Panic attacks are sudden, overwhelming surges of fear that seem to come out of the blue, create a sense of distress, and then retreat, sometimes as suddenly as they began.  They can be accompanied by feelings of dizziness, a racing heartbeat, tingling fingers, and shortness of breath.  One out of seventy-five people will experience a panic attack in their life.

When people experience a panic attack they often believe they are having a heart attack, or that they are going to suffocate and die.  Sometimes they will be rushed to the hospital, hooked up to an electrocardiogram machine to test their heart, and told that they are not having a heart attack and that they are “OK.”

But when you’re having a panic attack, or have had one, you usually don’t feel like you’re ok. You wonder what’s wrong with you and you live in fear, worrying about when it’s going to happen again.

While they may be indicative of an underlying anxiety issue, the pattern of panic attacks can be changed through understanding the relationship between body and mind and practicing some simple mental and physical exercises.

An easy way to understand panic is as an overreaction of the sympathetic nervous system.  Our nervous system is comprised of sympathetic and parasympathetic components.  The sympathetic system’s job is to rouse our body into an alert, protective state.  (The parasympathetic nervous system’s job is to promote release and relaxation.) This is commonly known as the “flight or fight” response.  In other words, our brains and bodies have evolved to protect us from threat and danger.

If you can imagine our ancestor roaming the African Savannah and being suddenly attacked by a saber tooth tiger. In order for her to have a chance for survival, she would have to react quickly to either defend herself or run away.  Our brain is designed to automatically prepare our body for fighting or running away.  It temporarily shuts down non-essential organ function and focuses our energy on those parts of the body that will be needed for survival. The heart and lungs work in tandem with quick short breaths to bring in as much oxygen as possible, and increased heart rate to circulate that oxygen to the outer limbs and the brain.  It is only when the threat is passed that the parasympathetic nervous system can kick in and help release the tension in the body, reduce the heart rate and allow the lungs to breath deeper slower breaths.

In our modern lifestyles, the problem is that most of our threats are not physical, but are psychological.  We may, for example, fear the loss of a job, the loss of a relationship, or how we are going to perform on a test.  We may have a childhood fear that is evoked or triggered by a recent event. If you have ever experienced a panic attack, you may feel like there was no trigger at all (although on further examination, that is usually not the case).

But our modern lifestyle is a relatively new phenomenon in the history of the human species, and our brains have not had the time to adapt to the new realities of threat.  They react to psychological threat as if it was physical threat.  The problem is, while physical threat usually has a concrete beginning and end, psychological threat often has no clear indicator of when the threat has passed.  When our brain doesn’t get a sign that the threat has passed, the sympathetic nervous system continues the flight or fight response, creating a heightened state of anxiety – and then panic.

What works well as a short-term physical survival mechanism is counterproductive as a long-term strategy for coping with psychological stress.  In fact, what happens in the case of panic attacks is that because the brain cannot identify where the threat is coming from, it escalates the fear response as a reaction to the body’s experience of fear. This is what causes the intensification of panic that, for the sufferer, makes it feel like the attack will never end and that he or she will die.

It is helpful to understand the mechanisms at work in order to change your pattern of panic.  It is most important, first of all, to acknowledge and to tell yourself that you are not going to die.  You can start by repeating to yourself, “This is just a panic attack… it is just my overactive sympathetic nervous system… I am not going crazy and there is nothing terrible happening… and this will soon pass.”  The significance of this is that it serves to de-escalate the panic process.  By the time a panic attack is in full flight the brain is now reacting to its fear of the panic itself.  So you see, it needs to get a different message than the message the body is feeding back to it. 

It is critical that you DO NOT TRY TO STOP THE PANIC ATTACK.  When you try to stop a panic attack it reinforces to the brain that this is a terrible threat (otherwise why else would you be trying to avoid it?), causing the brain to muster the flight or fight system once again.  Instead, it is best to breathe deeply and just let the waves of panic flow over you.  In fact, breathing deeply is the physical component of the strategy.  Deep breathing is a natural part of our body function when the parasympathetic nervous system is activated.  By initiating deep breathing on our own we are promoting the activation of the relaxation response. 

By practicing the three-part combination of giving yourself reassuring, realistic messages about the panic, accepting and not fighting the experience, and breathing deeply, you can greatly reduce or eliminate the frequency and intensity of panic attacks. It may take a few attempts before you notice any changes in the pattern, but over time the brain starts to get the message that what it perceives as physical threat is, in fact, not. 

Ben Kotler, MA, is a Registered Clinical Counsellor in private practice at Wellspring Counselling and Consulting.  Described above is one of the Cognitive Behavioural Therapy strategies he uses in working with anxiety.  He uses a full-spectrum approach to psychological treatment that includes Short Term Strategic, Cognitive Behavioural Therapy, Depth Psychology, and Transpersonal psychotherapies.  For more help on dealing with panic attacks please consult a Registered Clinical Counsellor.

For more information contact Ben Kotler