How to Get Through a Panic Attack
I have panic attacks.
I think lots of people do.
I believe panic attacks are the body processing intense emotional or physical experiences that the mind cannot always wrap itself around. I think something big happens and the mind closes up shop, so the body has to take over and deal with it quickly via a panic attack. Truthfully, I believe panic attacks arise because they are trying to help, not harm.
I also believe that panic attacks happen to everyone in varying degrees of severity, length, and form. Life is essentially traumatic, and we aren’t taught to cope with the turmoil of it in a healthy way. I know folks who had panic attacks triggered by large crowds, death of a loved one, rape, abuse, violence, illness, fatigue, stress, or leaving their spouse. The reasons behind panic attacks are endless and they are nothing to be ashamed of.
What is common (in my own panic attacks, at least) is that they conform to a repeating pattern that I’ve come to rely on and occurs in three distinct phases: a trigger, the panic attack itself and recovery (which also has three distinct phases). Knowing that there is a pattern, specifically during the recovery phase, has been like following breadcrumbs through a dark forest. It has helped me find my way back home to myself, and my hope is that it can do the same for you.
First a Disclaimer: I'm not a psychologist. I am not trained and hold no certifications for this kind of work. This writing is my interpretation and perspective on what happens before, during and after my own panic attacks and how I navigate the pattern of my own experience. Please take what pieces work for you, mold them for your own use, and discard the rest. If you are having severe or life threatening panic attacks, please seek professional help.
Phase 1: The Trigger
A trigger is the subconscious connection of an internal or external stimulus with an intense emotional or physical experience. Triggers happen lightning fast and can be internal (like a thought, emotion, or sensation) or external (like a sight, sound, or smell). Triggers can be anything from a confined space, to a string of specific words, to a holiday, or the anniversary of a death. The primary thing all triggers have in common is that they generate some kind of internal response.
When you get triggered, remember to take slow, deep breaths. Some triggers will fizzle out right then and there, like blowing out a match. Others will ignite into a panic attack and that’s okay too. It is important to remember that you have done nothing wrong to deserve this trigger or this panic attack. You have nothing to be ashamed of.
If the trigger heads toward a panic attack, get to a space where you feel safe (like your car, a bathroom stall, or with a trusted friend). Having these safe spaces mapped out ahead of time can add comfort to an otherwise uncomfortable process.
It can be difficult to effectively communicate the urgency of a trigger to others without exposing too much vulnerability and detail. Especially in an office environment, for example, it wouldn’t be entirely appropriate to say, “I’m triggered right now!”. Instead, try these words: “I’m upset. I am okay and you don’t need to worry. I just need a few minutes to go and collect myself.”
Phase 2: The Panic Attack
A panic attack is the body processing intense experiences from the past or present. Their length can vary from seconds to minutes, and some people report panic attacks that last hours or even days. I don’t know if a panic attacks are the same for everyone, but my own start with tunnel vision. My hands and chest shake. Then, I feel submerged in memories and emotions that appear in quick, yet complex explosions. They seem to taper off at some point on their own accord. Returning to the present, I notice a blank spot where the last handful of minutes should be: I call that blank spot ‘lost time’. Trying to remember lost time is very much like trying to recall a dream: doable, but fuzzy.
I think what is most important to remember is to breathe. Most people feel like they are suffocating during a panic attack, like the air refuses to go into the lungs. This creates more panic and less breathing, which creates more panic, and so on. You don’t have to breathe deeply or in any specific way. You don’t even have to remain calm. You just have to inhale and exhale. Breath through the fear the best you can.
An anchor is a strong sensation that is rooted in present time. An anchor can be a hot shower, cold snow, heat in the cheeks, holding a hard table, a secure hug or blanket, or pinching the skin of the hand. It is something you can touch, feel, or hold onto to help draw you back to the real world. Practice grabbing onto an anchor when you enter into a panic attack. It can help you ground before, during, and afterwards.
I find that I am unable to communicate anything about this phase to others while I am in it. I simply cannot form the words. Are you able to communicate during this phase? If so, how do you do it and what have you said that has worked for you?
Phase 3: The Recovery
Recovery is how we integrate the intense experience into our psyche and soul so that we can complete the cycle and, if we must return to that same intense experience via a panic attack, do so with less severity and frequency. There is an idea the Buddhists call ‘inherent goodness’. It is the belief that we are born whole and good, and it is the cruelty of life that breaks our heart into cruel pieces. I don’t know about you, but panic attacks leave me feeling shattered. Honoring recovery with gentleness and space feels like repairing myself with gold, and remembering my inherent goodness.
Recovery (for me) can take anywhere from three days to three months and has three distinct phases: returning to the body, heart, and soul.
