The most common question people ask is what they can do to prevent, reduce, or control a panic attack. Panic attacks are very common and studies have shown that as many as 33% of the population will have a panic attack at some point in their lives. If you are reading this article it is likely you have experienced this before or know somebody who has. As a precautionary note, I am assuming you have already been to your doctor or the emergency room (not uncommon) and they have told you “there is nothing wrong with you.” Panic attacks are very frightening and produce strong physiological symptoms of fear that if misinterpreted can develop into panic disorder. Not all people who have a panic attack will develop panic disorder but knowing what a panic attack is can help prevent the development of panic disorder.
A panic attack is defined by the Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV-TR) as four or more physiological symptoms of panic that peak within 10 minutes. The symptoms include:
1) Palpitations, pounding heart, or accelerated heart rate
3) Trembling or shaking
4) Sensations of shortness of breath or smothering
5) Feeling of choking
6) Chest pain or discomfort
7) Nausea or abdominal distress
8) Feeling dizzy, unsteady, lightheaded, or faint
9) Derealization (feelings of unreality) or depersonalization (being detached from oneself)
10) Fear of losing control or going crazy
11) Fear of dying
12) Parasthesias (numbness or tingling sensations)
13) Chills or hot flushes
These symptoms are symptoms of fear itself. When these occur unexpectedly the person is likely to look outside of themselves into their immediate environment and try to ascertain what is causing the symptoms. What is threatening? They are rapidly trying to identify the threat. Unable to find anything they immediately begin to believe that something internally must be wrong with them. When this happens their anxiety mounts and the symptoms will quickly intensify. Quite simply the person’s body is identifying threat when no threat is present. Once their body has misidentified that threat is present it immediately responds by “setting off the panic alarm.” The spiraling chain of events has caused a panic attack. So where does it begin?
Researchers do not have a definite answer but one of the major contributors to the onset of a panic attack is what is referred to as autonomic arousal. This is a phrase that describes the feeling of being keyed up, anxious, nervous, upset, worried, or unsettled. As a person becomes more aroused physiologically their body also turns up their blood pressure, heart rate, and respiratory rate because the body is under stress and needs more energy to be in this aroused state. Our body can only make more energy through cellular respiration and to do this it needs more blood flow and more oxygen. Unfortunately people often times fail to perceive this increase in arousal and it “sneaks up” on them. When they do finally notice it they perceive it as a sudden change and believe something must be wrong with them. Then it’s off to the races. Since a panic attack increases several physiological markers in our bodies, it must be possible to intervene somewhere. The best place to do this is respiratory rate. Today you will learn how.
Before we learn respiratory control let’s talk over a few things. First, learning respiratory control is NOT a treatment for panic disorder. Respiratory control is a technique to combat the impact and strength of a panic attack. Treating panic disorder is much more involved than any self help book or article can tackle. If you are concerned you may have panic disorder you should see a qualified professional who has expertise in cognitive-behavioral assessment and therapy. Second, this technique takes practice before it will work. You should practice at least twice per day for 20 minutes each session. More practice is always better. Third, you may feel an urge to gasp for air. Understand if you are an anxious person your body has become accustomed to over breathing and needs to be retrained. It will resist this so you must force your body to adhere to the cadence we will outline. Fourth, always take regular size breaths (NO DEEP BREATHING HERE) and breathe ONLY through your nose. Fifth, make a conscious effort to breathe using your stomach muscles and not your chest. Your chest should not move. Sixth, stick to the count and do not let your mind wander. Concentrate especially when you are just learning the technique. Let’s go through it.
- Regular sized breath in.
- Once at the top of the breath (you have breathed all the way in) count to 3 slowly
- After counting to 3, slowly breathe out
- Once at the bottom of the breath (breathed all the way out) count to 3 slowly
- After counting to 3 breathe in and repeat the cycle
The technique is very effective if practiced. If a person becomes skilled using it our body CANNOT resist and the anxiety will diminish. It is impossible for our body to remain in a highly anxious or aroused state if a person is able to turn their body down physiologically. You must practice the technique and don’t give up or become disheartened if it does not work immediately. If this or other techniques do not work see a qualified professional such as a psychologist or a counselor.