How To End An Anxiety Or Panic Attack
An anxiety attack can be terrifying, but it wont kill you. If you want to overcome it, take a deep breath and know it will end soon.
“Anxiety” is a general term that describes a variety of experiences, including nervousness, fear, apprehension, and worry, that are common in several mental health disorders. While most of us have anxiety at some time, this is completely different from an anxiety attack or anxiety disorder. Normal feelings of nervousness, worry, and fear often have a known trigger . But when you’re having a full blown panic attack or anxiety attack, the symptoms chest pain, flushing skin, racing heart, and difficulty breathing can make you feel as though you’re going to faint, lose your mind, or die. The reality is, you wont. The key to surviving is to learn all you can about anxiety attacks and practice the skills you need to get through them.
According to the Mayo Clinic, signs of an anxiety attack include:
- Abdominal cramping
- Fear of loss of control or death
- Feeling of unreality or detachment
- Shortness of breath or tightness in your throat
- Trembling or shaking
The Anxiety and Depression Association of America offers practical strategies in how to deal with stress and anxiety attacks, including:
- Accept that you cannot control everything.
- Do your best.
- Maintain a positive attitude.
- Learn what triggers your anxiety.
Here’s how to stop an anxiety attack and recover.
The Factors That Can Lead To Panic Disorder
The following three factors contribute to interoceptive conditioning, higher anxiety sensitivity and development of panic disorder.
- Biological vulnerability. A genetic predisposition to certain personality styles, such as negative affect, contributes to the development of anxiety.
- Psychological vulnerability. Early developmental experiences can make certain individuals more likely to experience anxiety, especially if they grew up in controlled environments without opportunities to explore threatening situations.
- A specific psychological experience. A negative experience with an illness may cause a person to fear certain symptoms associated with that condition. Also, an individual may fear an illness if a family member modeled the illness as something to fear.
Gruner says that panic disorder often starts with an unexpected panic attack that surprises the person. They might have a panic attack while driving, in a parking lot, on a planesomewhere where it could have severe consequences to have a panic attack and also where the attack seems unwarranted based on the situation.
The first panic attack can be very disconcerting, and then an individual can fear that it may happen again, says Gruner.
Remedies For A Panic Attack
Counseling, specifically cognitive behavior therapy , is the most effective treatment for panic disorder. CBT is a type of counseling in which a therapist helps a person change the ways they think and how they behave. Counseling may be used alone or in combination with medication.
Selective serotonin reuptake inhibitors, also known as SSRIs, are often used for depression and are usually the first type of medication a doctor prescribes for panic disorder. Other medications used to treat panic disorder include serotonin-norepinephrine reuptake inhibitors , serotonin modulators, tricyclic antidepressants and monoamine oxidase inhibitors .
Benzodiazepines may also be prescribed, but theyre used less often because theyre more likely to be abused.
Physical activity has also been shown to be an effective remedy for the symptoms of a panic attack. There are other complementary and alternative treatments for panic attacks, too, but theres a lack of high-quality evidence to support their use, and they could interfere with medications. Be sure to discuss your treatment options with your doctor.
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How To Stop A Panic Attack: The Usual Suggestions
When I started looking online at the advice for panic attacks, I got really frustrated.
Most of what I found was not very helpful.
One expert advisesthe very best thing you can do is actually nothing.
Other typical suggestions are to control your breathing by taking deeps breaths or breathing into a paper bag.
But deep breathing can sometimes make panic symptoms even worse.
Another oft-recommended technique is to consciously relax your muscles.
But, as anyone who has had a panic attack can attest, its virtually impossible to will yourself to relax in the middle of a panic attack.
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Other suggestions focus on managing your thoughts, such as picturing a happy place, thinking positive thoughts, or reciting a positive mantra such as I am safe or This feeling will pass and Ill be OK.
And, while learning to manage anxious thoughts is an excellent long-term strategy, its not much use in the middle of a panic attack there is no reasoning with yourself at a time like that!
Another popular piece of advice is to distract yourself by calling a friend, squeezing a stress ball, or even doing jumping jacks.
And, of course, doctors often prescribe anti-anxiety medications.
But these drugs are highly addictive and have many unwanted side effects.
If these suggestions work for you, thats fine.
Treatment Options For Your Clients
Treatment options are suitable for clients who are experiencing panic attacks because of a clinically significant mental health condition such as panic disorder.
The first port of call for such clients should be Cognitive-Behavioral Therapy . CBT is a diverse therapy that can involve any combination of a suite of therapeutic interventions, unified by the goal of helping your client reevaluate their beliefs and âreprogramâ the habitual links between their beliefs and behaviors.
As the name suggests, the mental health interventions involved in CBT can be categorized as either cognitive or behavioral.
Cognitive therapies involve identifying and disrupting beliefs that cause the negative mood or anxiety that trigger panic attacks and educating patients to understand their panic attacks and put psychological distance between themselves and their experiences.
Behavioral therapies can involve relaxation techniques, practicing how to navigate potentially triggering situations, and exposure therapy, in which a client is safely guided through a direct or visualized experience of a potentially triggering situation.
