Tips to Get Through a Panic Attack

By Alex Dimitriu, MD

Suddenly overcome by fear, trembling, sweating, head pounding; heart racing? Don’t panic! Relax – and breathe. A focus on slow, deep breathing can help you get through a panic attack.

My comments follow research reported in the April 2018 edition of Psychophysiology by Trinity College Dublin, demonstrating a direct, neurophysiological link between respiration and the brain. The study indicates respiration can prompt release of a chemical messenger, noadrenaline, in the brain, and this chemical apparently plays an important role in enhancing the brain’s overall health.

Physicians have long known that the relaxation, visualization – and breathing – techniques taught in Yoga and used in meditation help many patients manage their anxiety, including panic disorder. The study finding that breathing effects changes in brain chemistry goes a long way toward supporting claims of Yoga practitioners about how regulation of respiration benefits the mind, reducing stress and improving cognition and attention.

Previous studies also have shown a link between breathing patterns and areas of the brain responsible for emotion and mood, and authors of another April 2018 published report, this one in the journal Nature Communications, have discovered a possible connection between breathing and neurons that regulate smell, further bolstering breathing-brain theories.

Panic attacks are brief episodes of intense, incapacitating apprehension and anxiety that occur seemingly without warning and are accompanied by real, physical symptoms, such as chest pain, heart palpitations, shaking, abdominal cramps, nausea, dizziness or weakness, and disrupted breathing.

Genetics; a heightened sensitivity to fear or threat of the unknown; a sudden life change like a divorce, death of a family member or lost job; activation of “anxiety cells” in the brain; even natural hormonal fluctuations, such as those in menopause – all are considered potential causes of panic attacks.

Affecting twice as many women as men, panic attacks normally last about 10 to 15 minutes and may occur only once or twice in a person’s lifetime. If they become recurrent, however, a person will likely be diagnosed as having panic disorder and be referred for treatment.

Management of anxiety problems range from instruction in breathing and muscle relaxation techniques to cognitive behavioral therapy (positive thinking and repeated exposure to situations causing fear), medication, exercise, even improvements in diet.

Panic disorder is an extreme form of anxiety, and anxiety, in all its forms, is on the rise in the United States. A national 2017 American Psychiatric Association survey shows American angst about “health, safety, finances, relationships and politics,” as measured on a scale of 0-100, has jumped up sharply.

Nearly 3 percent of the U.S. population suffer from panic disorder at some point in their lives, according to the National Institute of Mental Health. The rate is much higher when including those who have experienced just one or two isolated panic attacks, but who have not been diagnosed as having panic disorder.

For many people, anxiety has become such a part of their everyday existence that they remain unaware of how it is affecting them mentally and physically.

Should a panic attack occur, I advise the following:

• Breathe deeply, inhaling air slowly through the nose and exhaling through the mouth.
• Do not fight the physical symptoms. Instead, focus on releasing tension in the body’s muscles and calm anxious thoughts as a way of dampening the “fight-or-flight” sensation and what researchers call the brain’s natural “suffocation alarm.”
• Stop thinking negatively. Find a distraction. Visualize a positive experience or more pleasant, relaxing location.
• Seek treatment if attacks reoccur.

Here are my tip for assisting someone in the throes of a panic attack

• Remain calm yourself; take the person to a quiet location.
• Converse softly and slowly; use short sentences.
• Encourage deep, measured breathing. Breathe with the person.
• Suggest doing a simple physical task like stretching out the arms as a distraction.
• Be supportive. Tell the person he or she is going to get through it.

Alex Dimitriu, MD, is double board-certified in psychiatry and sleep medicine and is the founder of the Menlo Park Psychiatry and Sleep Medicine Center in Menlo Park, CA. http://www.doctoralex.com