.

1. 4-7-8 Breathing: Inhale for 4, hold for 7 and exhale for 8.

2. Box breathing: inhale for 4, hold for 4, exhale for 4, hold for 4

About Me:

I am Dr. Cassandra Aasmundsen-Fry, Psy.D. If you are experiencing distress or want to improve your well being, please reach out to me to book a session over Zoom or in person. I can be reached by WhatsApp at +60125472408 or at Cassandra@Mindwell.biz. I am a Clinical Psychologist with a Doctorate in Clinical Psychology who sees both individuals and couples in Mont Kiara, KL, Malaysia. In addition, I provide talks, workshops and content creation.