How I Get Through a Panic Attack
photo taken by yours truly
The first time I had a full blown, can’t breathe, body-tingling, I-might-throw-up kind of panic attack was in 2015 on a 5 hour road trip from Seattle to Spokane.
My husband was driving us to Spokane so I could interview for a master’s level seat in a mental health counseling program. I was sitting in the front seat of the car, wearing new pants I had bought for the interview. They were a little snug, and I could feel the pressure of the waistband digging into my stomach. I tried unbuttoning my pants to relieve the physical sensation, but I had already started to feel an intense irritability and anger boiling inside me. I didn’t know it then, but I was about to have a panic attack.
With my history of Eating Disorder pathology, the sensation of my clothing being too tight is always a trigger. The tightness of my clothes against my body leads me down a spiral of thinking I’m too big for what I’m wearing, therefore I must have gained weight, therefore I have not been in control of my eating, therefore I am not in control, therefore everything is out of control. Anxiety anxiety anxiety.
These days I’m aware of my triggers, and how they are information about the fact that I am anxious. But in this moment, sitting in the car on the way to an important interview, I had little awareness or tools to understand what was about to happen.
I felt like everything started to move really slowly and really quickly all at the same time. I started breathing heavily and fidgeting in my seat. My skin started to feel like it didn’t belong to me, and I wanted to crawl out of it. Scrape it off of me. I started writhing and groaning in my seat, unable to sit still as I tried to stop the feeling of not belonging in my body from growing. My skin and muscles and flesh couldn’t possibly be mine, couldn’t possibly belong to me. I started to panic. Like if I didn’t get my soul out of my body, I would explode and die.
Josh pulled the car over on the side of the highway. I was starting to hyperventilate. I felt like I needed to expand and spread my whole body--I wanted my limbs as far away from my torso as possible, and I reclined my seat all the way back in an attempt to stretch my arms and legs and neck as far away from my heart and gut as possible. “What’s coming out of my face!?” I yelled. “You’re crying, Rach,” Josh had parked the car and come around to open my door. With a fearful look on his face, he gently pulled me out of the car.
I threw off my jacket and resisted the urge to strip the rest of my clothes from my body. My head was spinning. My breathing increased as I fought tears. This made no sense--why did I want to cry? I shoved any tears I could back down and felt a choking sensation in my throat. I grabbed my stomach and groaned. Go away go away go away I thought, hating every moment of what felt like my body fighting against me.
Eventually, I got back in the car. Exacerbated, I felt lightheaded and dried up, like all the water in my body had been replaced with caffeine. “What was that?” Josh asked me. “Nothing. It was just a fat attack,” I replied.
Over the course of the next 5 years, I had more “fat attacks.” But I learned very quickly that these were not fat attacks.
They were panic attacks.
What is a Panic Attack:
A panic attack is the body’s natural and normal response to threat. In the olden days of yore, human’s greatest threats were survival related: “Is that bear going to eat me,” “Will I starve if I don’t find food,” “I will freeze and die without fire,” etc.
In the face of extreme, survival-based danger, our brain sends signals to our bodies saying, “get ready to fight for your life.” The body, because it works so beautifully, gets ready. How? Our autonomic nervous system activates and sends adrenaline hormones through our bloodstream. These hormones cause our breathing to intensify so we get more oxygen. Our lesser needed functions like digestion shut down. Our sense of smell, touch, and sound become hypersensitive. Our body is preparing to respond to threat (Bhandari, S. 2019).
These days, we aren’t faced with dangers like bear-attacks or running from a herd of antelope. (ok, maybe some of us are, I don’t know your life.) So our brains start to attach this same-level threat to non life-threatening experiences: We start to associate threats like not getting a job, losing a relationship, or being rejected as life-threatening. This is because they are the next-worse thing to a death-threat: they threaten our sense of worth.
In some cases, like not having employment, the threat does trickle down to survival: if I don’t get this job, I won’t be able to pay my bills, and I will lose my home. Even though the imminent threat of life is not in our face, it dangles in the background and convinces our brain that getting this job right now is a matter of life or death.
So we have panic attacks. Our brain interprets a threat as so dangerous that it activates the nervous system and sends our bodies into survival mode. We hyperventilate and choke on our breathing and get knots in our stomachs. We tingle and writhe and sounds become overwhelming. We have the urge to punch walls or run as fast as we can. Anything to fight everything in our way, to get away from where we are, or curl up in a ball and disappear. To fight, flight, or freeze.
The Science of Getting Through a Panic Attack
This is where science is so cool. If our autonomic nervous system is telling our bodies to prepare for threat, can it also tell our bodies to relax? Yep.
There are two stems of the autonomic nervous system: parasympathetic, and sympathetic. The sympathetic nervous system is what prepares the body’s energy sources for threat. The parasympathetic nervous system is what replenishes and takes care of the body’s energy sources (Low, P. 2018).
So how do we activate our parasympathetic nervous system when we’re in the middle of a panic attack?
By using a reverse process of soothing the body’s physical senses. With varying techniques, you can trigger your parasympathetic nervous system by physically altering the state of your body, essentially jumpstarting the effect that your parasympathetic nervous system would have if it believed you were completely safe.
You bypass the messenger (parasympathetic nervous system) and go straight to the physical response that would naturally occur: you slow your heart rate, steady your breath, relax your muscles, and decrease sensory activation. The brain will interpret this as your body responding to no threat. The sympathetic nervous system will take a chill pill, and your parasympathetic nervous system will take the driver’s seat.
