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Onpsych Blog

Panic Attacks: Coping Strategies (Part 2)

Fighting panic is not a good idea, however if you detect the early symptoms there are a number of strategies that you can use before panic gets out of control

1. Retreat – exit the panic-provoking situation if possible until the anxiety subsides, for example if you are driving, slow down then pull over – nb retreat is temporary with the intention of returning, not escaping or avoiding

2. Distraction – divert your attention away from your bodily symptoms by:

  • Talk to another person – express your feelings to them, it will help you get your mind off the panic symptoms

  • Engage in a simple repetitive activity – eg count backwards, count the money in your wallet, count the number of red cars if you are driving

  • Do something that requires focused attention – read a magazine, do a puzzle, calculate, play a musical instrument, paint etc. These activities use more complex executive skills that force your thinking brain to take over

  • Move around or engage in physical activity – this helps dissipate the extra energy or adrenalin created by the fight-or-flight reactions, so instead of resisting the normal physiological reaction that accompanies panic, you can move with it

  • Stay in the present – focus on concrete objects around you in your immediate environment eg if driving focus on the cars in front of you, or try touching physical objects in your environment eg touch the floor or “ground” yourself in some other way which will help minimize the attention given to physical symptoms

  • Experience something immediately pleasurable – pleasure and anxiety are also incompatible – have someone hold you, have an enjoyable snack, relax in a hot bath

3. Practice using your 5 senses: Focus on one sense at a time so that you can be more aware of your perceptions

  • Visual – pick an object in your field of vision and pay attention to the details of colour, texture, shadow, shape etc

  • Hearing – stop and listen. What do you hear?

  • Smell – what to you smell? Do not forget to “stop and smell the roses”

  • Taste – be mindful of the food and beverages that you put in your mouth

  • Touch – feel the texture of different objects such as stones, shells, feather or the warmth of a mug of coffee

4. Practice thought stopping – this can disrupt anxious thoughts – take a deep breath and shout “stop it!”, get rid of negative thinking, Replace these with “I am strong”, “I can do this”, “I am not going crazy!”

5. Practice abdominal breathing – helps modify your breathing pattern - breathe slowly and regularly to reduce possible symptoms of hyperventilation – if you breathe too high up in your chest and your breathing is shallow you tend to hyperventilate which in turn can cause symptoms similar to panic attacks – inhale slowly through your nose counting up to 5, hold to 5, exhale slowly through your mouth up to 5 (up to 10 times)

6. Practice progressive muscle relaxation – involves tensing and relaxing different muscle groups of the body. Firstly you tense particular muscles in your body for example your neck and shoulders, then you release them. Take notice of how your muscles feel when your relax them – practice daily so that you can distinguish between a tensed muscle and a relaxed muscle.

7. Repeat positive coping statements – “its only anxiety, its not going to get the better of me”.

8. Use breathing or relaxation in combination with coping statements

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