What are the best ways to talk yourself down during a panic attack?

Hi Gail,

Thank you for choosing to reach out through BetterHelp. I think it takes a lot of courage and willingness to take that first step even to ask for any type of help. The first thing, which you may have already done, is speak to a medical provider about your symptoms. This is always the first place to look when you are having physical symptoms of this nature. 

In general, Panic Disorder is experiencing at least one panic attack. This is an experience in which the person feels heart palpitations, sweating, trembling and shaking, shortness of breath, feeling like your choking, chest pain/discomfort, nausea/vomiting/abdominal pain, feeling dizzy/unsteady/light-headed, feelings of not being connected to self or reality, feeling of losing control, fear of dying, tingling sensations, and chills or hot flashes. All of these symptoms are not required to clinically diagnosis a panic attack. To qualify as a clinical panic attack, a person needs to have four or more of these symptoms during the same episode with no discernible medical reason, underlying mental health issues, chemical interference, or trigger of any kind. The more symptoms the person has; the more severe the attack. Panic Disorder becomes the condition when the person's fear of a panic attack (following the first ones) becomes so great that they create a panic attack or cause themselves an intense degree of anxiety due to the fear of having another panic attack.

Given I do not know the circumstances of your case, I will address the rest of the question as if we have ruled our medical issues, chemical interference, underlying mental health issues, and triggers. If you are having these attacks very frequently, this could indicate an underlying mental health concern, such as PTSD or Generalized Anxiety Disorder. Both of these conditions, can create a fight, flight, freeze response, which is not needed for the situation, thus creating the sense of panic. If you think it is possible you are experiencing either of these or something similar, I would suggest seeking individual therapy. These are typically not mental health conditions that a person can effectively treat on their own.

Suggestions for other things to try, aside from deep breathing (which by the way I agree really only goes so far, a lot of the time):

• Grounding (bringing yourself back into the moment by sitting still and making a mental note of the things you see around you "the carpet is very stained and still soft" and continue this until panic subsides. Other ways to use grounding is create a sensory change (e.g., placing your bare feet on a cold floor holding something soft). Sensory changes are often very helpful in these situations (sensory changes meaning things you smell, taste, feel, see, or hear).
• You can look up Progressive Muscle Relations, as this is another coping skill you may find to be beneficial. Most importantly you have to calm down the body, so that you can then calm down the mind. Without getting the body out of flight/freeze/fight, you are going to have a nearly impossible time getting your thoughts off the panic. This means I need to activate my parasympathetic nervous system. How do I do this? Engage in activities that induce relation (e.g., listening to rain on an app or in real life, laying back and closing your eyes for 20 mins, lighting a candle you enjoy). ANYWAY that will cause a feeling of being more relaxed.

Lastly, everyone is different and what works for you will be something you will need to discover for yourself. The only way to do this is to try as many things as it takes to find 2-3 coping skills that work for you. Do not be discouraged if one does not work. Try it a few times and then consider it just to be one that doesn't work well for you and move onto to something else. These episodes you are experiencing sound scary and very distressing. Not knowing why they are happening can make is even more disturbing. I would encourage you to seek counseling from a therapist to explore the most primary reasons for these symptoms.

I hope this was helpful, and I also hope you find whatever combination of things will help you to feel better. There is a solution out there! You just have to do the work to find it.

Thank you again for your question and willingness to be vulnerable and take the step needed to address this issue. 

Sending you all the best,

Leslie Hagedorn, LCSW, LSW