I have to admit to leading something of a double life: on the one hand I write about confidence, but I also suffer from panic attacks and anxiety. Having a panic attack is one of the most unpleasant experiences I've ever had, and even just mild anxiety can make life pretty painful. It's not something I'd wish on my worst enemy. Well, maybe just on the really bad ones.
So here's how to handle a panic or anxiety attack:
Recognize The Symptoms
Most people I know who suffer from anxiety or panic attacks didn't recognize what was happening to them when they first had a panic attack. They were just going about their daily lives when suddenly: BAM! Their heart started racing, they were overwhelmed with fear, their bodies started shaking, they couldn't concentrate, they became exhausted and just had to stop everything they were doing. Some thought they were dying, or were having a heart attack.
I was overseas traveling alone in France when I had my first full-blown panic attack, and the word “frightening” just doesn't cut it. It was fucking terrifying, and I found myself throwing up out of sheer terror. Fortunately I had a sympathetic friend back home I could call, and recognized what was really going on.
Understand What's Going On
Another common theme among most people I know who have had panic attacks is: a life time spent suppressing their emotions. Most western cultures have a pretty bad track record of shaming us when we express how we feel, and many of us learn as children to repress any emotion from sadness, fear and anger, to joy, love and excitement.
When an animal in the wild is attacked by a predator, the fear will cause them to respond in one of three ways: to fight, to run (flight), or to freeze (play dead, deer in the headlights, etc). If the animal is fortunate enough to escape the predator by freezing, they will typically shake for a few seconds afterward to liberate the fear from their nervous system. Unfortunately we often teach children not to show their fear, to “be brave”, and to shut down this natural healing response.
If we habitually suppress our emotions the pressure in our nervous system builds up to the point where it can suddenly explode with overwhelming panic much later in life. There may be little or no trigger for the panic attack; all it may take is a slightly nervous situation for the pressure cooker of pent-up emotion to explode as our nervous system releases itself.
Remind Yourself That It Will End Soon
Once you realize that a panic attack is just your body's way of releasing pent-up emotion, you will feel less fearful and be able to remind yourself that it won't last forever. Every panic attack I've ever had has come to an end, usually fairly quickly. Albeit not as quickly as I would have liked, and often for a while afterward I would feel anxious about whether it's coming back again. But they do pass. The more I tried to avoid, ignore or make the feeling go away, the longer it hung around.
One teacher suggested to me that the best way to handle a panic attack was simply to lie down, remind myself that it was just my body releasing pent-up fear, and wait for it to pass. Don't try to suppress the fear or push it away; that's what caused the problem in the first place. Accept that right now you feel fearful, and that in a while you will not.
Talk To Someone
Anxiety attacks are one of the most unpleasant and unnecessary experiences you can have. The simplest way to start releasing the pressure of the unexpressed emotions that lead to them is to talk to someone about exactly what you're going through and particularly how you feel about it. Often we may feel shame and reluctance at wanting to do this, and this is simply the same shame that stopped us from expressing how we felt in the first place. I'm still frequently amazed when I tell people that I get anxiety attacks at how many other people have exactly the same thing; yet I would generally never have known just by meeting them.
I've spent most of my life pretending that I wasn't afraid of situations that scared me a great deal; and the longer I pretended the more pressure I built up. I have found myself bursting into prolonged bouts of sobbing after telling someone else just how fearful I really felt, and starting to let some of the fear, sadness and trauma around the anxiety attacks out.
Don't let fear and shame get in the way of you getting professional help if you need it. Many lay people aren't well equipped to deal with your anxiety because it triggers theirs, and their defensiveness may make them less than sympathetic about what you're going through. A good therapist, counsellor or psychologist can give you the support that you need; just make sure that the therapist you go to shows you lots of empathy. They should be encouraging you to talk as much as possible about how you feel, and prodding you to avoid getting stuck in your story or your thoughts. The most effective therapy I've found for dealing with anxiety is Acceptance and Commitment Therapy.
Remind Yourself That You Can Handle It
Another good idea is to remind yourself that a panic attack isn't the end of the world, and that you can handle it. You've survived before, you'll survive this one, and you'll survive the next one too should it ever happen. Catastrophising by telling yourself that this is a disaster, that it's terrible, and that it shouldn't be happening just tend to make you feel even more fearful. When you talk to other people about your experience, avoid labelling it is “horrible”, “awful”, “terrible”, “dreadful”; on the other hand don't minimise your suffering either, but try just saying that it was challenging and expressing how you felt about it. Part of you probably even likes a challenge.
Most of all, remind yourself that you can handle this.
A panic attack floods your system with adrenaline on the false assumption that you have to mobilise yourself from a predator that doesn't exist. All that adrenaline is why your heart starts racing and it has to go somewhere. One of the best ways to burn it off is to do some vigorous aerobic exercise. I find jumping with a jump rope, like they use in boxing gyms, the most effective way to do this. The bouncing up and down seems to help stimulate the nervous system, and I'd much rather skip than jog. If you prefer jogging, swimming or cycling, more power to you.
Follow up your aerobic exercise with some strength exercise, like push-ups or weightlifting and you'll feel stronger. Exercise not only helps burn off he adrenaline, it also improves your fitness and strength, which makes your body feel less vulnerable and hence less prone to panic in the future. Exercise also helps move your attention from your neurotic thoughts and feelings to your body, and is the best antidote available for depression, anxiety's closest sibling.
Learn To Relax
People keep reminding me that I need to learn to relax. They're right. When we're stressed out and tense all the time, that's a recipe for anxiety. Too much of that and our brains start sending us panic until we get the message.
You need to learn to relax if you want to avoid future panic and anxiety attacks. Meditation, Yoga, and time-out with a good book can all help. But you need to do them regularly, not just when you're feeling anxious. Make regular relaxation a part of your daily routine and learn to break the adrenaline addiction that makes us go-go-go all the time.
Ask Yourself: Is It Really Fear?
The fear we experience during a panic attack is out of proportion to the immediate threat that we encounter. Sometimes there may be no threat at all; at other times the only threat may be the fear of another panic attack, given that they are so unpleasant. When our nervous system is filled with years of bottled up emotion, it may come out as fear even though it's really something else in the pressure cooker.
In my case, I forced my anger down hard because I saw the destructive effects that it had in my parent's relationship while growing up and I promised myself I would never be like them. I didn't know at the time that anger could be expressed positively, so I just assumed it was a bad thing that had to be suppressed at all costs. Now I understand that it's just an emotion that needs to be expressed constructively. So when I get overwhelmed with anxiety for no apparent reason, I go into a room by myself and start yelling and screaming about all the things that are currently pissing me off. I literally have an argument with myself. Letting the anger out makes the anxiety go away.
Any emotion bottled up hard enough for long enough can lead to a panic attack down the track. The key to mastering your emotions so you don't have to suffer from panic attacks in the future is to learn to express your feeling constructively. For more this, read Section 2: Emotional Mastery in Confident Man.