You're happily watching T.V., wondering what to order for dinner, and then, out of nowhere, your heart races, your chest hurts, you can't breathe, nothing feels real anymore, and you know something terrible is about to happen. Nobody really knows why we have them, or what triggers them -- like I said, you could be knitting with your grandma with a basket of kittens in your lap. To your body, the house might as well be burning down around you.
The suckiest thing is, there's not a whole lot you can do to really halt a panic attack in its tracks. Since they last, an average of about ten minutes from start to finish, any medication you take wouldn't even have time to kick in before the episode's over. Even beta-blockers, which can help keep your heart rate even in the middle of the worst attack, take time to do their thing. Medication wise, you're much better off trying to head a panic attack off before it starts. Fortunately, there are some quick body hacks you can use to help mitigate them while they happen:
First, say, "I'm having a panic attack."
Part of what's weird and distressing about panicking is that the world can take on a feeling of unreality. You may feel like the only things that are real are the sense of impending doom, and the feeling that you're losing control. Saying the words "I'm having a panic attack" can help root things in reality and shift your perspective.
Get your face good and wet.
The mammalian diving reflex is an automatic response to diving into cold water. While this isn't nearly as strong in adult humans as it is in other animals (including human babies), a cold, wet rag applied to the face can help ease a hammering heart.
Practice diaphragmatic breathing.
One of the hallmarks of a panic attack is hyperventilation. You feel like you can't breathe, so you begin breathing faster and more shallowly to compensate. Unfortunately, hyperventilation eliminates CO2 faster than your body can produce it. To combat this, focus on breathing by expanding your stomach, rather than your upper chest or shoulders. Belly breathing forces you to take deeper, fuller, slower breaths, and can help bring your levels back where they should be. Pursed lip breathing, a technique where you purse your lips and attempt to exhale slowly, is another technique that can help. On a related note...
Blow into your finger.
If your problem is a racing heart, there's hope for that, too. Take a deep breath, place a finger between your lips, and pretend to inflate that sucker. This is called the Valsalva maneuver. This move works on the vagus nerve, and it's really effective -- my heart rate dropped about twenty beats per minute. It's also something humans do naturally, though you might not realize you're doing it at the time. It's very common to experience while lifting weights, for example, and may have an evolutionary purpose in increasing intra-abdominal pressure to protect the spine. Research shows that it's pretty safe for otherwise-healthy people, but, if you have heart disease or are at risk of stroke, it may cause an unhealthy spike in blood pressure.
Take a short walk.
If your panic attacks are like mine, this sounds impossible. You can't walk, you can barely even move. How can you possibly go for a walk while you're having an attack? The thing is, I've had a few occasions when I've been forced to walk in the midst of an immobilizing panic attack -- it actually helps. Even when my heart was racing, walking didn't actually make anything worse. Don't try to go for a run, just get up and walk around your room.
Do you have any tricks that help lessen the intensity or duration of your panic attacks? Let me know in the comments!