Overcoming Panic Attacks
“I genuinely believe that part of what makes me an effective therapist who specializes in working with anxiety disorders and supporting clients through panic attacks is that hearing their experiences resonates with my own. “
More from Tracy Sciulli, MS, Doctoral Candidate,LPC, RYT-200:
“I became very passionate about learning the physiological and neurological responses behind the scenes, which led to a panic attack, to help myself. I was a young adult when I first felt the onset of symptoms. It was as if my mind and body were on a runaway train, and I was clueless about what was happening, let alone how to bring that train back to the station. My heart started to pound, sweat began to pour over my face, and with shaky hands, I felt weak throughout my body. My mind started racing to search for an answer or a reason. Each second, I seemed to usher in faster thoughts that got more catastrophic. I thought I was having a heart attack or something terrible would happen. Today, those are the very symptoms clients report to me, and I genuinely nod my head knowing that experience.”
Why a Panic Attack Starts
The starting point for a panic attack can be different for everyone. A fearful thought or worry could cross their mind, followed by the onslaught of physical symptoms, and then those fearful thoughts get reinforced and worse. For others, the racing heartbeat or tightness in their chest could start the panicked thinking, "What's wrong? What's happening to me?" Regardless of the starting point, your mind and body perceive a threat and do exactly what needs to be done to counter it. Your mind and body work together to activate the sympathetic nervous system, or the fight and flight response. This stress response is helpful when we need to gear up for problem-solving, moving our bodies to escape danger, or defending ourselves. However, panic attacks happen often when there is no immediate threat. It is a common misconception that panic and anxiety alone are disordered. Panic and anxiety are normal and adaptive responses present from birth. We feel those emotions to help us stay safe. Panic attacks occur most when we start over-generalizing what is considered a threat or don't have the skills to cope with what we are thinking about or feeling.
How to Control Panic Attacks
I noticed that my panic started with my thoughts. I wanted to figure out what was wrong or understand why I had terrible thoughts crossing my mind. Today, I coach my clients by educating them that we have thousands of thoughts per day. The majority of those thoughts are automatic and out of our control. We pay attention to automatic thoughts that get our attention the most. It makes sense that when something terrible crosses our minds, it gets our attention. It is out of anyone's control to stop anxious and panicked thoughts from happening in the first place. But with practice through mindfulness, CBT, and the power of giving yourself grace for being human, it is possible to command and control what you want to be thinking about next. Catching the panicked thoughts early in their tracks and talking back to them reinforces that you can't stop the automatic thoughts that can start a panic attack, but you can change the course of your thoughts to prevent having a complete panic attack.
If someone is already escalating into a panic attack, cognitive or thinking-based strategies like the ones I mentioned above won't work. That's because your body is too far into the fight or flight response to have your cognitive processes fully accessible. That's when body-based strategies such as deep breathing, slowing down the breathing rate by exhaling for longer than your inhale, distraction through intense sensations such as cold therapy, sour candy, or tuning into an engaging show, song, or podcast is more effective.
When someone is calm and not experiencing panic, regular practice of strategies, often called self-regulation strategies, is like going to the gym for your nervous system. The more you practice deep breathing, cold immersion, mindfulness, regular exercise, good sleep habits, and redirecting your thoughts, the more equipped you will be to stop a panic attack in its tracks.
I recommend that anyone with known heart conditions, concerns with blood pressure, or a history of stroke should err on the side of caution and call 911 or go to a local urgent care. Panic attacks usually have an intense onset and last only a few minutes. Other more serious physical concerns typically have a slower symptom onset and don't resolve using any of the above strategies. Medical professionals are happy to assess your vitals and answer questions. Working in integrated healthcare settings has taught me that many individuals who have had heart attacks or challenges with blood pressure often feel panicked that something related to their condition is happening again. So, I empathize and encourage learning your warning signs for a panic attack and creating a care plan with medical professionals involved in routinely monitoring your condition to know when to seek a medical opinion.
I have successfully treated my panic attacks by creating a routine that supports my nervous system and plans for times I'm most likely to pay attention to upsetting thoughts. My daily routine includes going for a walk, moderate exercise, or yoga for 15 minutes, deep breathing when I notice my heart rate rising and redirecting upsetting thoughts to what I want to think about. I'm a big fan of using music, podcasts, and physical activity during the early morning to redirect my attention when I'm most likely to struggle with anxious thoughts. Investing in yourself and creating habits to support a healthy nervous system and minimize future panic attacks is possible.
