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What is a panic attack and five things to do if you have one


Whenever I teach clients how to help themselves with a panic attack, they often say, "If only they taught that in schools!" And I wish we did! If a professional tennis player and a Good Morning America journalist can get taken by surprise, it's clear we all need help with identifying and coping with panic attacks. Here are some basics: 1) What is a panic attack? Panic attacks are an escalation and amplification of physical and mental danger signals echoing off each other. Hearing a loud noise can make anyone feel startled. A normal response is to then identify the noise -- maybe the wind blew over a fan -- and then say, "oh, phew!, that was loud!, I better go set that fan back up more securely," and, because you know you are not at risk, you ignore the fact that your heart is beating a little faster and you might have broken out in a sweat. In a panic attack, your physical and mental responses escalate each other: the loud noise triggers a startle response, and your brain says, "oh, something has SCARED me" and then your body responds to that thought with a greater increased heart and breath rate, sweating, and other sympathetic nervous system responses, which then cause more fearful thoughts -- "oh my heart, I must be in real danger!!", which amps up the physical fight or flight responses, in an increasing spiral. 2) How do I know if it's a panic attack and not a heart attack? Always seek medical advice but here's something to have in mind: while a racing heart might make you afraid you're having a heart attack, an important clue is, can I walk this off? If walking helps you feel better (because it's a calming meditative physical exercise), consider that it could be a panic attack. If walking or even just standing up to walk makes you feel worse, because it's an effort for your system to physically do, then it could be a physical issue.

3) How do I help myself in a panic attack? By grounding. If you are mindfully grounding yourself in the present moment, then it's very difficult to be engaged in escalating fearful thinking. Here are six ways you can ground yourself by paying attention to your breath and/or your five senses.

  1. Try a four count in/five count out breath.

  2. Notice how your breath feels cool and dry coming into your nose, and how it changes to warm and moist coming out of your nose.

  3. Look around the room and notice everything that is your favorite color.

  4. Count the number of square or triangle shapes you can see.

  5. Notice your five senses: describe five things you can see, four things you can feel, three things you can hear, two things you can smell, and one thing you can taste.

Bonus point #6: Practice all of these skills in a calm moments. By practicing them, they will be easier to remember when you really need them, and you will have created an even more calming response because they will be associated with calm moments.

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