When you have a panic attack, do you know what to do? Or do you just suffer the attack and wait for it to pass?
Not knowing what to do makes the attack much worse. It adds uncertainty and a feeling of helplessness to an already horrible situation, often increasing the severity of the attack and causing it to last longer.
But there are things you can do when you have a panic attack. Simple things. Things that make the attack less severe. Things that make it stop altogether.
By knowing in advance what you need to do when you have a panic attack, it’ll mean the next time an attack strikes you won’t have to think (it’s hard to think when you’re panicking). Instead, you can just act.
In this post, I’ll share the 3 most important things you need to do anytime you have a panic attack. Let me talk you through these 3 things one at a time.
1. Stop the Feelings of Detachment
Detachment is the general feeling that you’re not connected to the world or to yourself. Detachment often happens during a panic attack, and it can be truly terrifying.
If you experience detachment during your attacks, you may feel:
- like you’re disconnected from the world
- like your life is a dream
- like you’re not real
- like you’re not in control of yourself
- like you’re watching yourself from outside your body
If you experience detachment during a panic attack it’s vital that you stop it immediately. Left to do its own thing detachment can snowball to the point where you feel like you’re going insane.
But how do you stop detachment?
Since detachment, by definition, makes you feel disconnected from the world, you need to take action that reaffirms your connection to the world.
You do this by “grounding” yourself.
By “grounding” I mean that you do things that remind you that you’re connected to the world, that you’re present in the moment, that you’re in control of yourself.
Here are my favourite ways to ground myself when I experience detachment:
- speak out loud – hearing your own voice reminds you that you’re present in the moment and that you’re in control of yourself
- interact with something – this can be another person, a pet, or even a piece of technology like your phone or computer. Interacting with anything is a great way to establish your presence in the world
- listen to your recorded self – if speaking out loud doesn’t work for you, try recording yourself speaking and then playing it back during a panic attack. Being able to hear yourself without having to talk “in the moment” can work better for some people
- touch something hot or cold – a shock to your sense of touch can work well in snapping you back into the moment. Try ice cubes or a baked potato fresh from the oven (but don’t burn yourself – juggle it)
- experiment – what works for me may not work for you, so it’s important that you look for your own ways to ground yourself
Feeling detached during extreme anxiety is horrible, but this is something that you can stop. Experiment to find the best ways to ground yourself, starting with my ideas and then looking for your own.
When you find what works, do it the moment you experience detachment as part of a panic attack.
2. Stop Your Anxiety Fidgets
When you’re having a panic attack, you’ll instinctively perform small physical behaviours as a coping mechanism.
I call these physical behaviours “anxiety fidgets.” Here are a few of the more common anxiety fidgets:
- pacing around
- biting your nails
- biting your lip
- hand fidgeting
- playing with your hair
- grinding your teeth
- touching your face
- adjusting your position
- crossing and uncrossing your arms and legs
These seemingly harmless physical behaviours are incredibly damaging during panic attacks, and here’s why.
There’s a strong connection between your body and your mind. When you’re depressed you’ll slouch, drop your head, frown. When you’re happy you’ll stand tall, smile, relax your muscles.
These physical changes happen partly because it’s more natural to slouch when you’re depressed or smile when you’re happy.
But there’s another reason why your physical behaviours change with your mood – conditioning.
Your whole life, anytime you’ve experienced happiness, you’ve smiled, and you’ve done this tens of thousands of times.
You’ve conditioned your mind that these 2 things always happen together. So now, when you’re happy, your smile happens as a reflex.
The conditioning is so strong that this link even works in reverse. So if you smile, even when you’re not happy, you’ll often improve your mood and feel happy.
This is why anxiety fidgets are so damaging.
For years, anytime I was anxious, I would pace up and down my hallway.
In just the same way that my mind became conditioned to smile when I was happy, it also became conditioned to feel anxious when I paced.
Thousands of times I paced when I was anxious, and that conditioned my mind that pacing and anxiety always happen together.
Pacing now produces a reflex response in me to feel anxiety.
So when I paced during a panic attack to distract myself from what I was thinking and feeling, I was triggering a reflex to feel anxiety.
What I thought was helping me was making my panic attack worse.
That’s what anxiety fidgets do, and that’s why they’re so dangerous.
