Panic attacks can be frightening and they can arise suddenly. Symptoms include: a racing heart, dizziness, feeling like you are going crazy or having a heart attack, difficulty breathing, and feeling a sense of terror.
The good news is that panic attacks are very treatable, often within just a few therapy sessions. However, if you want to work on it on your own, here are some strategies:
1) Deep breathing is the most important step in dealing with panic attacks. It is best to practice deep breathing while you are calm, rather than in the midst of a panic attack.
To practice deep breathing, do the following: Close your eyes or stare out the window, you are going to breath slowly through your nose for three seconds, hold your breath for three seconds, and then slowly exhale through your mouth for three seconds.
Your stomach should rise with each breath, that is how you know you are breathing from deep in your lungs. Rest your hand on your stomach to confirm that you are breathing deeply.
If you have thoughts popping in your mind while you are breathing, don't push them away, just acknowledge them and gently bring your attention back to your breathing. Focus on your senses - the feeling of the air in your lungs, the sounds in the room, the temperature, the feeling of the chair beneath you.
Set a timer on your phone and do this for two minutes. Practice three times a day.
Once you get good at deep breathing, when you start to feel the initial symptoms of a panic attack, start your deep breathing, keep doing it until you feel calmer.
2) One strategy that works very well and that your therapist will likely use is hyperventilation. This strategy is used because it mimics the most common symptoms of a panic attack, namely a racing heart, dizziness, tingling fingers and anxiety. Your therapist will ask you to breath out deeply and quickly for 10 seconds, and this is followed immediately by slow, deep breathing until you feel calm again. This would be followed by either repeating the 10 second hyperventilation or it would be increased slightly to 15 seconds, again followed by deep breathing. This process works because it exposes you to what you fear, namely, the physical symptoms of a panic attack, but combines that with the calming effects of deep breathing - over time and with practice, you will stop fearing these panic symptoms. They may be uncomfortable but they won't be scary. This process of using hyperventilation to help with panic is best done with a trained therapist.
3) There are books available that can help you with your panic attacks. Learning more about panic attacks can help minimize your fear and help you understand what is going on in your body. These books will help you realize that you cannot go crazy, faint, die, or lose total control of your body by having a panic attack. Here are two books I would recommend to help those who experience panic attacks:
4) Facing your fears is the most important strategy for all anxiety disorders, including panic attacks. Most people deal with anxiety by avoiding it or distracting themselves. While this strategy is understandable, it is making the situation worse for yourself because you are reinforcing the idea that you cannot handle the stressful event, which makes you fear the situation more. The key is to move towards what makes you anxious, in this case it might be light exercise, or getting your heart-rate up a little, and tolerating the uncomfortable feelings, through deep breathing or using calming coping statements (e.g. "I'm ok" or "My heart is racing because I was just exercising"). Once you get through the experience, congratulate yourself. Through repeated experiences where you face and manage the fear, the anxiety will diminish and you will feel stronger and more resilient.
Further reading: Management strategies for panic disorder