I’m having a panic attack, what should I do?
Stop. Drop. Roll. I mean, pretty much.
There’s so much advice out there about what to do if you’re having a panic attack and how do deal with it in 20 steps. Thankfully most of the advice is consistent and mirrored across each other, as good medical and wellbeing advice should be. But from my personal experience, when you’re in a full blown panic attack, you’re not about to remember 20 things. Or even 10 things.
In these complex and overwhelming times, I’d like to try my best to Keep It Simple, Sweetydarling so that you might actually remember.
Stop. Literally stop what you’re doing. Chances are you won’t have much choice in the matter if you have symptoms like rapid heart rate, sweat, lack of focus, intense worry or anxiety. You may need to pull over if you are driving. You may like to sit on the ground against a wall. You may like to sit with your head down between your legs. You may like to go outside where there is spaciousness or fresh air. You may need to leave a meeting. You may need to end the phone call. Be real. Your body is sending you a message to act.
Breathe. It’s basic and primitive because it works. There are numerous breathing techniques, but here’s an evidenced based model to try: box breathing. Breathe in 2, 3, 4, hold, Breathe out 2, 3, 4, hold. Repeat 12 times. Your nervous system will show you the evidence that this works. Fill the belly, feel it rise, feel the chest rise. Deflate the chest and belly on the out breathe. You may like to place a hand on your belly and on your chest. For some, if this worsens the panic attack, try focussing on something instead - like your thumb, the flooring texture, or counting.
Reassure. Name it for what it is - say to yourself, “this is a panic attack, I am ok, it will pass”.
Go inwards. Reduce your sensory input. Whatever works for you: close the eyes, place your hands over your eyes, put headphones in to block out noise, or listen to white noise. Gently hum to yourself. Move away from crowds, go to a quiet room, maybe a place without traffic or screens. Here, many people find their most primitive instincts kick in and they find themselves doing actions that are naturally self-soothing, like rocking, cradling themselves, pacing, rubbing their hands together or stroking their hair or upper arm. These are instinctive and designed for this reason. Embrace your body’s wisdom if you find yourself gravitating to something like this.
Repeat.
Now, here are my favourite longer term strategies for prevention and intervention:
Tell someone. Don’t pretend that it didn’t happen. Tell a friend or a professional. Speaking out loud about things is a way of externalising a problem and by doing so it can sometimes reduce the impact/power of that problem. It can normalise it. And you might find support in knowing you’re not alone.
Identify your triggers. Over time and with reflection, notice what might’ve been happening before the panic attack. Pretend you are a Detective and doing a fun investigation game. Where were you? Who were you with? What time of day was it? What were your surrounding circumstances, stressors, thoughts, feelings at the time of the attack? You might start to develop a picture of certain things that are more likely to trigger a panic attack and therefore have greater chance at reducing them by having strategies at hand (and NOT to avoid these, as you may initially prefer to do - see anxiety cycle)
Keep lavender on hand. A nice oil in the bag, or desk drawer. Dab some on your wrists or cuffs or hankerchief. Grow some in a pot in your office, in the garden at home. Pick some and crush it in your fist and inhale. There are also natural remedies in most chemists or natural health food stores. For others, a visit to the Doctor for temporary medication may be required.
Practice mindfulness. Sounds woo, but it is recommended by many for a reason. It builds mindfulness skills and resilience over time… bringing you quicker, closer access to the tools that help you deescalate from panic attacks and recover faster. This is just like going to the gym for muscle and body training, or doing memory training on apps. We exercise our minds in this way to keep us mentally and emotionally strong also.
Mantras. Some people develop mantras of calming, soothing, positive messages they know help them when they are in panic attack mode. Words or a phrase may come naturally and unexpectedly, while others may require you to test the waters and see what feels helpful to you and then have them on standby.
Other holistic wellbeing activities. Maintain movement, a nourishing diet, relational / spiritual/ cultural connections and a sense of purpose.
