Use simple physical and cognitive strategies to stop a Panic Attack.

When a person has a Panic Attack, the level of adrenaline, which is a stress hormone, increases in their bloodstream. Adrenaline is responsible for the physical symptoms you experience during a Panic Attack, including accelerated heart rate, sweating, trembling, and shortness of breath.

When a person has a Panic Attack, they also experience cognitive symptoms, such as fear of dying, losing control, or going crazy.

This blog post is the final post in a series of four that address Panic Attacks. To see a complete list of symptoms, read How psychologists treat Panic Attacks. To learn about why Panic Attacks happen read Why we have Panic Attacks. To learn about what triggers a Panic Attack, read What triggers a Panic Attack.

Because the symptoms of a Panic Attack are both physical and cognitive, I teach my clients to use both physical strategies and cognitive strategies to dismantle an Attack. This combination is usually enough for people to stop having Attacks. When it is not, I work with clients over the longer-term to address underlying issues that contribute to their anxiety.

Physical Strategies to stop a Panic Attack:

1. Exhale all the air from your lungs.

The first thing I suggest my clients do, when they feel a Panic Attack coming on, is to exhale all the air from their lungs. This is because people breath shallowly during a Panic Attack. This style of breathing only worsens an Attack, because shallow breathing causes carbon dioxide to build up in your lungs, and high levels of carbon dioxide signal to your primitive brain that you are in danger, which prolongs the Attack.

People instinctively hold their breath when they are in danger. (For more information about this, read Why we have Panic Attacks.) Exhaling all the air from your lungs is a good first step to stopping holding your breath. Once you have exhaled completely, you instinctively take a huge inhalation of air, which delivers oxygen to your lungs, which in turn tells your primitive brain that you are safe.

2. Deep breathe to let your body know you are safe.

I teach my clients to use deep breathing to help stop a Panic Attack. It is impossible for your body to be both stressed and relaxed at the same time, and deep breathing induces a relaxation response.

There are many ways to practice deep breathing. All involve lengthening your breath, which means slowing down the pace that you breathe at so that both the inhale and the exhale are taken over two or three or four seconds. All methods involve deepening your breath, which means using your entire diaphragm to both inhale and exhale, rather than just your lungs.

This style of breathing is also referred to as diaphragmatic breathing, and it is what you witness when you watch the belly of a small child when they are asleep. You see the entire abdomen of the child rise and fall. This is how adults are designed to breath, as well. However, most adults have lost this style of breathing.

One theory is that this loss occurs because of the focus on being slim in our society. Said another way, people don’t want their stomachs to stick out. But when we have a well-developed diaphragm and abdominal floor, which both come with deep breathing, our bellies do stick out more. What can you do about this? When you practice good posture and move with your back straight and your shoulders back, the protrusion of your belly disappears.

Practice deep breathing to develop the habit.

I encourage my clients to practice deep breathing for at least 10 minutes every day until they can reliably do it without thinking. I suggest they turn the timer on on their phones, sit down in a comfortable chair, and breath along with the sound of a second hand on a clock, if they can find one.

I suggest they begin by breathing in for two seconds, and then out for two seconds for at least a minute. When they are comfortable with this pattern, I suggest they slow down this pace to in for three seconds, and out for three seconds. When they are comfortable with this pattern, I suggest they slow down this pace to in for four seconds, and out for four seconds.

You can keep extending the length of time that you inhale and exhale while the timer is going. Many people can reach eight seconds in, and eight seconds out, with practice. However, making it to four seconds in and four seconds out is enough to be able to stop a Panic Attack, when you feel the first inkling of it arriving, and to prevent it from gaining any steam.

If you like, I encourage you to play with apps to find one that teaches other modes of deep breathing. Many people like to listen to a recorded voice direct them through an exercise, rather than counting seconds in their own head. Avoid apps that ask you to hold your breath for any length of time during the breathing exercise, however, because your body believes it is in danger when you hold your breath.

Cognitive Strategy to stop a Panic Attack:

Recite a simple script to remind yourself that you are not in any danger.

Many people can cope more effectively when a Panic Attack occurs once they understand what a Panic Attack is. To learn more about this, you can read How psychologists treat Panic Attacks, Why we have Panic Attacks, and What triggers a Panic Attack.

The following text is a sample script that consists of 10 statements, which draw from information presented previous posts in this series. When a Panic Attack occurs, you can recite this script to yourself to remind yourself that you are not in any danger.

A Sample Script goes like this:

1. “Ah, I know what this is… It’s a Panic Attack.”
2. “I know what to do.”
3. “Exhale.”
4. “Deep breathe.”
5. “I am in no danger.”
6. “There is no grizzly bear.”
7. “Inhale.”
8. “Exhale.”
9. “I must have heard a branch snap… but there’s no bear.”
10. “Relax.”

These 10 statements provide an example of how I counsel my clients to create their own scripts to help them remain calm when an Attack starts. Once my clients understand that a Panic Attack is nothing more than an adrenaline rush caused by their primitive brain believing they saw a bear – when there is no bear — they are likely to never have another Panic Attack.

This may sound surprising, but once you understand what a Panic Attack is, most people no longer fear them. And once the fear is gone, the Panic Attacks disappear, too.

Work with a psychologist if you continue to struggle.

I would like to encourage you, if you attempt to utilize the strategies presented in this series of four posts without success, to seek the help of an experienced psychologist. Treating Panic Attacks is one of the skills we are all taught early on in graduate school. Working as a team with a psychologist, you can explore additional reasons for your heightened anxiety, and experiment with different ways to help you address that anxiety effectively, so that you can stop having Panic Attacks.

— Dr. Patricia Turner, Registered Psychologist, Calgary, Alberta