Anxiety

Overcoming Panic Attacks: 6 Strategies That Work

Your body is short-circuiting. Is this the end? Nope, it's a panic attack.

Posted May 28, 2020

Panic is no picnic: You get hit with a tidal wave of fear. Your body short-circuits. You’re convinced that this is the end—you’re either dying or going crazy. In short, panic is an awful feeling, and the 1 in 4 Americans who have experienced it often go for months or even years without knowing what panic is or what to do about it.  

Fortunately, panic is straightforward to treat. Working with a trained cognitive-behavioral therapist is your most surefire way to get personalized treatment, but here are six methods you can try on your own:

Strategy #1: Practice the symptoms you’re afraid of. 

I know, I know—inducing the physical sensations you experience during a panic attack on purpose is the last thing folks with panic want to try, but hear me out. 

Interpreting the symptoms (a pounding heart, feeling lightheaded) as dangerous (“I’m dying!” “Something’s horribly wrong with me!”) throws fuel on the fire. Symptoms snowball and over a matter of moments, you find yourself in the midst of a full-blown panic attack.

Therefore, by intentionally bringing on the very symptoms you’re afraid of, you can practice having them outside the context of an attack. Eventually, you’ll stop seeing them as threatening. You’ll learn your body can handle a racing heart or a tight throat. When you practice having your own symptoms, you’re always in the driver’s seat and you’ll get the chance to habituate, or as I like to say, your brain will get bored.  

So if you’re worried about a pounding heart, set a timer for one minute and knock out some high knees or burpees. Terrified of feeling dizzy? Set that timer, sit in an office chair, and spin around and around until the time is up. Shortness of breath feels awful? Breathe through a coffee stirrer for one minute. Lightheadedness? Lie on the floor for a minute and then stand up quickly to induce a head rush. Do you get a sense of unreality when you panic, like the world is a dream or nothing is truly real? Get really close to your hand or a wall and stare at it for a minute. It gets a little freaky, which is exactly the point. 

The trick? Stop when the timer says stop, not when your body wants to bail. It’s important to hang in there so you learn you’ve got this. Repeat every day until it’s totally boring.

Strategy #2: Bring it on.

This sounds weird, but in panic disorder, which is fear of having a panic attack, a little reverse psychology works wonders. When you start to worry about panic or feel that first twinge, tell yourself, “All right body, I want more. Let’s do this! Hit me with your best shot!”  

Ironically, being willing to feel panic symptoms will stop the cycle of escalation. After all, panic is the fight-or-flight response gone haywire, so when you try to fight panic itself, it all amplifies exponentially. By contrast, when you welcome in the sensations of fear, your body has no reason to fight or flee.

Think of when you were a little kid and you would make yourself dizzy on purpose or pump higher and higher on the swings to feel your stomach drop. Back then you weren’t just willing to feel the sensations, it was downright fun. Tap into those memories and lean in.

Strategy #3: Remember it’s just anxiety. 

Panic is all in the interpretation. Think of it this way: It’s 3 a.m. and the phone rings. What happened? Well, it could mean your sister is dead, your brother needs to be bailed out, or your teenager is in the emergency room. But it could also mean a wrong number, a prank call, or someone who got their time zones seriously mixed up. Until you pick up the phone, the reason for the call is a product of your interpretation.  

So it is with anxiety. Instead of interpreting it as “I’m dying,” think, “This is just my overly sensitive burglar alarm. I’ve felt this before. I wasn’t dying then, and I’m not dying now.” Interpret the anxiety not as something dangerous, but as something annoying you’ve handled before and can handle again. It’s just anxiety.

Strategy #4: Come up with a new thought. 

The thoughts that go through our head—the cognitive symptoms of panic—are scary: I’m dying, I’m going crazy, I’m going to pass out, I’m going to throw up and humiliate myself. The list goes on.

So when you feel panic starting to rise, talk back to your thoughts in a new way. One patient made her new thought, “I got this.” Another pictured the wave of panic as an ocean wave to surf—what went up would inevitably come down. And a third decided on none other than “F--- you, anxiety!” Choose what works for you.

Strategy #5: Slowly inch into panic situations.

One client of mine had a panic attack in a spin class and not only didn’t go back, but also stopped exercising entirely. She wouldn’t even take the stairs. She was worried that getting her heart rate up would induce another panic attack, something she never, ever wanted to experience again.  

So, to fight her panic, in addition to challenging the thought that her heart couldn’t handle exertion, she also started slowly inching back into exercise and getting her heart rate up a little at a time. First, she jogged a few steps, then a block, then around the block, and slowly, she got herself back to the gym.  

If it’s a place you fear, like being worried you’ll have a panic attack in the middle of the grocery store, start by going in to buy one item close to the checkout lane. Next time, grab a basket and browse, deliberately taking a little longer. When that’s boring, grab a cart and do a week’s worth of shopping. Don’t try to rush through it and get out. Take your time. Don’t move on to the next level until the current one is easy. Remember: Your brain has to get bored.

Strategy #6: Avoidance feeds panic.

Think of a situation that makes you panicky—I’ll bet you white-knuckle it until you can’t stand it anymore, and then quit, which makes you feel better. 

But consider this: While quitting does make you feel better in the short-term, it also reinforces the idea that what you’re doing was truly dangerous, and getting out is what saved you. This makes sense if you’re feeling panicky about swimming with sharks while you have a nosebleed, but it doesn’t make sense if you’re feeling panicky about crossing a parking lot, sitting in a restaurant, or riding the subway. You must be willing to endure a little anxiety—emphasis on little; never more than you’re ready for—so your brain can round the corner and start getting bored.  

But you don’t have to jump in with both feet. Aim for inducing about a 3 on a 1-10 scale. You need to start with some anxiety, in order to give you something to work with. Experience the 3, and then wait it out. Your anxiety might escalate to a 4 or 5 at first, but if you stick with it rather than quitting, it will go back to a 3, then a 2, and then a 1.  

Try it out. Do the thing you’re scared of, a little at a time. Your brain will get bored, but you have to let it get over the hump. Then you can move on to the next step. As you master more and more situations, even the things you thought would be 9s or 10s will start to look easier.  

Before you know it, you’ll be driving across bridges on windy days and sitting smack in the middle of a crowded restaurant. Which is infinitely more fun than sitting in the emergency room with doctors telling you nothing’s wrong.