Whatever combination of interventions works best for your client, CBT has been shown to be a successful therapy in most cases and is well suited to managing panic attacks, where controlling those triggering links between beliefs and behaviors is crucial.
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Anxiety Sensitivity Is A Risk Factor For Panic Disorder
Most people experience some level of nervousness before a date or a presentation. In fact, it would probably feel strange if you delivered a presentation to your colleagues and didnt experience an increase in heart rate. But why do some people have panic attacks while others experience only subtle arousal?
The underlying mechanism that drives panic disorder is called anxiety sensitivity, a phenomenon where an individual becomes afraid of their bodily sensations, explains Gruner.
When people have high anxiety sensitivity, they can mistake natural bodily sensations as harmful physical health symptoms, and this can lead to more anxiety and trigger panic attacks. For instance, a persons increased heart rate might cause them to worry about an impending heart attack. A feeling of losing control might make them afraid that they are mentally unstable, or losing their mind, so to speak.
Most psychologists agree that anxiety sensitivity is not hereditary, but rather learned from personal experiences. Your mind and body learn to respond to internal changes as if they were a threat, says Gruner.
The process of learning to fear bodily sensations is called interoceptive conditioning. During the day, we all experience natural physiological changes. Its possible to condition oneself to be overly sensitive to even slight bodily changes, such as a natural increase in heart rate, so that panic attacks become a conditioned response to these changes.
How To Treat Panic Attacks: 6 Exercises And Techniques
20 Apr 2021 William Smith, Ph.D.
Panic attacks can seem as challenging to treat as they are to control.
However, with a systematic approach and adherence to a few simple techniques, panic attacks can become manageable.
In this article, youâll gain a working understanding of what triggers a panic attack and how to approach treatment for your client. Youâll learn about the options for clinical treatment, as well as exercises and techniques your client can use to manage their panic attacks, both during an attack and in their everyday life to reduce the likelihood of an attack occurring.
Before you continue, we thought you might like to . These science-based, comprehensive exercises will not only help you cultivate a sense of inner peace throughout your daily life, but will also give you the tools to enhance the mindfulness of your clients, students, or employees.
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How Panic Differs From Anxiety
Panic and anxiety are often used interchangeably, but they refer to different events. Instances of panic are short-lived and intense. They usually last less than 10 minutes because the body cant stay in such an aroused state for extended periods of time.
A panic attack activates our fight-or-flight response that helps prepare our body to protect us from real or perceived threats. However, panic attacks can occur with or without a threat. Anything from watching a scary movie to exercising to consuming excessive caffeine can trigger the physical changes that may lead to a panic attack.
On the other hand, anxiety is a more future-oriented emotion and usually results from thinking or imagining a negative occurrence in the future. Anxiety can be long-lasting, with a lower level of arousal in the body.
Anxiety and panic are interrelated, and both contribute to panic disorder, says Gabe Gruner, LICSW, a psychotherapist at the Psychiatry Outpatient Clinic at Brigham and Womens Hospital.
Gruner specializes in obsessive compulsive disorder and other anxiety disorders. The anxiety part of the disorder involves worrying about future panic attacks, he says. A person with panic disorder may think, When will my next panic attack occur? What will happen? Theyre anxious about the panic attack, even when theyre not having it.
What Causes A Panic Attack Hangover
Though used interchangeably, panic attacks and anxiety attacks are different. A panic attack is a sudden episode of extreme fear that triggers severe physical reactions such as chest pain, shortness of breath, and nauseaall despite there being no real danger. An anxiety attack is more gradual, but it signals intense feelings of distress, fear, and restlessness.
Still, an anxiety attack can mirror a panic attack in terms of symptoms and the two can happen simultaneously. While both attacks typically last anywhere from a few minutes up to a half an hour, the hangover can extend to the next day, according to psychologist David H. Rosmarin, PhD, ABPP, an associate professor at Harvard Medical School and the founder of Center for Anxiety. He defines this time frame as the aftershock of a panic attack.
When the adrenaline is released into the body, that’s what triggers the initial surge of anxiety and then the aftershock, or the aftereffect of panic, Dr. Rosmarin says. What you’re experiencing is that drop of adrenaline from high level to its equilibrium. It’s been referred to as an anxiety hangover because there are feelings like after a person’s been drinking.
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What Do Panic Attacks Feel Like
During a panic attack, physical symptoms can build up very quickly. These can include:
- a pounding or racing heartbeat
- feeling faint, dizzy or light-headed
- feeling very hot or very cold
- sweating, trembling or shaking
- pain in your chest or abdomen
- struggling to breathe or feeling like you’re choking
- feeling like your legs are shaky or are turning to jelly
- feeling disconnected from your mind, body or surroundings, which are types of dissociation.
During a panic attack you might feel very afraid that you’re:
- losing control
- going to die.
Tip : Be A Good Listener
While you shouldnt push a person with PTSD to talk, if they do choose to share, try to listen without expectations or judgments. Make it clear that youre interested and that you care, but dont worry about giving advice. Its the act of listening attentively that is helpful to your loved one, not what you say.
