Tips for Coping With Panic Attacks From a Maryland Anxiety Counselor
Panic attacks can be terrifying to experience but respond well to anxiety treatment.
Panic attacks can be a terrifying and overwhelming experience. If you've ever had one, you know that the sudden surge of intense fear, racing or pounding heart, and physical discomfort can make you feel as if you're losing control, or worry that you’re dying. While panic attacks can be frightening, it's important to remember that they are manageable, and there are effective coping strategies that can help you regain control and find calm again. As a Maryland anxiety counselor, I have walked a lot of folks from panic to peace and helped them gain mastery over panic attacks. Let’s talk about what panic attacks are, their common triggers, and some practical ways to cope with them.
understanding panic attacks
Panic attacks are intense episodes of anxiety that can come on suddenly and without warning. They involve a combination of physical and psychological symptoms, which can include:
Rapid heartbeat or palpitations
Shortness of breath or a feeling of choking
Trembling or shaking
Sweating excessively
Nausea or stomach discomfort
Dizziness or lightheadedness
Tingling, or pins & needles sensations, in the limbs
A sense of not being connected to your body or a sense that the moment is unreal
Chest pain or discomfort
A fear of losing control or going crazy
A sense of impending doom
A strong urge to escape the situation
These symptoms can be so overwhelming that many people mistake panic attacks for more severe medical conditions, such as heart attacks, or worry that they are dying. New and intense symptoms are usually a good idea to get checked out by a physician (if you’re dizzy because you’re anemic, or your chest pain is due a heart issue, learning about taming panic attacks isn’t going to help you!). But if you’ve had symptoms checked out by your medical provider and it looks like it’s not an underlying condition, read on to learn more about panic attacks and how to manage them. Understanding that panic attacks are a specific form of anxiety is the first step in coping with them.
Stress is a common trigger for panic attacks.
Common Triggers of Panic Attacks
Panic attacks can be triggered by various factors, and these triggers can vary from person to person. Some common triggers include:
Stress: High levels of stress can increase your vulnerability to panic attacks. Even expected events like family holiday visits can trigger intense stress for many.
Caffeine and Stimulants: Excessive caffeine or stimulant consumption can trigger panic attacks in some individuals.
Phobias: Specific phobias, such as fear of flying or heights, can lead to panic attacks when confronted with the phobic situation.
Traumatic Events: Past traumatic experiences or recent traumatic events can increase the likelihood of panic attacks.
Medical Conditions: Certain medical conditions, like hyperthyroidism, can mimic the symptoms of a panic attack (again, see your medical provider to check).
Substance Abuse: The use of alcohol or recreational drugs (even ones that are meant to relax you) can trigger panic attacks.
Understanding your triggers can help you make wise choices about taking care of yourself, and giving yourself extra space and support when you know you’re approaching something tough for you. But we want to be careful about not getting too caught up in trying to avoid everything that MIGHT trigger panic. Avoidance makes anxiety worse. It makes our world smaller and smaller, as we try to avoid every possible trigger and play defense all the time. The real turning point in getting the upper hand with panic attacks is knowing that, even if they occasionally come up, you can become an expert on managing them quickly and easily.
Coping Strategies for Panic Attacks
Step one: Name what’s happening
The first step is the most important one: knowing you are having a panic attack. When the intense sensations of a panic attack wash over you, it’s hard to think very clearly. If, in that haze of confusion, you focus on the symptoms themselves and how distressed you are about them, the louder they will likely get. Fixate, with terror, on your pounding, racing heart, and you’ll likely feel that pounding and racing even more. Become hyperaware and freaked out about the pins and needles feelings in your limbs? That’s likely to just intensify them. When you can tell yourself, “This is a panic attack. I know exactly what this is and what I can do about it. It’s uncomfortable but I am safe”, then you have already taken a massive step towards finding more ease and calm.
For all you brain geeks out there, one of the things we do when we name and put language to our experience, is we activate the prefrontal cortex part of the brain. This is where all the best, most advanced, logical thinking we do comes from. It’s also the part that goes quiet when the VERY LOUD ALARM BELLS of survival go off in the part of our brain that triggers our fight/flight response (the amygdala). Getting the prefrontal cortex heard again can help those alarm bells start to turn down as the amygdala gets the message that we really aren’t in immediate danger. tl;dr version: Just saying the words to ourselves helps us to stop freaking out.
Step Two: Moving from panic to peace
When you recognize that a panic attack has got you spun up and you need to regain your footing, try some of these strategies:
Deep Breathing: When you feel a panic attack coming on, focus on your breathing. Take slow, deep breaths to help calm your nervous system. Inhale for a count of four, hold for four, and exhale for four. Repeat this cycle until you start to feel more relaxed.
