6 Ways To Effectively Handle Panic Attacks

Understand what you are feeling and know the symptoms

Those suffering from panic attacks (a type of anxiety), feel they are having an imminent health crisis because the symptoms of panic disorder are sudden and more severe. According the National Institute of Mental Health, anxiety disorders are the most common mental illness in the United States, affecting 40 million adults (18 percent of the population).

“Symptoms of anxiety disorder range around mood, cognitive, and physical symptoms,” explains Joel Sherrill, PhD, deputy director of the Division of Services and Intervention Research at the National Institute of Mental Health.

The long list of symptoms include everything from feelings of restlessness or having difficulty concentrating to muscle tension, fatigue, and sleep problems. While people who have anxiety attacks often experience symptoms for months, they don’t always realize they have anxiety.

“They seek treatment because they can’t sleep or they get a massage or go to the doctor because they can’t relax,” says Karen Cassiday, PhD, ACT, President of the Anxiety and Depression Association of America. “Worry itself seems like the right thing to do so they don’t seek help for the worry,” says Dr.Cassiday. “With panic, you have unexpected, sudden attacks of intense fear,” says Dr. Sherrill. “You feel out of control, like you are going to die, and the physical symptoms—tightness of chest, difficulty breathing—can be alarming.”

First, rule out other possibilities

Other physical conditions as well as the side effects of certain medications can mimic the symptoms of an anxiety attack and panic disorder. “Anyone who is experiencing symptoms that are intense or overwhelming, especially if they are new, should seek medical advice to make sure they rule out physical cause,” says Dr. Sherrill. Conditions such as low blood sugar, an overactive thyroid gland, hormonal imbalances, autoimmune disorders, inner ear disorders, and dysfunction of the mitral valve of the heart can mimic anxiety while medications such as codeine, calcium channel blockers, ACE inhibitors, statins, and benzodiazepines can cause anxiety-like symptoms such as agitation, dizziness, flushing, tremors, restlessness, palpitations, and fatigue. “Those who experience a panic attack may think they are having a heart attack,” says Dr. Sherrill. “The first thing to do is make sure they are not.”

Recognize that you are not in danger

Anxiety can manifest in many ways, such as general anxiety, social anxiety, phobias, separation anxiety, and panic attacks. According to the Anxiety and Depression Association of America, it’s a normal biological reaction—the body’s way of telling us that something isn’t right—that prepares us to act quickly so we stay out of harm’s way. Yet when anxiety becomes overwhelming and begins to interfere with our daily lives, it becomes anxiety disorder. Panic attacks happen out of the blue and overwhelm with physical symptoms of a racing heart, nausea, trembling, and irregular pulse. “It’s traumatic,” says Dr. Cassiday, “Like the feeling that you got as a kid when someone held you under the water too long—you feel like something terrible is happening.” Many people who experience a panic attack believe they are having a heart attack or stroke and misperceive it as being in imminent danger. “They want to get help because it feels unusual, it doesn’t make sense, and they will call their doctor or go to the emergency room,” says Cassiday. With generalized anxiety disorder (GAD), people experience an attack of worry and experience symptoms of fatigue, restlessness, muscle tension, and sleep problems. “They get caught up in the worse case scenario and they can’t let go of it—what if I lose my job, what if my partner is having an affair, what if my child gets in a car accident,” says Cassiday. While the symptoms of panic attacks and anxiety attacks can be alarming, the most important thing to realize is that you are not in danger, she explains. “You need to understand that it is a false alarm. Even though you think you are going insane, you are not–most panic attacks will peter out after two or three minutes.”

Breathe quietly and slowly

People who suffer from anxiety and panic attacks often experience chest pains, which are caused by hyperventilating and tight muscles in the chest, explains Cassiday. “They go to the emergency room hyperventilating, holding their chest and belly—they are so tight that they forget to breathe.” While the episode can be scary, it’s important not to tell the person suffering the panic attack to “take a deep breath,” says Cassiday. “You don’t want them to over inhale carbon dioxide.” Instead, if you are hyperventilating, breathe calmly. Close your mouth and breathe quietly through your nose, gently, and as slowly as possible to restore carbon dioxide levels—that will make you feel better, says Cassiday. People tend to breathe faster when they are anxious, which can make them lightheaded and dizzy and cause more anxiety. “If you breathe at a rate of six to eight breathes per minute, it cues your body that everything is okay.”

Maintain a healthy diet

If you are experiencing anxiety and stress, the average person can minimize that by eating a good balanced diet, says Dr. Sherrill. Enjoying healthy, well-balanced meals, staying hydrated, and limiting alcohol and caffeine are the first steps in helping relieve anxiety through diet, but there are other foods and habits to consider to help stay calm. A study from Ohio State University showed that omega-3 fatty acids (from foods such as salmon and walnuts) can reduce anxiety while other research has shown links between foods rich in zinc (oysters and liver), magnesium (leafy greens and whole grains), antioxidants, and probiotics. Making sure that you don’t skip meals is also important to avoid a drop in blood sugar, which can cause you to feel jittery and worsen your anxiety.

Exercise regularly

We know that exercise is good for our physical health, but research also shows that adults who engage in regular physical activity experience fewer depressive and anxiety symptoms. “If you are experiencing anxiety and stress, the average person can minimize that by exercising, practicing mindfulness based movement such as yoga and Tai Chi,” says Dr. Cassiday. Aerobic exercise helps your body produce endorphins, which help relieve pain and induce feelings of euphoria while simple activities such as taking a walk can help take your mind off anxiety.