Returning to the body is, primarily, about soothing the body. I often shake uncontrollably at this point, even if it is warm outside, so wrapping myself tightly in soft blankets or cozy clothes, taking a warm bath, or drinking hot tea (actions that I associate with comfort and safety) can help.
It is important to remember and reiterate that you are safe. You have made it through your panic attack. You have survived.
Practice reciting things you know to be true right now such as: your name, age, where you live, where you sleep, what story of the building are you on, what are you wearing and where you got the clothes, etc. Say these things out loud, if it helps.
If someone was around during or after your panic attack, I have found it helpful to communicate something physical that I need (like a hug, a cup of coco, or a blanket). Asking for what you need (during panic attacks and otherwise) strengthens a bond. Our loved ones can feel just as helpless (if not more so) than we do during the phases of panic attacks because they don’t know how to help. Asking for what you need can feel super vulnerable, but it will help soothe your body and allows others to offer support.
Returning to the heart is about allowing emotions to flow. The first emotion I usually feel after my body has been soothed is rage. I often repress the anger and instead become agitated, anxious, and frustrated. I get snippy at silly things, mean, and hateful. I am trying to regain my boundaries and a sense of myself.
When I have allowed my anger to cycle, next comes grief. I am impossibly sad. Grief, for me, is wrapped in an all-encompassing depression. It requires all my mental effort just to exist, to put one foot in front of the other, and even to get out of bed. I cannot make any plans or commitments when I’m like this.
The last emotion are what I call ‘shame days’, and I basically hate myself. I hate who I am, how I act, how I look, what I say, what I think, how I treat people. I question everything about myself and who I am and in my mind is an immediate and unrelenting internal criticism. On shame days I cannot make decisions and I am, in a lot of ways, paralyzed.
I think it is helpful to remember that emotional work can be exhausting work. As I’m going through the recovery phase, returning to the heart, and navigate emotions, I feel like I’ve been steam rolled so flat that inhaling is an effort. It helps to honor the exhaustion, to treat myself just like I would if I were ill: with extra sleep, nutritious food, and gentle actions.
Practice accepting whatever emotions arise. Try not to dismiss, judge, or deny. You are allowed to feel exactly what you feel. Focus on what’s in front of you. Put one foot in front of the other. Take it one minute, one hour, or one day at a time.
Communicating this part of the recovery phase to people who aren’t my close circle is delicate. It has been a practice to communicate the feeling without communicating the specifics. I say:
- I’m feeling down today,
- I’m feeling disheartened, or
- I’m having one of those ‘what’s-the-point-of-it-all’ days
When communicating to the people I love, I try to be honest and open. I try to communicate what I’m feeling while also expressing that they didn’t do anything wrong.
Returning to the Soul is about integration. Integration means to blend into a functioning or unified whole (Websters). It’s about taking the lesson from the intense experience or panic attack and applying it to your life today.
Here’s what I mean, have you ever seen The Sixth Sense? Spoiler alert: it’s about a kid who sees dead people. He is haunted by ghosts that attack and abuse him and he seeks help from a therapist. In the end, he discovers that it’s the ghosts who need help. They need this boy to hear their stories and help them with specific tasks so they can move on. I think our triggers and our panic attacks are like those ghosts. They appear in our lives and, in terrifying and utterly inconvenient ways, ask for our help. I wrote in my book, Your Fearless Soul, that being fearless doesn’t mean you are without fear. A Fearless Soul faces that which it fears the most, which can include facing those ghosts.
Each panic attack, each trigger has meaning. They are desperately trying to communicate some vital piece of information to our psyche and our soul. Imagine your panic attack had voice and practice asking it: what are you trying to tell me? What are you trying to teach me right now?
The learning may be:
- A forgotten truth,
- To surrender or release,
- To forgive,
- To make self care a higher priority,
- That it is time for you to leave,
- That is is time for you to fight,
- It is okay to rest, or (my personal favorite)
- The past really did happen and you aren’t crazy.
Integration and the answer to the questions always lie in gentleness. Be kind to yourself. Be gentle to your heart and soul. Be accepting of whatever answer comes to you.
A FINAL NOTE
I notice that if I have missed any of the steps in the recovery phase (soothing the body, feeling the emotions, and integrating the experience) I tend to go back and revisit whatever phase I missed. I’m not entirely sure why, but it seems like they each build on each other, like steps out of a hole in the ground.
What about you? What is your experience with these phases? What works for you to get through triggers, panic attacks, recovery? What doesn’t work?
My favorite book for navigating emotions:
The Language of Emotions, by Karla McLaren
My favorite speaker on vulnerability and shame:
Brene Brown (check out her TED talk)
My favorite book for accepting what is:
My favorite heart and soul artwork: