How To Treat Panic Attacks And Manage Them
By: Sarah Fader
Updated May 21, 2020
Medically Reviewed By: Heather Cashell
In 2004, all the viewers of American news channel, ABC News, received first-hand education on what a panic attack looks like. Anchor Dan Harris was reporting the news headlines when he suddenly succumbed to a panic attack so severe, broadcasting had to be cut short. The incident can be viewed here.
Panic attacks are still shrouded in mystery for many people. For some, like Dan Harris, recurring panic attacks are a symptom of an underlying mental disorder that can cause a great deal of discomfort, and can even be become debilitating. Since the onset of an attack is often unexpected and out of the blue, getting treatment and learning how to manage anxiety and/or panic in order to limit panic attacks can be very helpful.
How Can a Panic Attack be Treated?
It is possible to stop an attack in its tracks, but in order to keep it from occurring, a person needs to visit a qualified doctor or psychiatrist for assessment and a treatment plan.
Stopping the Attack
When in the grips of a panic attack, a person cannot function properly and often needs to take time out afterwards to gather him or herself again. Doing the following could be helpful to stop or find relief from an attack as it takes place:
Don't Fight the Attack - Advising on how to handle a panic attack, Prof Paul Salkovskis, clinical psychologist and professor at the University of Bath, UK, recommends that it's necessary to fight the fear of panic attacks, instead of trying to fight the attack itself. While very distressing, these episodes are not harmful. Salkovski advises sufferers to "ride out the attack. Try to keep doing things… Confront your fear. If you don't run away from it, you're giving yourself a chance to discover that nothing's going to happen." He also recommends focusing on the surroundings as the anxiety starts to pass, adding: "If you're having a short, sudden panic attack, it can be helpful to have someone with you, reassuring you that it will pass and the symptoms are nothing to worry about".
Immediately Take Medication - Natural remedies such as the well-known Rescue Remedy is reported to be very effective for calming a person down. Take a few drops when the first signs of an attack make their appearance. It can also be helpful to take it as a matter of course, if anxiety is a problem, and has the added benefit of no harmful side-effects.
However, if the panic attacks are frequent and severe, self-medication should not be attempted, and it would be best to see a qualified doctor or psychiatrist for a diagnosis and prescription medicine. The doctor is likely to prescribe a benzodiazepine, such as Xanax, which can also be taken when experiencing an attack.
Become Aware of and Manage Breathing - Hyperventilation, or over-breathing is usually associated with panic attacks. Often, it is erroneously assumed that one should take deep, calming breaths in order to calm down. However, this action is likely to exacerbate the problem, as there is too little carbon dioxide in the bloodstream due to over-oxygenation. This is why breathing into a plastic or paper bag is a well-known and old remedy for treating a panic attack. This advice probably appears counter-intuitive, but breathing in less oxygen will have the desired outcome. If no bag is nearby, taking short, deliberate and gentle inhalations through the nose, with equally measured but short exhalations through the mouth, should have the same effect.
In order to limit panic attacks, the underlying causes need to be identified and treated.
Treatment and Long-term Management of Panic Attacks
Panic attacks are normally a symptom of an anxiety disorder, or they are associated with mental disorders like agoraphobia (fear of crowds). It's treatment and management are well documented, with plenty of good advice available online and in other literature.
Medicine: A panic disorder, which is a subset of anxiety disorders, can only be diagnosed by a medical doctor or psychiatrist, who is likely to prescribe psychiatric medication such as a benzodiazepine and an antidepressant. The latter includes Serotonin Reuptake Inhibitors (SSRIs), Monoamine Oxidase Inhibitors (MAOIs), or tricyclic antidepressants.
Lifestyle changes: It is important to manage anxiety and excessive stress as a means to limit panic attacks. Managing anxiety can include dietary changes such as avoiding or limiting stimulant-intake, such as coffee; also sweet foods that causes fluctuation in the body's blood sugar. Light exercise might be a good way to manage stress. Yoga is an excellent exercise to balance both body and mind, but hiking in nature, jogging or dancing will have equally soothing and stress-releasing effects.
Complementary medicine: Calcium and magnesium are the two minerals crucial for mental health and relaxation. Supplementing with both will nourish the central nervous system, as well as relax muscles. Be sure to take extra during times of elevated stress or worry. Tissue salts such as Mag. phos. (magnesium phosphate) and Kali phos. (potassium phosphate) are indicated for anxiety and stress disorders, and is a good supplement for anxious children too. Herbs such as kava-kava, St. John's Wort, zizyphus, lemon balm, valerian, withania, passionflower, magnolia and hops are well-known for their antidepressant and anxiolytic properties. Always check for possible interactions with other medications, as herbs can have powerful physiological effects. Research demonstrated Omega 3's anxiolytic effects in people diagnosed with anxiety disorder, and is known for its brain-building properties.
Therapy: Cognitive-behavioral therapy (CBT) is sometimes referred to as 'panic attack treatment without medication', and is reputed to outperform other forms of psychological treatments for panic disorder. CBT involves a combination of interventions such as:
- Relaxation techniques
- Cognitive Restructuring (becoming aware of thoughts and mental processes that contribute to feelings of anxiety and panic, and replacing them with balancing, soothing thinking)
- Mindfulness (a meditation technique)
- Stress reduction
Myths About Panic Attacks
Perhaps because the episodes are so distressing, a number of misconceptions surround panic attacks.
Panic Attacks Can Cause Fainting Spells
While a person may feel dizzy and faint during a panic attack, he or she is unlikely to pass out. Fainting is caused by very low blood pressure, but during an attack, the blood pressure actually rises a bit.
Panic Attacks and Anxiety Attacks are the same thing
Colloquially panic attacks are the same as anxiety attacks. Yet, clinically speaking, there is no such thing as anxiety attacks, and the term is not used in the Diagnostic Statistical Manual of Mental Disorders (DSM). Anxiety disorders is the umbrella term for a spectrum of mental disorders related to abnormal anxiety, under which panic disorder falls. Panic attacks are a symptom of a panic disorder.
A panic attack will have symptoms of severe anxiety, but with added attributes. Symptoms of anxiety, according to the DSM, include the following:
- Palpitations or racing heart, or increased heart rate
- Sweating, trembling or shaking
- A dry mouth not due to medication side-effects or dehydration
- Difficulties with breathing
- The sensation of choking
- Chest pain or discomfort
- Nausea or upset stomach
- Sensations of dizziness, unsteadiness, fainting and lightheadedness
- Feeling that one's surroundings are unreal, or that one's self is not really present
- Fear of losing control, going crazy or fainting
- Fear of dying
- Hot flushes or feeling cold
- Numbness or tingling sensations
These symptoms are fairly common and most people will report that they have experienced one or more in response to severe stress at least once in his or her lifetime. They shouldn't be underestimated in terms of unpleasantness, though, and may indicate disorders such as Generalized Anxiety Disorder and Social Anxiety Disorder.
A panic attack, however, is characterized by some or all of the above symptoms, plus the following:
- It is a distinct episode of great fear or discomfort
- Its onset is sudden
- It reaches a climax within a few minutes and lasts at least a few minutes
- It is not a single episode, i.e., it recurs.
Avoid Stressful Situations to Avoid Panic Attacks
This is tantamount to saying that one should avoid life, which is a ridiculous tenet. While stress-management usually forms part of a therapeutic regime to reduce panic attacks and anxiety, avoiding stressful situations as such is not advised. Research has shown that this appears to reinforce anxiety and panic. With the correct treatment and medication, any person can function normally despite suffering from any anxiety disorder.
A Panic Attack is Like an Epileptic Attack - Others Should Leave a Person Be Till It Passes
For many panic disorder sufferers, this cannot be further from the truth. While it differs from person to person, many report that having a comforting person around who calmly talks him or her through the attack is very helpful. Others may prefer distraction - it really depends on the person experiencing the attack. However, a non-judgmental and compassionate approach is likely to appeal to every sufferer.
Finding Help for Panic Attacks
As mentioned, only a qualified doctor or mental healthcare professional can diagnose a panic order with panic attacks, and prescribe medicine for treatment. Also, psychotherapy is often indicated as a necessary part of the treatment regime. For the latter, BetterHelp can be an ideal platform, where qualified Cognitive Behavioral therapists can assist online, and in the privacy of one's own home.