Advocate

Coping Skills: Panic Attacks

The structure of this advice was based on the article by HelpGuide.org

  1. Education
  2. Relaxation Techniques
    1. In The Moment Coping Skills
      1. Basic Calm Breathing:
      2. 2-to-1 Breathing
      3. Cyclical Sighing
      4. B.O.L.R.A.I
      5. Body Engagement
  3. DARE Method
    1. Defuse
    2. Allow
    3. Run towards it
    4. Engage
  4. Self-Care
    1. Exercise
    2. Sleep
    3. Trigger Foods
  5. Support Networks
  6. Conclusion
  7. Citations:

Panic attacks are stressful, overwhelming and can become disrupting to normal life. They are relatively common, even more so for those of us with a history of trauma. They are manageable and you can reduce their occurrences and manage them better when they do happen.

Education

Knowing more about panic attacks can help relieve some of the distress, especially the anticipatory fear. Reading about what panic attacks are and the stress responses will allow you to find the best way to cope with them and can promote feelings of personal control. It can also help with the repetitive feelings of being crazy.

Learn what a Panic Attack is in this article: Symptom Explainer: Panic Attacks

Relaxation Techniques

Our ability to handle panic attacks can be helped by strengthening our bodies ability to regulate. Longer term relaxation skills are key for the above mentioned strengthening. This should be coupled with learning more in the moment coping skills to calm the body in the moment. 

Activities that can promote relaxation, grounding and regulation help during building episodes of stress and can be maintained even when anxiety is low to continue widening the window of tolerance [how much stress you can go through without falling apart]

  • Art projects, including things like colouring or mandalas it doesn’t have to be elaborate
  • Aromatherapy
  • Journaling
  • Mantra practices
  • Meditation
  • Progressive Muscle relaxation
  • Visualization activities
  • Yoga

In The Moment Coping Skills

Basic Calm Breathing:

Steps:

  • Take a slow breath in through the nose, breathing into your lower
  • belly (for about 4 seconds)
  • Hold your breath for 1 or 2 seconds
  • Exhale slowly through the mouth (for about 4 seconds)
  • Wait a few seconds before taking another breath
  • About 6-8 breathing cycles per minute is often helpful to decrease anxiety but find your comfortable breathing rhythm.
  • Take a slow breath in through the nose, breathing into your lower
  • belly (for about 4 seconds)
  • Hold your breath for 1 or 2 seconds
  • Exhale slowly through the mouth (for about 4 seconds)
  • Wait a few seconds before taking another breath
  • About 6-8 breathing cycles per minute is often helpful to decrease anxiety but find the breathing rhythm best suited for you.

Avoid clenching your muscles and make sure you are using diaphragmatic breaths. This means your stomach should be expanding and not your lungs. These breaths bring in more oxygen and it’s harder to hyperventilate a common effect of anxiety and flashbacks.

Sitting up straight is the best for because it allows for the most room for our lungs to expand, laying flat is the second best. Please avoid slouching or turning in on ourselves. If possible remove the stress off your shoulders by supporting your arms on the side-arms of a chair, or on your lap, grounding your feet is also important.

2-to-1 Breathing

This is a practice that helps give us a path to regularity and best engaging the parasympathetic system. It also requires a powerful redirect of focus to our breathing and the way that it feels. Knowing how proper breathing feels is good to know when we have started to become dysregulated. This is generally hard to do during flashbacks or mid panic attacks, most effective before or after the most extreme point.

Steps:

Count the duration of both exhalation and inhalation as you breathe normally and adjust it gently so you are exhaling and inhaling for the same amount of time. Most people are comfortable with a count of 3 or 4 counts for each exhalation and inhalation. So one full breath lasts for a count of either 6 or 8. So you are breathing in 4 and exhaling 4 counts.

Now, without altering the duration of the total breath cycle, adjust your breathing by slowing the exhalation and gently quickening the inhalation to achieve a 2-to-1 ratio. For a breath lasting 6 counts, this means exhaling for 4 and inhaling for 2. For 8 you can adjust slightly exhaling for 6 and inhaling for 3.

Cyclical Sighing

Inhale deeply through your nose. Take a second, shorter inhale, further filling your lungs. Exhale slowly through your mouth. Repeat this exercise for five minutes.

B.O.L.R.A.I

A skill to deal with dissociative episodes of stress and feeling lost or confused. When our emotions and physical sensation are pulling us from the world we can move forward. Coined by the lovely Kristen she has a YouTube channel Kristen Chronicles.

  • Breathing: Take deep and slow diaphragmatic breath
  • Observe: check how you are feeling inside, your thoughts and physical sensation.
  • Let Go: let the feelings and sensation exists but don’t act and breath our to have the feeling leave
  • Redirect: put our thoughts in a new place
  • Affirm: Set an affirmation to give yourself. An example: I am here and I am safe
  • Empowerer: Choose the next act to take that can move you forward.

Body Engagement

Usage of the above breathing skills while engaging the senses and movement can add to their effectiveness.

Some examples include: pressing on your legs, rubbing your arms, stomping your feet, walking, dancing, rubbing your palms together, and more. This helps engage the brain-body connection, gives sensory input, proprioceptive input (awareness of self and movement) and allows our body to release some tension.

