- Although no one knows what causes panic attacks, it is possible to stop them.
- One quick maneuver involves activating the diving reflex.
- It's a basic distress-tolerance skill for those times we feel overwhelmed.
Panic attacks are seemingly formidable adversaries. They're frequently described as merciless, unrelenting, and striking without warning or provocation. Are panic attacks the enemy? Or are they mere messages about our stress levels?
The Diagnostic and Statistical Manual of Mental Disorders (5th Edition) or DSM-5, describes panic attacks as "an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes," followed by a series of physical symptoms, including sweating, trembling, dizziness, and racing heart. According to the Anxiety and Depression Association of America, panic disorder affects 6 million adults, or 2.7 percent of the U.S. population. Panic disorder is defined as recurrent and unexpected panic attacks and persistent concern about additional attacks or their consequences.
Of note, individuals with other psychiatric conditions can also experience panic attacks, more specifically individuals with social anxiety disorder, or SAD. A 2015 study even suggested that situational panic attacks associated with the fear of specific social situations such as public speaking could aid in diagnosing the severity of SAD.
What are the Symptoms?
According to the DSM-5, panic attacks entail at least four of the following physical symptoms:
- Pounding or racing heart
- Breathing problems
- Weakness or dizziness
- Tingly or numb hands
- Chest pain
- Stomach pain
- Derealization (when people and objects seem unreal)
- Depersonalization (being detached from oneself)
- Fear of losing control or "going crazy"
- Fear of dying
What Causes Panic Attacks?
There is no known cause of panic attacks, but the medical and psychological fields have several theories. These theories include genetics; a chemical imbalance of neurotransmitters such as serotonin, GABA, and cortisol; adverse childhood experiences; and hyperactive regions of the brain associated with fear and memory, such as the hippocampus, amygdala, and medial prefrontal cortex.
Please note that these tips do not remedy the root cause of panic attacks. They are simply coping skills to help empower you and to assist in regulating your emotions.
Activate Your Diving Reflex
Materials Needed: Bowl of Cold Water Between 55-65 Degrees Fahrenheit, Ice if Necessary
Please note that it's recommended that the water temperature not fall below 50 degrees Fahrenheit as you could experience facial pain during submersion.
Disclaimer: If you have a pre-existing allergy, medical, heart, or blood pressure condition, please consult your Primary Health Care Physician before trying this exercise.
This technique is a go-to distress-tolerance skill taught in Dialectical and Behavior Therapy (DBT) for use when our emotions are at an all-time high—and we can all agree that 2020 left us in need of more coping skills. Activating our innate mammalian diving reflex is an easy and holistic way to get heart rate down—and down fast.
All mammals, including us, are equipped with this ancient safety instinct. Researchers suggest that the evolutionary adaptation may have developed to help conserve oxygen during times of asphyxiation, such as drowning. The primal reflex is activated when receptors in our faces, specifically, our nostrils and sinuses, are subjected to and submerged in cold water.
The technique entails dipping our faces in a bowl of water below 70 degrees Fahrenheit (but not below 50 degrees Fahrenheit) for 10 -20 seconds, coming up for a breath, and repeating the process up to three times.
Please feel free to alter the amount of time holding your breath according to your comfort level. The immediate effects of "tipping" the temperature include activation of the parasympathetic nervous system, the branch of our autonomic nervous system responsible for rest and relaxation, and a sudden and substantial decrease in heart rate. What could be more useful for a panic attack?
Suppose the panic attack strikes while you're at school or work, and using a bowl of water isn't feasible. In that case, you could always utilize a portable instant cold pack and place it across your sinuses (covering eyebrows and cheekbones) while holding your breath, but this could diminish the effects for adults.
Watch the diving reflex demonstration below.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Linehan, M., M., (2014). DBT Training Manual. New York, NY: The Guilford Press.
Rathus, J. H., & Miller, A. L. (2015). DBT®skills manual for adolescents. Guilford Press.