There’s lots of advice on how to overcome panic attacks – from your GP to charities like MIND, from eminent psychiatrists to quack practitioners. Some of it’s good, some of it’s unhelpful. I’m not a professional (at literally anything) so all I can tell you is what works for me. And normally it’s a multi-pronged approach – no ONE thing is guaranteed to nail it. What helps is having a toolbox full of things that help and being able to pull them out when needed.
• Focus on your breathing. In situations like this, there’s a right way and a wrong way to breathe. You probably take shallow breaths when you start to panic – and many people start to hyperventilate (inhaling deeper or taking quicker breaths than usually).[9] Normally, you breathe in oxygen and breathe out carbon dioxide (hello GCSE science). But when you hyperventilate, the carbon dioxide levels in your bloodstream drop. You start to feel sick or dizzy, and this provokes more panic. So you need to calm your breathing down. Easier said than done, I know. I begin by taking one big breath and telling myself, ‘I CAN breathe.’ Breathe in through your nose, and put one hand on your chest and one on your stomach. Notice the breath move through your body – you should feel your stomach move but your chest should remain pretty still. Keep doing this for as long as you need to until you’re convinced that you can breathe.
• Find a quiet place to sit down. If you feel like you’re going to faint (even though you’re not), take a seat, but don’t hunch up. Keep your chest broad so that you can keep on taking proper breaths.
• Notice your surroundings. It helps me to focus on the sky, or on an interesting building, or to watch a dog walk past. Anything to centre you back in your surroundings.
• Try not to rush away. The instinct is SO strong to get the fuck out and head for ‘safety’ but, in doing so, you can set up problems for yourself in the future. If you feel scared in a place and leave before you calm down and realise that there’s nothing to really fear, then your brain tends to designate that place as ‘unsafe’. Then you start to avoid places and your world can get really small really fast. So stick it out if you can. Just as an example, leaving the scene of a panic attack meant that I later avoided:
– Planes
– Lifts
– Busy spaces
– The centre of London
– Sainsbury’s
– Theatres and cinemas
– Motorways
– Coaches (not really, I just don’t like coaches. Not enough toilets)
• Focus on your senses. Touch something soft, stroke your own arm, smell the air. Panic attacks can make you feel very far away from your own body – try and reconnect with it.
• Talk to someone – make eye contact. Stroke a dog, smile at a waiter. It can help to make you see that you’re not in danger. If there’s nobody around, call a friend and tell them that you just need two minutes to talk – a little encouragement from my sister really helps when I’m feeling like I might have an attack.
• Expect that afterwards you’re likely to feel exhausted, trembly and sometimes a little teary. The adrenaline has dissipated and your body is wrung-out. Get yourself some food, drink lots of water, sit down for a bit. Keep warm – often panic attacks leave you cold and shivery. Be nice to yourself; don’t berate yourself, don’t tell yourself it’s pathetic. Nobody asks to have panic attacks – it’s not a sign that you’re weak or incapable. Tell yourself that you’re OK, you handled it well, you’ve done well to get through it. Anxious people have minds working against them, the last thing you need is to add fuel to that.
It’s important to know that while panic attacks are a beast, you will not die. They feel awful and, boy, do they take it out of you, but they cannot hurt you. Knowledge is power, and the more you understand why you’ve had an episode and the more you KNOW they’re not dangerous, the less hold they have on you. With that in mind, it might be good to write down a bit about two times you had an attack and the events surrounding them. It’s helpful to know your triggers and arm yourself with that information.
There are lots of ways to help prevent panic attacks – and again, you’ll find your own tools. But here are a few suggestions:
Avoid caffeine – anxious people have so much adrenaline, we don’t need any more encouragement.
Avoid nicotine and wine – but I guess you know this one anyway.
Try yoga/breathing exercises/meditation – which are all known to help with stress and calm people down.
Exercise – yup hi, we’ve got this one covered.
Get enough sleep – sleep disturbance is often high in people with mental-health problems and it contributes to anxiety FOR REAL.[10] However you do it, make it a bigger priority.
Eat regularly. When my blood sugar drops I can feel my anxiety climbing. I try and eat every hour, which is fun and also makes me feel like a baby. Try not to forget to eat and then grab a sugary doughnut. I mean, for sure have doughnuts, but just make sure you have proper meals too.
Do things that scare you – this sounds sinister but we’ll get to it and it won’t sound so odd, I promise.
When a situation is looming that you find scary, plan for it. I research routes in advance so that I’ll be somewhat familiar with them. I sometimes look on Google Maps and see what a venue looks like – not to plan my exit but just so I feel comfortable when I get there. This is all a way of me having an element of control over my worries. I accept I can’t plan everything ahead, but I can show my anxious brain some research and say, ‘Hey look! This doesn’t look so bad, does it?’ So much of learning to tackle anxiety is reframing your thoughts and changing the narrative in your brain. Can you start here by writing about a situation coming up soon that is making you feel a bit nervous? What would help you to stop dreading it and, if not look forward to it, then at least not let it weigh too heavily on your mind?