You need to identify your own anxiety fidgets and make sure you never perform them again during a panic attack.
You can stop your anxiety fidgets in 3 steps:
- take note of your own anxiety fidgets next time you have a panic attack
- think of a way to make the anxiety fidget impossible to perform during your next attack (if you pace then sit down, if you bite your nails then sit on your hands, if you grind your teeth then chew gum, and so on)
- use what you’ve come up with to make sure you never perform your anxiety fidgets during a panic attack
You can use these 3 steps to stop any of your anxiety fidgets.
3. Stop the Negative Trains of Thought
A negative train of thought is any series of connected, unpleasant thoughts that you’re unable to stop.
You can experience a negative train of thought at any time, but they’re more likely to happen when you’re having a panic attack.
Here’s how negative trains of thought typically work:
- you’ll have an unpleasant thought during a panic attack
- that unpleasant thought will linger long enough to trigger a second unpleasant thought
- the second unpleasant thought will trigger a third, and so on
- each thought will be worse than the one that came before it
- you’ll have increasingly unpleasant thoughts until you hit on a thought that’s the worst case scenario
Negative trains of thought are damaging because they’re made up of dozens of individual thoughts. So many unpleasant thoughts, hitting you one after another, take a huge psychological toll on you.
Negative trains of thought are also damaging because they always lead to a thought that’s the worst case scenario for the subject that’s on your mind.
The damage that these trains of thought cause means that you cannot allow them to go unchecked if they happen during a panic attack.
But how do you stop them?
The bad news is that you can’t stop them. I’ve tried distractions, relaxation, positive self talk, everything. But the momentum of a negative train of thought is too great to stop.
The good news is that you don’t need to stop them. Instead, you can speed them up. Speed a negative train of thought up enough and it will be over before it has a chance to do any real damage.
Let me explain how this works.
Your negative trains of thought are always the same. You don’t have new trains of thought each time. You have a handful of negative trains of thought that repeat.
In my case, I have negative trains of thought on several subjects: my health, my family’s health, and money. When my anxiety increases it will often trigger one of these negative trains of thought.
You’ll have your own handful of negative trains of thought, and when your anxiety increases, one of them could strike.
Because you only have a handful of these negative trains of thought, and because the thoughts that make up the trains are always the same, you can memorize them.
Once you’ve memorized them you can recall them during a panic attack and move the thoughts along faster than normal.
Speeding up your negative trains of thought is something you should do every single time you have a panic attack, and here’s how to do it:
- become hyper aware of your negative thoughts during panic attacks
- pay attention to individual thoughts and the order they occur in
- after each attack, write down the thoughts you had and the order they occurred in
- do this repeatedly until you see the repeating patterns in each of your trains of thought
- study your notes every day until you’ve memorized each of your negative trains of thought
- during all future panic attacks, use your memory of the trains of thought to move them along faster, forcing yourself not to linger on any individual thought
When you start speeding up your trains of thought it will feel awkward, but stick with it and it will soon feel natural.
As you improve at this, you’ll find you can move the trains of thought along really quickly. The quicker you get, the more benefits you’ll notice.
And what are the benefits?
First, your negative trains of thought will be over much sooner, so you’ll be exposed to unpleasant thoughts for less time.
Second, you’ll gain back some of the control over your thoughts that your anxiety had taken from you.
And third, by memorizing your negative trains of thought you’ll take away a lot of the uncertainty that you used to experience during panic attacks, since you’ll know what thoughts are coming before they happen.
I started out in this post by saying that most people don’t know what to do when they have a panic attack, and so they do nothing but endure the attack and wait for it to pass.
My aim with this post was to change that, to give you solid steps you could take when you have a panic attack, and I hope that’s what I’ve done.
You now have 3 simple things you can do the next time you have a panic attack:
- you can stop your feelings of detachment
- you can stop your anxiety fidgets
- you can take control of your negative trains of thought
Do these 3 things when you have a panic attack and the attack will be much less severe and will end much sooner.
Become familiar with these 3 ideas. Learn them by heart. Then, when a panic attack strikes, you won’t have to think what to do. Instead, you can just act instinctively.
Knowing that you have these 3 simple techniques ready to use when you need them, you never need to have that fear again that you won’t know what to do when you have a panic attack.