There are often things we do out of habit when stressed like rock or pinch ourselves (some damaging some not) to have the best effect we need to add some deliberate movement.

Having stim aids can also be helpful. This includes things like putty, stress balls, koosh balls, chewy toys, velcro, fidget spinners, a rock with a texture or shape that is grounding, tangles, weighted stuffed animals and more.

DARE Method

Barry McDonagh created a method for dealing with panic called DARE. This was written about in her book: “DARE: The New Way to End Anxiety,” This is used to help reframe dealing with panic and help with long term management. 

Defuse

Panic attacks are worsened by negative “what if” statements, such as “What if I’m dying?” “What if I’m crazy?” etc. When you feel panic attack sensations practice saying “I will get though his is, it’s harmless.” or other statements that remind you that the feelings are not always facts.

Allow

Practice accepting unpleasant feelings and sensations. Fighting ourselves and trying to force the anxiety away or punish ourselves will only escalate panic attacks and cause more distress between episodes. Letting the shaking, the rapid heartbeat, the sense of detachment all exist, it can start to promote healthy relationships to the body. Applying knowledge you have about panic attacks can help.

Run towards it

Dare the symptoms to intensify. View the hyperarousal as exciting instead of scary. Put yourself into controlled experiences that raise your heart rate. You’re inviting in the sensations that alarm and working to reframe them into being something neutral to good. Noticing positive nervous system excitement can help reinforce these ideas. This statement will change the way your brain and body respond to the anxiety.

Engage

When panic attacks wind down and your body is leaving the extreme arousal try and do something so you don’t stay overthinking the panic sensations. Doing a craft, talking to other people, watching a calming show/movie, playing with a pet and other things.

However, I is okay to feel exhausted and shaky but doing what you can can help.

Self-Care

Taking care of your body is always good for anyone. But when our body deals with higher levels of stress it can be harder to keep up with self care and it can be even more important to help regulate the body and living. Living in the aftermath of trauma is hard enough and if we have frequent panic attacks we are living in a very vulnerable place. Allowing ourselves to give as much time as we need to keep ourselves in a more regulated state.

Working on the basics of self care will be helpful. Some of the basics like nutrition, hygiene, sleep, down time and some social interaction that you can do are all going to be important in healing from trauma in general. It can be hard when energy is low or our minds are scrambled, but starting with the easiest steps first is perfectly acceptable. 

Some specific self-care that can be part of goals that can especially effective with panic attacks include:

Exercise

This is very important for strengthening the body’s ability to be filled with energy and come down in a controlled and healthy way. The body releases regulating neurotransmitters and hormones and can help the body feel more balanced. Activities like walking, running, dance or swimming that have a rhythm. Rhythmic movement is known to be regulating and healing for people.  

Sleep

Sleep is key to regulating neurotransmitters and hormones. It helps our energy usage, immune system, function of our central nervous system and more. Sleep is also very important if you have been experiencing panic attacks. Panic attacks use so much energy and your body needs to recover. 

When sleep is hard it can take some time to get into a health pateren. Long form sleep advice can be found here: Coping Skills: Help With Sleep

Trigger Foods

It can be very helpful to limit caffeine and alcohol, these are very common triggers for those with panic and anxiety in general. It can also be useful to log if there are foods that worsen your anxiety, it’s known that our GI system can be influential on mental health.

Do avoid food logs if you have a history of obsessive thoughts around food or are dealing with disordered eating.

Smoking cessation is also helpful for anxiety management.

Support Networks

Human interaction can be very regulating for anxiety. Connection of any kind with people you trust can allow you space to talk to when you’re feeling alone or afraid. It is also known that connection is powerful in simple factors of breathing syncing, seeing another person’s face reciprocal communication. This can activate calming body responses. If possible being physically next to another person is known to be healing and if it is comfortable for you touch can be comforting as well.

Being close to other people is healthy and good for your overall mental health and is just enjoyable and good in many circumstances. 

It can be hard to find people if you have been isolated, especially for long periods of time. You can start reaching out possibly from joining a club or class to meet new people. Playing club sports can let you reach new people. LGBT centres can be a good place to meet new people if you’re in the LGBT community. 

Support groups can be helpful both with getting some face-to-face time with other people and help learn new coping skills from others experiences. It doesn’t have to be an anxiety specific support group for it to be helpful. Support groups for other mental health struggles can still be good for your health and anxiety. 

Conclusion

Panic attacks are so hard to deal with. They can cause a lot of life interrupting situations and worsen other things you are dealing with. And for those of us who have a connection of panic to our abuse it can feel doubly impossible to do. However, you can learn to help yourself and heal. It’s always okay to seek out professional help but if that isn’t possible or wanted you can still start to make your anxiety less intrusive and overwhelming.

You have the power to heal, even if it takes a ling time, even if it feels hard, it is possible.

Citations:

Posted in Coping SkillsTagged , , , , , , 1 Comment

One thought on “Coping Skills: Panic Attacks”

  1. Pingback: Symptom Explainer: Panic Attacks – Survivors Healing Survivors

Leave a comment