A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Instead, offer to talk as many times as they need.
Some of the things your loved one tells you might be very hard to listen to. Its okay to dislike what you hear, but its important to respect their feelings and reactions. If you come across as disapproving, horrified, or judgmental, they are unlikely to open up to you again.
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How Is Panic Disorder Treated
If youre experiencing symptoms of panic disorder, talk to a health care provider. After discussing your history, a health care provider may conduct a physical exam to ensure that an unrelated physical problem is not causing your symptoms. A health care provider may refer you to a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. The first step to effective treatment is to get a diagnosis, usually from a mental health professional.
Panic disorder is generally treated with psychotherapy , medication, or both. Speak with a health care provider about the best treatment for you.
Common Internal Ptsd Triggers
- Physical discomfort, such as hunger, thirst, fatigue, sickness, and sexual frustration.
- Any bodily sensation that recalls the trauma, including pain, old wounds and scars, or a similar injury.
- Strong emotions, especially feeling helpless, out of control, or trapped.
- Feelings toward family members, including mixed feelings of love, vulnerability, and resentment.
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When To See A Doctor
You may not need to see a doctor if youve had just one panic attack, according to Hocking. One panic episode may be a fluke, but two episodes is a trend and should alert the person that theres something they dont understand and should seek professional help, he says.
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Relax Your Body To Ease An Anxiety Attack
It’s easy to say, “Just relax,” right? But once you start to observe your body during an anxiety attack, you might find that certain parts of your body clench up during an attack. Make a deliberate effort to tighten and then relax those parts of your body.
Or, if those parts feel like they wont obey during an anxiety attack, pick a body part that will respond, such as your toes or your shoulders. The more you can breathe deeply and relax, the easier it will be to cope.
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Stress Hormones Are Limited In What They Can Do
Even though anxiety attacks can feel powerful, stress responses and the hormones they produce are limited in what they can do. While they can prepare the body for emergency action, stress responses cant cause you to snap and lose your mind, cant cause a mental breakdown, cant cause you to do something you dont want to do, dont last forever, and will end.
Again, for more information on the stress response and its many actions, see our anxiety attack symptoms section or our Stress Response section.
Causes Of Anxiety Fear And Panic
There are many different causes of anxiety, fear or panic and it’s different for everyone.
When you’re feeling anxious or scared, your body releases stress hormones, such as adrenaline and cortisol.
This can be helpful in some situations, but it might also cause physical symptoms such as an increased heart rate and increased sweating. In some people, it might cause a panic attack.
Regular anxiety, fear or panic can also be the main symptom of several health conditions. Do not self-diagnose speak to a GP if you’re worried about how you’re feeling.
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Cognitive Behavioral Therapy Is 70 To 90 Percent Effective As A Treatment For Panic Disorder
Panic disorder is one of the most treatable anxiety disorders. The prevailing treatment is cognitive behavioral therapy . A new offshoot of CBT, known as Acceptance and Commitment Therapy , has also been found effective in treating panic disorder. Psychologist Steven Hayes developed ACT in part as a way to treat his own panic disorder. This form of therapy uses acceptance and mindfulness techniques to change how you relate to your physical sensations of anxiety and anxiety itself.
CBT is an incredibly effective treatment for panic disorder. Seventy to ninety percent of people who undergo CBT will get better, says Gruner.
A key part of CBT in treating panic is a method called interoceptive exposure, in which the person deliberately confronts the unpleasant physical sensations that are causing anxiety. People become more sensitive to these sensations because they fear and avoid them, so facing the sensations and learning that they are not dangerous can lower anxiety sensitivity.
CBT sessions are usually conducted on a weekly basis and last for around 12 to 16 sessions. The treatment tends to show long-lasting results, and relapse is uncommon.
Selective serotonin reuptake inhibitors are also often used to treat depression and anxiety disorders, with or without CBT. These drugs can be effective, but CBT has been found to be a longer-lasting treatment than SSRIs.
What Should You Do If You See Someone Having A Panic Attack
Remind the person they are safe, using a calm, soothing voice, and gently encourage them to breathe slowly and deeply. Suggest they sit down, and stay with them, reminding them of your presence and support.
Tell them youre here, and wont leave them until theyre ok. If they ask you to leave, as long as theyre not in immediate danger, take a few steps back and give them some space. Stay nearby so you can still keep an eye on things, and let them know that should they change their mind, youll come right back.
A soothing, familiar voice helps some people, but try to avoid repeatedly saying things like dont worry or asking them if theyre alright over and over.
Of course you mean well, but your words may not have much benefit in the moment. They can also make the situation more stressful, since your loved one may believe theyre doing something wrong by not being alright.
Take action with your words by:
- asking if they want to leave the room and go somewhere else
- reminding them to keep breathing
- engaging them in light conversation, unless they say they dont want to talk
They may want a hug, or they may want no physical contact at all so dont presume either way.
Help them feel grounded. To help someone ground themselves, you can try:
During an attack, its okay to calmly ask what you can do to support them. Just prepare for the possibility of a short or curt response.
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