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Can't Talk | August 9, 2020

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How To: Cope With A Panic Attack

How To: Cope With A Panic Attack
  • On May 1, 2015

As a life-long anxious mind, I have had my share of panic. I don’t usually have “full blown panic attacks,” but there are many times when I’m in anxiety and not responding to the world like my regular self.

I’ll never forget my first panic attack, though. I had given birth to my second child, and a few days after being released from the hospital I had some complications with my surgical site (cesarean). I had never experienced anything like that before, and due to an excess of hormones in my system I went from my normal worry into a panic attack.

Panic is a weird and unsettling experience–my limbs began to tingle and my vision narrowed and greyed around the edges. I grew very floaty in the head and my heart banged in my chest. Things were happening around me but I was hardly aware of them. Thankfully, I’m well versed in all things anxiety so I knew exactly what was happening. I can only imagine what it would be like to have an attack and have no idea what was going on.

Whether you experience the full range of panic symptoms or simply have moments of high anxiety, I believe these steps can help. I know they help me. Give these a try:

Step 1: Notice you are having anxiety

Anxiety is manifested by very specific symptoms, and can vary per person. Look for any of the following:

  • Sudden irritability (this is red flag number one for me and anxiety)
  • Nausea unrelated to anything in the real world
  • Sweating
  • Breathing hard for no clear reason, or trouble taking in deep breaths
  • “Cotton Brain”–when I’m going deeper into anxiety, I stop being able to process things as well or quickly. I feel like I’m wrapped in a few layers of cotton batting. I am there, but only if you say my name a few times. I miss a lot. If it’s particularly bad, I’ll feel “floaty.” The technical term for floaty is dissociation.
  • Trembling limbs and shaking muscles
  • Tightness and shoulders hiked up to the ears
  • Tingling in arms and legs
  • Flushing/feeling hot
  • Frequent yawning
  • A sense of needing to escape the situation
  • Obsessive thinking about one topic, difficulty switching attention.

It probably seems silly to make step one noticing the problem, but I find much of the issue with anxiety is that it feels terrible, but not always like fear. Fear and anxiety are not the same thing.

Naming a thing takes some of the power away from it. Name this reaction an anxious one, and suddenly it’s less threatening. It’s a chemical brain fart, not an actual life-threatening situation.

Step 2: Sit down and focus on your butt

No kidding, best trick I ever learned. Sit somewhere solid–the floor or a hard surface is better than a bed but whatever you can manage. Turn your attention to your butt on that hard surface. Keep focusing on your butt. Your mind will wander. Bring it back to your butt.

This works because anxiety is essentially the limbic system in overdrive. (So–it isn’t a weakness or a failing or even genuine fear. It’s entirely structural and chemical.) What we do when we pay all our conscious attention to our butts is allow the system to see there is no threat. No threat means no reason to put on the big alarms and dump all that chemistry into our system. You’re actively soothing the limbic system by focusing all you’ve got on your butt.

Step 3: Breathe breathe breathe breathe breathe

When the limbic system goes out of whack, one of the things it does is shorten our breath. This is super helpful if we’re in a deadly situation and we need to run fast, because it increases the oxygen in our system and decreases our CO2. However, in panic panting reminds our brains that something is wrong and encourages it to continue to overreact.

Breathe slowly using a yoga breath–in for a count of four and out for a count of four. Don’t force it, and don’t stress it. Your goal here again is to soothe that limbic system, remind it that you are not in danger and do not need all the helpful things it is currently doing for you.

Step 4: Watch your self talk

Most of the anxious people I know do this weird thing in anxiety. They bag on themselves for having anxiety in the first place. When they are freaking out, they tend to chide themselves for freaking out. They tell themselves they shouldn’t feel so upset, or wonder what’s wrong with them and why they can’t be like other people. They feel stupid and useless. They withdraw, thinking they’re not good for anyone.

Here’s the thing–your limbic system is like a prey animal. It’s a tiny mouse backed into a corner. If you start shouting at a mouse in a corner, it will not say, “oh yeah bro, cool, my bad,” and saunter its mouse way out the front door. No, the mouse will go further into panic mode and maybe bite you or poop on your floor.

