Coping with panic attacks - What to do to help yourself or a loved one calm down

Your heart is pounding, your vision is blurring and your breathing is rapid... You feel like you are dying...

If you've ever had a panic attack, you know how terrifying they can be. If you have never had the experience, consider yourself lucky.

Panic attacks typically are self-limiting and short in duration. The usually develop and peak suddenly, their intensity reaching the highest level within ten minutes and then abating. Someone experiencing a panic attack may feel their heart bouncing around in their chest (palpitations); may feel sweaty or shaky; might feel like they are choking or can't breathe; and may feel disoriented or dizzy as well as an intense amount of fear¹.

Today a friend of mine had a panic attack unexpectedly (as they usually are "out-of-the-blue") and I happened to catch it and help them calm down. I want to offer some tips to those of you who experience panic attacks or have loved ones who do.

Generally the first thing you want to do is control your breathing, as calming your physical self down will help to short-circuit any of the "fight-or-flight" responses occurring in your body. If you are having a panic attack (or your friend or family member is), get into a comfortable position and relax the body and focus on proper breathing. I quickly knelt by my friend and got them to a chair. I told them to focus on their breathing and breathe in through their nose and out their mouth using only their belly. I kept eye contact with them and held their hand and breathed with them.  It is hard to think during a panic attack so if you can be the guide for breathing, it is much easier for the other person to follow; also, if you are helping someone else, it is important to keep calm yourself.

If you are alone when panicking, it may help you to call a friend/family member to help you breathe or talk through what you are feeling while focusing on breathing (but be safe! If you are panicking while driving, pull over and make the call or use a hands-free device). If you can't call anyone find a comfortable spot and begin your breathing exercise. Distraction works well in this case - video games, movie, music, writing. Anything to get your mind off the feeling of fear or the physical symptoms you're experiencing. If you continue to breathe correctly your anxiety should subside. If it doesn't, there are help-lines to call and the operators will be able to assist you.

Once you've regained control of your breathing and are in a safe place to relax, you can work on progressive muscle relaxation (PMR) exercises (especially if you are prone to panicking before bedtime). This will bring the anxiety level down even farther. The slow and controlled breathing is an important first step and might help you come completely out of an attack or might just bring you back to a manageable level of anxiety; but the PMR exercises can really help you get centered again, especially after a panic attack. It all depends on your base-line anxiety levels.

If you are noticing that you are having many anxiety attacks in a short period of time or that they are getting worse or your work/school/relationships are suffering you should speak with your doctor. There are many helpful therapy programs (CBT especially) as well as medications that can help you manage your anxiety. It is not a weakness to reach out for help when you need it.


List of crisis lines*:

https://www.lifeline.org.au/  (Australia)
http://suicideprevention.ca/thinking-about-suicide/find-a-crisis-centre/ (Canada)
National Suicide Prevention Lifeline toll-free at 800-273-8255. (USA)

*if your country is not listed, a quick Google search should help you find one in your area.




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¹  Kessler RC, Chiu WT, Jin R, Ruscio AM, Shear K, Walters EE: The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication.
Arch Gen Psychiatry 2006, 63:415-424. PubMed Abstract | Publisher Full Text | PubMed Central Full Text 

Driving Anxiety: How to cope when you're going over 100km/h!

We all know driving is dangerous, but we casually get into our cars and drive everyday without thinking more than once about safety - putting on our seatbelts, checking mirrors, and we're off to work, or school, etc.

Until you feel that sense of uneasiness welling up from your stomach, or the fog and pressure building in your head.... Maybe you feel too hot, or cold.... Maybe your vision starts blurring and you start sensing the worst.... And then you end up in a full-blown panic attack, speeding down the highway in a giant metal weapon.

Having panic attacks is extremely rough and having them while in control of a vehicle is monumentally worse.

I have some tips for those of you conquering this issue in your life right now:

1) Deep-breathing techniques

If you perform some deep-breathing you might find that your physiological response tones down enough that you can actually reduce the panic feeling and retreat from the edge of the full-blown panic attack.
If not, at least you will be able to calm yourself sufficiently to pull over.

2) Distracting yourself:
-by adding numbers on license plates you see
-really focusing on what other people in their cars are doing
-talking to yourself, or using a hands-free device to call your friends or parents (or if you are secretive about your panic, your local crisis line). Sometimes just talking with someone, about anything or your particular situation, is extremely helpful for distracting you from the physical or mental stimulation that was pushing your anxiety.

3) Have some snacks and water on hand. Eating a few bites of apple or some popcorn or veggies might help you to refocus yourself, while giving you a bit of nutrition.

4) Track your panic - see if you can find a root cause or causes. If it happens around the same time of day or on the same stretch of road, try to prepare yourself by knowing that it will likely be rough but because you have made it through before, you will again, and again. Gradually, through exposure, and pure Conqueror-spirit, you will be able to drive through those tough spots.

5) Are there other things in your life that you are ignoring or repressing? Relationship or school/work issues? These may be making themselves known in the form of panic attacks in stressful (ie: driving) situations. If you haven't already, talk to a close friend or relative about what's going on for you. If that doesn't help, or doesn't help sufficiently enough to reduce your anxiety, see your doctor or a local counselor.

6) Finally, if these practical approach tips aren't working for you, speak with a local counselor or your doctor about other ways you can manage your anxiety while driving. It may be helpful for you to try some herbal or pharmaceutical anti-anxiety medications.

While you are working out what methods will work the best for you, you can always take the bus on days when it just absolutely won't work for you to drive. Try to find a carpool for your work or school; this will allow you to be more productive on the way to and from work, as well.

Note: I do not advocate avoiding anxiety-triggers, as that will only compound the problem; however, I do advocate remaining safe while figuring out what is best for yourself in these hard times.
If it is for you to carpool or bus while you practice driving at night or on the weekends, then do so.

Be safe, stay calm and Conquer on!



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