HOW I GET Through a Panic Attack
First and foremost, if you are having a panic attack, it is important to try and find a safe, private space. This is because, like it or not, you will have the panic attack. I have learned that the harder I try to fight one off or stop it from coming, the worse the panic becomes, and the more painful the panic attacks are when they inevitably boil over.
These tips are designed to help a panic attack pass more quickly and efficiently: not stop it from happening. If there is anyone you trust in proximity, ask them to sit with you and help you. Having another person will increase the likelihood of your success with any of the following tasks.
1. Use Ice Packs to Slow Heart Rate
This is ALWAYS my first move when having a panic attack. I grab an ice pack or bag of frozen berries from the freezer and simply hold it. The ice does many things, but the main purpose is to help reduce your bloodflow and circulation, which will help bring your heart rate down. Holding an ice pack is also a sure-fire way to reduce the anxious thoughts that might exist at the beginning of a panic attack, as your focus suddenly goes to “holy fuck that’s cold.”
2. Counted Breaths to Slow Breathing
This one can feel really hard if you are hyperventilating, but it can be really effective. Inhale through your nose for five counts, and exhale through your mouth for five counts. Do this as many times as you need to until your breath is no longer shallow or pant-like. If you have a friend with you, you can ask them to count for you. If you don’t, count in your head.
3. Observe and Name Your Surroundings to Deactivate Sensory Overload
If you’re inside, try to find a window where you can see outside. If you are outside, bring your attention to somewhere off in the distance. Begin to observe only what you can see and hear, and simply say out loud (or in your head) what you see and hear. For example, if I was looking out my window now, I might say, “tree, red car, fire truck, wind, laughter.”
4. INTENSE EXERCISE TO RELIEVE ADRENALiNE HORMONE RUSH
Run up and down your stairs. Do ten burpees. This will feel RIDICULOUS because you will likely be crying and hyperventilating, and you will feel very foolish as you do jumping jacks in a pool of your tears. But fast, intense, short exercise can be a great way to channel the extra adrenaline pumping through your body and help it get the F out of you faster (MPGteam, 2017).
Hopefully, by utilizing just one of these techniques, you’ll notice your panic attack starts to calm itself. Your breathing should deepen and slow down, your heart rate should decrease to a more normal state, and your brain will slowly return to the present moment where there is no imminent threat of death.
after a panic attack
The way you take care of yourself after a panic attack is equally important as getting through it. Be sure to be gentle on yourself. Your body and mind have just been through a seriously difficult process, and you will feel exhausted. Drink plenty of water, and get some rest.
Your instinct might be to brush off the panic attack like it wasn’t a big deal. Or you might beat yourself up for having such an intense reaction to stress. Or, if you’re like me, you’ll immediately try to figure out what caused the panic attack (a.k.a. immediately try to regain control.) The way you respond after a panic attack can be a very strong indicator of what is contributing to your anxiety.
If you brush off the fact that you had a panic attack, you’re ignoring reality. Reality is telling you that something is stressing you out to the point of physically breaking down. Chances are, if you respond like this to your panic attack, you’re turning a blind eye to something stressful in your life, and your body is trying to send you a very strong signal.
If you get down on yourself for having a panic attack, ask yourself if you get down on yourself for other things in your life. Are you putting too much pressure on yourself? Do you expect yourself to be strong, perfect, or always be in control? Having this kind of response may be an indicator that you are trying so hard to keep everything together, and your body is trying to tell you to give yourself a break. To give yourself permission to not have everything totally under control. To be vulnerable. To be less than perfect.
If you want to immediately figure out what caused your panic attack, you may be like me and constantly looking for answers when things are uncertain. Even after an incredibly physical and emotional experience like a panic attack, I start “getting to work” the moment it’s over. This might be a sign that you need to rest.
No matter your response, the moments and even hours after a panic attack are not the time to analyze or dissect why you had the panic attack. Wait at least 24 hours to recover mentally before asking yourself what your brain believed was so threatening. Give yourself permission to rest. Treat your body as though you just ran a marathon. Eat some pasta. Take a bath. Then, you can start to build awareness around the anxiety you are experiencing.
If you or someone you know suffers from regular panic attacks, remember to be gentle with yourself and eachother. Offer these tips to someone you love, and ask for support if you find yourself having a panic attack.
If you have any questions about anxiety, panic attacks, or anything in this article, please don’t hesitate to reach out.
Happy Coping!
XO -Rachel
References:
Bhandari, S. (2019, November 13). Random Panic Attacks: Here's What Happens to Your Body. Retrieved January 4, 2020, from https://www.webmd.com/anxiety-panic/panic-attack-happening#1.
Low, P., By, Low, P., & 2018, L. full review/revision D. (n.d.). Overview of the Autonomic Nervous System - Brain, Spinal Cord, and Nerve Disorders. Retrieved from https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/autonomic-nervous-system-disorders/overview-of-the-autonomic-nervous-system.
MPGteam. (2017, September 20). Dialectical Behavior Therapy (DBT) Distress Tolerance Skills: TIPP Skills. Retrieved from https://manhattanpsychologygroup.com/dialectical-behavior-therapy-dbt-distress-tolerance-skills-tipp-skills/.