Yelling at your own brain for being anxious will yield similar results. The anxious mind can’t process content, it only knows bad is bad is bad. If you yell at yourself, the brain will pick that up as threat and dump more chemicals into your system in an attempt to help you.

A bonus word to watch out for is “can’t.” Many anxiety sufferers feel they simply can’t survive in this unpleasant state. They tell themselves they can’t do things they want to do because they are too uncomfortable in anxiety. Please be alert for this word. If you tell an anxious mind it’s in danger and it can’t do “this,” it will perceive “this” as a threat and help out by increasing panic symptoms.

I’m here to tell you that you can survive an anxiety attack. It won’t do much to you apart from cause a lot of discomfort. It’s not fun but it isn’t deadly. You can, you absolutely can, do “this.” It’s just kind of sucky to do it.

(Which isn’t to say you should always force yourself into uncomfortable situations. Anxiety doesn’t have to impede your life, but you’re allowed to decide when it’s worth it to face the discomfort and when it isn’t. Just don’t assume you never can.)

Step 5: Eat and drink something

Often anxiety is exacerbated by a lack of self care in general. Be sure  you’ve had enough water and food, especially if you’re headed somewhere that you’re likely to feel anxious. If you’re mid-attack, a glass of water or caffeine-free tea can be a soothing message to your brain that all is well. Drink slowly and mindfully.

Step 6: Distractions

I normally advise a lot of mindfulness and attentiveness to your inner self, but in the midst of a bad anxiety attack that isn’t always helpful. The anxiety can become so all consuming that trying to practice mindful attention just leads into a negative feedback spiral of thinking (and the nasty self talk that can come with it).

When anxiety is raging and it feels like butt attention isn’t helping, try distractions but do them right. Make sure they are the “spiral up” kind of comfort and make sure you won’t walk away from them feeling more anxious (for example–now is the time to watch a goofy comedy, not the news).

One thing to try is gentle movement. Try yoga or some light stretching. Move slowly but lean into the body. Don’t overdo it–remember we’re trying to soothe the brain not excite it. Some people do get benefit from doing cardio during panic attacks, so feel free to try it.

Step 7: Reach out

Talk to someone else. Sometimes it can be especially helpful to talk about something unrelated to why you’re upset. Sometimes you want to talk out your upset feelings. Beware the repetitive thinking and do whatever feels best. Warn trusted friends in advance that sometimes you just need to talk about nothing for a while.

Actual touch can also be useful. A hug or holding hands can help ground you in the here and now. Gentle touch can soothe the savage limbic system, so stroking the arms, legs or back can be helpful. You can do this for yourself, or seek it out.

As always, I advise talking to a therapist and a doctor about these things if you feel they are making your life less awesome. There are many treatments, both medical and cognitive, that can help with anxiety. Never feel shame for seeking help. In fact, set your bar high and shoot for that. You deserve to feel good.

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  1. Allyson

    Thank you for this. It took a long time for me to be diagnosed with panic disorder, and for a long time I was totally CONVINCED it was my heart. It’s a very frustrating condition because most people don’t realize just how awful it can be. Now that I know what’s going on, I can talk myself down from the worst of an attack… most of the time. I find that visiting panic/anxiety forums really helps. It makes me realize that I’m not the only one this happens to!

    • That’s a really great tip! Spending time with other people who “get it” makes total sense.

      I agree too that a lot of people don’t realize how bad it can feel, they’ll say it’s “just a panic attack” not knowing how distressing it is!

  2. Beverly

    I’m going through something really similar – I had a c-section at 33 weeks due to preeclampsia, and developed a massive hematoma and bleeding at the incision site. While my son is doing great, he’s still in the NICU and I’m experiencing PTSD from my own hospitalization. 6 weeks later it’s still terrible, but these ideas are really helpful, and I’m glad to (uh, sort of?) see anxiety identified with birth trauma. It helps to know someone else is out there who knows what it’s like.

    • I’m so sorry you’re going through that. Having a baby in NICU is just heartwrenching.

      I have trauma from my first birth–I had violent intrusive thoughts and intense anxiety and nightmares after an emergency csec (all was well and he’s 16 now). I had the same–a big hematoma and bleeding/fluid at the site after my second birth, super freaky. PTSD is the gift that keeps on giving, hooray?

      Hang in there-time and enough sleep will help (eventually)

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