How to manage panic attacks

Panic attacks can occur anywhere. You might be on public transport, in a crowded place or meeting a new person.

All of a sudden, your heart might begin to pound and your mind may start racing.

You might be triggered by something that’s happening around you, or simply by considering something that might happen. Regardless of what sets it off, a panic attack can be terrifying.

Often, panic attacks are a symptom of a deeper issue. In other cases, though, it may just be a one-off incident.

Whatever the trigger, understanding what panic attacks are, and how to manage them, is an important step in dealing with your mental wellbeing.

According to psychologist Dr Sasha Lynn, “A panic attack is an intense surge of fear or discomfort, which reaches a peak within 10 minutes, and involves a number of physical and emotional symptoms.”

These symptoms can include:

• increased heartrate
• tightness in your chest
• shortness of breath
• nausea
• a heightened sense danger
• a fear of death or losing control
• feeling dizzy or lightheaded
• shakes, tingles, sweating or hot flushes.¹

“They don’t just occur in anxiety either,” Dr Lynn adds. “They can happen in a bout of depression, substance use and other difficult areas of life.”

While anyone can have a panic attack, women are almost twice as likely to experience them as men.²

Understanding when you’re having a panic attack (and knowing how to deal with it) can help you realise that the situation is not life threatening and that calming down will help it pass.

“Recognising your early warning signs is helpful, and once you feel them coming on, learning to calm the body down with breathing and progressive muscular relaxation can be helpful,” says Dr Lynn.

“Once the body is calm, it’s time to work on the mind, learning to recognise those thoughts that are unhelpful, and challenging them.”

Dr Lynn adds that this isn’t as simple as ‘positive thinking,’ however.

“Because let’s be honest, there isn’t much to be positive about with a panic attack.”

If you have a specific thought or situation that triggers your panic, it might seem logical to simply avoid that thing in order to prevent an attack from occurring. But in fact, the opposite is usually true.

“The best way to get over an attack is to go through it,” says Dr Lynn. In this way, you can desensitise yourself to the situation or thought rather than fear it.

“Sit with it, let it peak. And then wait for it to subside.”

On top of that, Dr Lynn suggests “3 core staples” for preventing panic attacks from occurring, which are:

• regular exercise
• regular eating habits
• regular sleeping habits.

Although panic attacks can be triggered by different things for different people, Dr Lynn identifies several common environments and scenarios that may bring them on.

Here are her top tips for dealing with each.

The bus, train or tram can be a hot and crowded place, with lots of smells and bumps that can make even the sturdiest of us feel unwell. So, what can you do when you have a panic attack on public transport?

According to Dr Lynn, you might:

• slow down and take 10 calm, measured breaths
• slowly contract your muscles, holding for 7 seconds before releasing
• focus on the present, finding 3 things you can see, hear and smell
• move to a window or door (if you can).

While our logical brains might recognise the statistical safety of air travel, fear of flying is still a common phobia.³

Learning to manage the symptoms of a panic attack can make your travel experience more comfortable. Whenever you have a flight, Dr Lynn suggests:

• arriving early at the airport to watch the planes take off and land
• trying to get the most direct flight
• letting the cabin crew know how you’re feeling
• taking slow, deep breaths when things get a little bumpy, and reminding yourself that turbulence is completely normal during a flight.

Agoraphobia (an extreme or irrational fear of open or public places) and panic attacks often go hand-in-hand. To manage panic attacks when you’re out in public, particularly when you’re around a lot of people, Dr Lynn suggests trying the following:

• Focus on one specific thing around you, like a familiar face or landmark.
• Break the situation down and stay in the present.
• Use calm breathing and balanced thinking.
• Repeat ‘coping statements’ until the panic passes, such as “I will be okay” or “This won’t last forever”.

It can be particularly difficult to deal with a panic attack when you’re in a situation you can’t get away from, like a class or office meeting.

According to Dr Lynn, it can help to remind yourself that this is only one moment in your career or academic life, and it will pass.

If you experience a panic attack in this situation, you might:

• take slow, measured breaths and practise mindfulness
• find a quiet spot to calm yourself down
• focus on your senses of smell, hearing and touch.

Meeting new people can take you out of your comfort zone. And for some, it can trigger a panic attack.

For Dr Lynn, the best thing you can do in new or unfamiliar social situations is to “go in prepared.” This might include:

• having small talk ideas prepared
• keeping some questions in mind
• calming your body down in the moment by breathing and practising mindfulness
• reflecting on positive interactions that you’ve successfully had in the past.

Having frequent and unexpected panic attacks might be a sign of something more serious, like a panic disorder. If you regularly experience any of the symptoms mentioned in this article, it might be worth visiting you GP to discuss treatment options.