• Karen McPhail, RN, MSN

Managing Panic Attacks

Panic attacks are more common than most individuals realize. It is estimated that 1 in 10 adults in the U.S. experience panic attacks each year. And that about 1/3 of our population will have one at some point during their lifetime. Many individuals do not realize how to manage these situations or even what triggers their attacks. Their overwhelming sense of dread, fear, panic, the pounding heart beat, and rapid breathing is something that becomes paralyzing. So aside from medications how can these attacks be managed?

Below are some therapeutic interventions that can be tried.

1. Breathing exercises and techniques:

The first and most important step to take is in terms of your breathing! Controlling your breathing will help you to decrease your symptoms and anxiety. Hyperventilation which often occurs becomes a vicious cycle that leads to more anxiety, fear, and eventually dizziness or light headedness. Close your eyes to take away outside stimulation and focus on slowly doing deep stomach breathing rather than fast shallow breathing. Have a mantra to say in your mind as you inhale and then exhale such as I am happy, I am peaceful, I am safe, I am grounded, I am balanced. Slowly gain control over your breathing by focusing on each breath and your mantra. Over time and with practice, deep stomach breathing with focus will help you to slowly gain control, help your nervous system to relax and offer a viable means to manage and move past these issues. Gaining control is key and you hold the power within to do this.

2. Mediation, mindfulness, and relaxation techniques:

People often underestimate the value of relaxation, mediation, and mindfulness. I often recommend a daily meditation practice. Start off slowly and set realistic goals such as I will meditate for 5 minutes each morning. Over time increase the amount of time until you find a comfortable amount that works for you! I often find that meditating each am is a good way to clear ones mind and move forward without the clutter of the day clouding things. It is a way to start off fresh with a new beginning. I also recommend meditating in the pm at bedtime as a way to remove the clutter of the day, settle ones mind, relax and prepare for sleep. Guided mediation tapes can be very helpful, or simply putting on meditation music and quieting your mind. It may take time to find the right mediation routine so be patient and try not to get frustrated. Let it come naturally without expectations or pressure. For many a tree meditation works well and can be found online. The overall goal of this is to slowly train yourself to have control over your mind and body. With regular practice you will develop control over your nervous system and be able to use these techniques to relax and ease symptoms when pack attacks occur.

Other relaxation techniques such as yoga can be added to supplement and be of an overall health benefit. Yoga also helps one to develop a routine and learn control over their mind and body. Yoga combines movement with breathing. It helps to assist with relaxation and has a happy, satisfying, calming effect. A daily yoga class can set the proper tone for each day. With a daily meditation and yoga practice in place one can be better prepared to minimize and manage potential triggers and stress that may resulting in a panic attack.

3. Behavioral therapy:

Regular therapy can be beneficial to assist some individuals in moving past panic attacks. This can be used in conjunction with other items above. In therapy you can explore further what may be prompting or triggering these issues or your reaction to anxiety. With further insight one can then begin to modify and adjust specifics of their life to make a positive impact. Dysfunctional patterns can be addressed and positive and healthy patterns can be discussed and established. Individualized techniques based on anxiety triggers can be formed. When you understand more about your anxiety triggers and causes it is easier to reduce symptoms and begin managing.

4. Imagery exercises:

Similar in principle to mediation guided imagery can be beneficial for those who experience panic attacks. During therapy one is assisted in creating a safe space or safe place that helps them to become calm, relaxed, and peaceful. Each person will have a different experience with this clearly. During this type of therapy the individuals will be guided to focus in-depth on the details of their safe space, thus creating calming thoughts, and visual images that can then be called upon later to defuse and minimize stressors.

5. Other helpful techniques:

Exercise can be very helpful as it is a mood elevator and can calm a stressed and overactive mind. Find something that you enjoy doing and the fits your physical needs; walking, running, biking, pilates all can help one to keep a positive mindset and feel as if they are doing something positive and productive.

Music and aroma therapy can also be of benefit and create calmness and elevates ones mood. Lavender is a natural calming agent. Lavender oils and sprays can be helpful to ease stress and panic attack triggers. Having a standard song that is used for meditation daily can be helpful as the music can be played when you are having panic attack symptoms and your mind will be trained, conditioned, over time to sense the music and respond with a calming response. It creates an auditory happy and safe place. Music can also help to de- stress and be used as a method to shield one from potentially anxiety producing situations. Always have a set of headphones on hand so they can be used if needed while out and about. Decreasing external stimulation can also help. One may want to close their eyes if beginning to feel over stimulated or feeling trigged for a panic attack. Decreasing external stimuli will help one to focus on their breathing and other techniques to then decrease and ease symptoms.

Finally medications are sometimes needed in addition to the above interventions. A mental health professional can assist in finding the best possible fit if needed.

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