Grounding Techniques: Grounding exercises can help you stay connected to the present moment. Try the 5-4-3-2-1 technique, where you name five things you can see, four things you can hear, three things you can feel/touch, two things you can smell, and one thing you can taste.
Progressive Muscle Relaxation: Tension often accompanies panic attacks. Progressive muscle relaxation involves systematically tensing and then relaxing different muscle groups to reduce physical tension.
Learn relaxation and coping tools that you can use at home or anywhere.
Mindfulness and Meditation: Mindfulness-based techniques, such as meditation and guided imagery, can help you stay focused on the present moment and reduce anxiety. Check out these other blog posts on specific mindfulness tools for reducing anxiety such as breathing for relaxation, naming your emotions, and calming down the body.
Positive Self-talk: Challenge negative thoughts with positive affirmations. Remind yourself that panic attacks are temporary and that you can get through them.
Seek Support: Share your experiences with trusted friends or family members. Sometimes, talking about what you're going through can provide immense relief. Find more about how to talk to loved ones about anxiety here as well.
Professional Help: If panic attacks are frequent or severely impacting your life, consider seeking professional help from a therapist or psychiatrist. Cognitive-behavioral therapy (CBT) and medication are effective treatments for panic disorder. Combining CBT and mindfulness approaches can be powerful for reducing anxiety and panic. An anxiety therapist will have lots of experience of helping you make the most of these strategies, troubleshoot the challenges, and bring in even more tools that are effective in sessions to help you see progress in real time.
Be Prepared
Here’s the really tricky part: When you are in the middle of a panic attack, all those strategies above can feel hard to remember and hard to do. So, do yourself a favor and be prepared. Help Future You by putting in the work ahead of time. Practice all of those strategies above over and over again, under non-panic conditions. Build them into your day to practice when you are mostly relaxed already. Try them when you are just a little annoyed or stressed about something that bugs you but doesn’t tip into panic.
This does a few helpful things. It starts setting up pathways in your brain that can be helpful to you. Your brain loves to save energy so it tries to anticipate and automate as much as it can. When you make a strong bond between things in the brain, you just need to set the first thing in motion for all the rest of them to start following along easier. We are all just giant versions of Pavlov’s dogs, who learned to salivate when hearing a bell because they were trained to associate the bell with food. When your brain gets the message that, “When we do these breathing patterns/grounding exercises/etc, that means we are safe and relaxation follows”, then it’s already setting that whole pathway in motion once you remember to start doing these things to put the brakes on a panic attack.
Practicing ahead of time, and under calm conditions, also helps you to build your confidence and really get curious about how some of the strategies feel and work so you can keep refining them to work best for you. Solid practice helps us perform better under more pressure. That goes for sports players, performers, and anyone trying to do something well in an intense situation (like someone trying to manage a panic attack).
One tip that has helped a lot of my clients is to make a list of all your coping skills and strategies and keep that list in an easy to find place. That way, when it’s hard to remember things in the middle of a panic attack, you just have to remember one thing: Find The List. And then you have all your tools listed in front of you. Most people have their phones with them almost all the time so a Note on there works well. Other people have liked having the list written down on index cards that they then leave in lots of places, like on the fridge, in their wallet, on their desk, or on their bedside table. Do whatever works for you. Give yourself every advantage here.
You can do this
Panic attacks can be distressing, but with the right coping strategies and support, you can learn to manage them effectively. Remember that everyone's experience with panic attacks is unique, and it may take time to find the strategies that work best for you. Be patient with yourself and know that you are not alone in this journey. By learning to cope with panic attacks, you can regain control of your life and find a sense of calm even in the midst of anxiety's storm.
A free consultation with a Maryland anxiety therapist
Looking for support in reducing anxiety and panic? I offer specialized anxiety therapy appointments in-person, located in College Park, MD. Online anxiety therapy appointments are available anywhere in Maryland. Contact me to schedule a free 15-minute phone consultation and take the first step toward taming your anxiety.
Other services I offer include hypnotherapy, mindfulness-based therapy, life coaching, and support for LGBTQIA+ clients. Additional information is available on my counseling practice home page.
About the author, an anxiety counselor:
Beth Charbonneau, LCSW-C, is a Maryland therapist, specializing in anxiety therapy and treatment. With over 20 years of experience, she brings a holistic approach to calming both the mind and the body, and helping her clients feel empowered to find more joy in their lives. Learn more about her College Park-based counseling practice here.
