If you have anxiety, you may or may not have ever had a panic attack. A panic attack is not just a high level of anxiety, but it is a SUDDEN and INTENSE fear, that peaks within about 10 minutes. You may have a slow build up of becoming more anxious through the day, but a panic attack is a short and sharp experience of very intense fight-or-flight symptoms.

Not sure if your anxiety is a problem? Read this.

Panic Attacks include ​4 or more​ of the following symptoms in one episode:

• Palpitations, pounding heart, or accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of ​s​hortness of breath or smothering
• A feeling of choking
• C​hest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Feelings of unreality (derealization) or being detached from self (depersonalization)
• Fear of losing control or going crazy
• Fear of dying
• Numbness or tingling sensations (paresthesias)
• Chills or hot flushes
  
  Sometimes, there is a very clear trigger for a panic attack e.g. someone with a fear of flying is walking onto a plane. But other times, panic attacks are seemingly random and some out of nowhere.

How to deal with a panic attack

It is very important to remember that panic attacks are NOT actually dangerous. You will not die, are not having a heart attack, you will not stop breathing and ​they always end. ​Because they are so intense and terrifying for people, there is a great deal of fear around having them. But please keep reminding yourself that panic attacks are 1) Not dangerous, and 2) They will always end. Practice the following steps when a panic attack hits:

1) Recognise.

The more awareness you can bring to the fact that this is panic and will end eventually, the better. Recognise that you are experiencing intense anxiety that is most likely out of proportion to any actual danger. Often fighting the feelings, pushing them away or trying to immediately distract yourself can actually increase your fear of panic and give it more power. It is important to remind yourself that panic is never permanent and most panic attacks will pass in a few minutes.

2) Ground.

Now that you’ve recognised that you are having a panic attack, the next step is to ground yourself in the here and now and involve yourself in the present. Instead of giving in to the urge to flee, practice your 5,4,3,2,1 technique (Notice 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 things you can taste). For a full list of grounding tips, see PART 5 of this toolkit)

3) Calm.

Relaxing your nervous system is key to getting through (and sometimes preventing) panic attacks. Slowing down your breathing and counting in and out can be very effective at the first signs of a panic attack. Count to 5 slowing, breathing in, hold for a second, and count to 5 slowing, breathing out. Keep going for at least a few minutes.

4) Distract.

Once you have done the above 3 steps, then you can move on to healthy distraction. Notice that this is not the first step, because many people rush straight to distracting themselves as a way of avoiding how they feel, rather than dealing with how they feel, then choosing to redirect their attention. Distraction can be anything that gets you to focus on something other than the panicky feelings. Talk to someone, put on the TV, sing a song, go for a walk, make a cup of tea, read a magazine etc.

5) Challenge and reassure.

Now you’ve calmed down enough to think again, try to notice what anxious thoughts are running through your head, and see if you can challenge those fears. e.g.

• I know the doctor told me that my heart is fine, this is just my anxiety.
• Remember that panic never lasts forever, I can handle this.
• How can I be kind and reassure myself right now?

6) Move on.

Once you are able to calm down, distract yourself, and challenge the panicked thoughts, the panic attack will end and you can move on with what you want to do. If you need to reach out to a support person, take a break, or get outside and do something enjoyable, now is the time, ​you got through it!

I hope that helps!

Ready to REALLY tackle your anxiety? Read more about My Anxiety Toolkit, all the tools and tricks to managing your anxiety with confidence.