Someone who has experienced a Panic Attack, at times referred to as Anxiety Attack, would know that it can be an incredibly distressing and overwhelming experience. When someone experiences their first Panic Attack, they feel totally overwhelmed, helpless and clueless on what struck them, why it struck, and what to do about it.

So let us begin by looking at what is a Panic Attack — symptoms and causes. This will help us in designing our own Panic Attack Treatment.

What is a Panic Attack?

A panic attack is a sudden and intense surge of fear or anxiety that can peak within minutes. It can manifest with a variety of physical and emotional symptoms, which may include rapid heartbeat or palpitations, Shortness of breath, Chest pain or discomfort, Trembling or shaking, Sweating, Nausea or stomach distress, Dizziness or lightheadedness, Feelings of detachment from reality, Fear of losing control or dying.

However, in reality a Panic Attack is simply body’s exaggerated response to a perceived threat — which rarely has anything to do with reality. The exaggerated response in form of Panic Attack is a result of series of stress and anxiety attacks that went unchecked. These mild episodes kept creating stronger and stronger neural pathways. One fine day, these deepened neural pathways cross the threshold, and create a range of body sensations driven by hormonal fluctuations and brain hyperactivity, resulting in a full-blown Panic Attack.

Is Panic Attack something to worry about?

No. As mentioned before, a Panic Attack is body’s exaggerated response to an imagined, unreal threat. Upto 11% of American population has experienced a Panic Attack. According to World Health Organization, 264 million individuals worldwide have anxiety disorder, and are likely to experience heightened episodes like Panic Attacks or Panic Disorder.

Having said that, Panic Attacks can be very draining — physically and emotionally — and must be effectively handled to live a normal day-to-day life.

At this time, it is important to note that panic attacks can mimic symptoms of serious medical conditions like heart attacks. While in itself a Panic Attack is harmless, when you experience these symptoms for the first time, seek medical evaluation to rule out any underlying health issues.

Sympathetic and Parasympathetic Nervous Systems

Effectively managing Panic Attacks requires an understanding of the above two human nervous systems.

Sympathetic Nervous System (SNS) — also referred to as the Fight-or-Flight nervous system — is activated in response to any stress, danger or any situation that requires immediate physiological response. When activated, SNS prepares the body for action by increasing the heart rate, dilating the pupils, redirecting blood flow to the muscles, and releasing stress hormones such as adrenaline and noradrenaline into the blood stream. This results in increased respiratory rate and blood pressure, and a heightened state of readiness and alertness.

Parasympathetic Nervous System (PNS) is also referred to as the Rest-or-Digest nervous system. It promotes relaxation, recovery and conservation of energy. When activated, PNS slows down bodily functions, allowing the body to rest and recover. It enhances salivation and digestion, lowers heart rate, constricts the pupils, and helps the body return to a state of equilibrium.

When one is activated, the other one is inactivated. And their relative activity levels determine the individual’s ability to effectively handle stress or any perceived threat.

Panic Attacks are a result of an individual’s Sympathetic Nervous System going into overdrive. Therefore, effective management of Panic Attacks hinges on activating Parasympathetic Nervous System and limiting activities that trigger Sympathetic Nervous System.

Managing Panic Attacks

As noted above, activating the Parasympathetic Nervous System is the key to successfully handling Panic Attacks. Below are a few effective tips techniques to activate the PNS:

1.Bliss Breathing: Breath holds the key to the balance between PNS and SNS. Specifically, inhalation activates the Sympathetic Nervous System, and exhalation activates the Parasympathetic Nervous System.

So during a breath, if your exhalation duration exceeds your inhalation duration, you are effectively keeping the PNS activated longer.

I particularly found a pattern of breathing very useful during my Panic Attacks — inhale till the count of 3–4, and exhale till the count of 6–8. Repeat. Inhale through nose, and exhale through mouth for faster relief. To make it more effective, while you breathe, place palms of both your hands one above the other over your belly button.

As you practice the Bliss Breathing pattern, observe the motion of your hands as they move inward and outward while breathing, observe your breath, keep the count (3–4 for inhalation, 6–8 for exhalation) while inhaling from nose, and exhaling from your mouth. Do this for at least a minute, and you will start feeling better. Continue for a few minutes if needed.

2.Meditation: Meditation (more than once a day if stress levels are running high) as part of your daily routine will keep your Parasympathetic Nervous System activated for longer durations, and will help you cope with stressful situations better.

One powerful practice you can do is to bring down your breathing to six-breaths-per-minute for total of up to 5 minutes in a session. Repeat these sessions a few times in a day. You will see significant improvement in your Parasympathetic Nervous System activity, and your ability to cope with stress and Panic Attacks.

