How to Survive a Panic Attack

If you’re struggling with a panic attack right now — I’m so sorry, I know how rough it can be! If you have doubts about whether you’re having a physical health problem, go to your emergency room or urgent care center. Your doctor can help you rule out any medical issues. Once you’ve ruled out any medical issues, you can rest assured that panic itself will not kill you. If it’s panic, it may feel like the worst thing in the world, but you’re going to get through it.

How to get out of a panic attack, now

• Remind yourself that you’re not going to die of panic.

• Breathe slowly out of your mouth, as if you are blowing out of a straw or on a pinwheel. Continue repeating these slow exhales. Try to let each exhale go to the count of eight, with each inhale to the count of four.

• Listen to a song that you know has an uplifting and reassuring effect on you. It’s a great idea to create a playlist of songs that you know will help you feel better when you’re struggling. 

• Reach out to someone in your life who helps you feel reassured and safe.

• If you feel faint and if it’s accessible to you, lie down and put your legs up the wall. Or try bridge pose, or any heart-opening yoga pose that expands your sense of spaciousness in your chest, heart center, and lungs.

• Find a physical object that gives you comfort or reassurance, and hold it in your hand while you breathe.

• Distract yourself by watching a funny YouTube video or show you know you enjoy.
  
  

Ongoing strategies to reduce panic attacks

Support your nervous system and physical health

Much of the underlying physiological stress that causes panic attacks can be reduced by these modifications. 

• Avoid caffeine, alcohol, excess sugar, tobacco, marijuana, and other drugs. Especially if you’re sensitive, these can increase a sense of physical, body-based anxiety.

• Drink plenty of water.

• Get enough good-quality sleep. 

• Make sure you’re getting enough protein. Recommended daily amounts of protein vary depending on individual factors, but many people underestimate how much protein they need.

• Find ways to get daily movement in a way you enjoy: walking, running, dancing, swimming, hiking, sports — whatever you enjoy and can do on a regular basis.

• Check with your doctor to ensure you have adequate levels of essential nutrients. Certain nutrient deficiencies can cause or exacerbate anxiety and panic symptoms.

Address underlying causes of anxiety

What’s stressing you out? Is there an immediate danger or trigger? Usually, if we’re having panic attacks, there’s at least one thing in life that is causing stress, if not several. If there are things you can address, do so. It may be that you’re responding to a particular trigger or a general sense of overwhelm. Talking with a therapist can help to sort through what is underlying the panic.

Should I take anti-anxiety medications?

This is a personal decision. Some people can manage panic attacks with the steps listed above, while others may find that medications are helpful, at least in the short term. It's best to consult with your therapist, psychiatrist, and primary care doctor about your particular situation. If you choose to try medication, remember that it’s meant to be used in combination with strategies to address the underlying roots of the issue.  

Advanced training: Existential inquiry 

Ask yourself: What am I really afraid of?

It may be: I’m panicking because I’m afraid there’s something wrong with my health.

Or, I’m afraid I’ll die in a plane crash.

Or, I’m afraid I’ll get stuck in this elevator.

Next, ask yourself, And what would happen then?

Well, then I’d die.

And then?

Well, then I’d be dead.

And then?

Well, then my loved ones would be sad, and I’d never get to climb Mount Everest / write my novel / create my album / open a restaurant / reconnect with that person I’m estranged from / do what I know I was put on this earth to do. 

If you continue along this thread of inquiry, you’ll get to the heart of the matter.

For many people, panic attacks are so scary because they bring us face-to-face with our fear of death.

And all the implications of that. 

This was the case for me. 

The best way I’ve learned to reduce panic attacks – in addition to the steps above – is to examine my own fear of death.

If this is the case for you, a spiritual practice that examines the questions of what happens after we die can be a way to get to the heart of the fear, and find some solace or acceptance with the idea of our death itself. 

Exploring our own death can also help show us what we need to attend to in our lives. Is there something you’ve been putting off doing? Something you really know you want to get to in this life?

I’m not saying I’ve mastered this – far from it. But by asking, “well, what if?” – it opens up more of a conversation, more of a curiosity, that for me has been useful in really taking the teeth out of panic. Your line of inquiry may not go to a fear of death — it could lead to a fear of social exclusion, or some other kind of danger. But the idea is to get to the root of the issue so you can heal it.

Looking for more support?

If you’re looking for a therapist in NYC or anywhere in New York State, reach out to schedule a free initial consultation.