3.Avoid Tea, Coffee, Coke and other Caffeinated drinks: Caffeine is known to activate the Sympathetic Nervous System. So when your SNS is already in an overdrive, it is best to avoid these. Let your SNS calm down, and till then, try finding replacement for these drinks in Green/Matcha Tea or Water or Chamomile Tea. Try to completely avoid these beverages on days that are likely to be more stressful.

4.Stop consuming Negative Content: Stop consuming negative content of any kind — news, videos, horror movies etc. — and replace these with Fun content: content that can make you laugh, teach you positive aspects of existence, life etc. Keep such content — stand-up comedy videos, cartoon or comic movies — downloaded on your phone to keep you in good stead during flights etc. This is needed atleast for the duration till your SNS learns to stay in a settled state for longer.

5.Build Positive Self Image: Positive self image helps you gain better control on your emotions and feelings, which in turn helps you feel more in-charge during stressful situations. One can work on building positive self image by:

a. gaining a better understanding of one’s own strengths and weaknesses. A simple exercise of writing down all the successes and high-points in the past is a powerful way of realistically assessing one’s strengths.

b. practicing self-care by following a vibrant lifestyle involving regular exercise, healthy food habits, adequate sleep and pursuing hobbies that bring you joy.

6.Surround yourself with Positive People: If you happen to be in company of negative people — people who are pre-disposed to complaining, anxiety, stress — seek their help by honestly telling them that you are experiencing Panic Attacks and one of the therapies is to avoid stress of all kinds. If they care for you/love you and understand you, they will comply and restrict or rephrase such communications. And who knows, they might end-up transforming themselves in the process!

7.Supplement your way through: Vitamin Bs are known to help mitigate anxiety. Best is to consume Natural Vitamin B in form of Nutritional Yeast. They taste like cheese flakes and can be sprinkled over any food. Also helpful are Vitamin-D, Magnesium and Omega-3s. Find good sources of these supplements. I personally use MgD3 which provides me with both Magnesium and Vitamin-D, along with the required Omega-3s. There are certain common foods that have been proven to alleviate stress and anxiety.

8.Reinforcements: While the above strategies are effective, you might still need a few reinforcements to feel comfortable during stressful situations. Some of the reinforcements I used are:

a. Water bottle — I keep a small water bottle and sip from it whenever I experience anxiety.

b. Challenging Catastrophizing — one key feature of Panic Attacks is catastrophizing events. Having thoughts such as “if I have a Panic Attack, I won’t be able to breathe” OR “I would get so scared that I will pass out” OR “other people would notice my Panic Attack” — is normal for people suffering from Panic Attacks. The trick is to reason out the Catastrophizing. For instance, you can challenge the above thoughts by asking questions such as “how bad is it really if I pass out — I am sure someone will do the needful” OR “people noticing — is it a hassle or a horror” OR “I have never been embarrassed in the past — it turned out alright. Didn’t people notice once and then resumed what they were doing?” OR “I do notice my chest pain accompanying my anxiety — it is a part of the Fight-or-Flight response and will subside when my Parasympathetic Nervous System kicks-in” etc.

c. Activating Pre-Frontal Cortex — Mental Challenges, such as puzzles, sudoku, cross-word or brain training games, or any activity that requires problem solving and/or memory retrieval activate brain’s Pre-Frontal Cortex (PFC), which in turn has an inhibitory control on Sympathetic Nervous system. So engaging oneself in one such activity during a stressful situation will activate the person’s PFC, and help prevent a Panic Attack.

d. Realizing that Anxiety or Panic Attacks are NOT dangerous. So even if Anxiety or Panic Attack does kick-in, having this awareness helps the episode ebb swiftly.

e. Low strength prescription based anti-anxiety pills — I kept these only for psychological comfort, and NEVER consumed them. I do not consume them since these medicines interfere with the body’s chemicals, which are already in disarray for a person suffering Panic Attacks.

It is important to realize that some of these are relatively easy to follow (meditation, avoiding certain beverages, not consuming negative content, supplements), and can be implemented immediately, while some others (positive self-image, positive companions), can just be initiated, with a clear resolve that you will follow through with them for the purpose of definitively managing your Panic Disorder. Remaining are things you can do in a stressful situation to help keep a Panic Attack in check.

Conclusion

Panic attacks can be frightening, but with understanding and effective coping strategies, you can almost effortlessly handle them. Remember that Panic Attacks triggers are internal — unknowingly fostered through stressful lifestyle, over-thinking etc.— and thus you are the one who will be able to handle it the best. With time and the right attitude, understanding and tools, you can find calm in the face of anxiety and begin to live a more balanced and peaceful life.

Here is wishing you the same!

Disclaimer: This article is for informational purposes only and should not be considered a substitute for professional medical or mental health advice. Always consult with a qualified healthcare provider if you have concerns about your health or mental well-being.