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Panic attacks and what to do about them

Panic attacks are another common mental health condition that young people seek counselling support for. Panic attack symptoms are a response to the sympathetic nervous system, otherwise known as the flight and fight response which I have covered in a previous blog. https://www.teencounsellingonline.co.uk/post/helping-children-through-school-anxiety Panic attacks are not dangerous but the intensity of them are so powerful that they trick you into fearing that you are about to die or faint. 

Typical Panic Attack Symptoms

* racing heart, laboured breathing, feeling short of breath, hyperventilation 

* chest pain, tightness, and heaviness

* feeling dizzy and/or light headed

* numbness and tingling in the hands and feet

In addition, you may experience a variety of other physical discomforts, including:

* sweating

* feeling "hyper" and filled with energy

* stomach upset

* feeling pressure to urinate or empty your bowels

* weakness in major muscles, especially the legs

* dry mouth

* hot and cold flushes

Panic attacks are awful and those that struggle with them, usually have lots of questions. They want to know what causes panic attacks and why it’s happening to them. Understandably many suffers want to know the answers and how to ‘stop’ them but in becoming so focussed on finding the key they can actually make them more problematic. 

Sometimes there are triggers for panic attacks such as; sitting exams, giving presentations, or a new social situation and other times there are no obvious triggers at all.  Either way, at the time the panic attack is happening it can be extremely frightening.   

If a client is aware of what triggers their panic attack, it is most likely they have adopting avoidance strategies to manage the distress they cause.  The avoidance is giving the client relief from a possible panic attack.   However, in most situations this is not the viable option as by avoiding panic, life fulfilling opportunities are being missed.  For example, not going to a job interview could mean missing out on a dream job.

The best way to deal with panic attacks is in a calm and accepting way. Clients never want to hear the word ‘accepting’ however it really is the key to overcoming panic attacks.  Trying to fight it will only cause more distress so instead we actually need to do the opposite of what our distress tells our body.

Think of it this way. If you are scared of water and you fell off a boat into the sea, you are likely to instinctively panic, which would cause you to flap your arms around, swallow water and sink.  However, if you fell in and were able to breathe calmly and then relax, you would be able to float rather than drown.  That’s similar to how a panic attacks works. So in the moment when our instinct is to fight it, we actually need to accept the panic attack is happening.  As we learn to ‘float’ through the panic attack the intensity of it will subside. 

A panic attack will end.  This is the first thing we need to tell ourselves when it’s happening.  It’s not your job to make it end.  Your job to ride the wave knowing that no matter how awful, it has to end.  It needs it be normalised in your own thoughts as much as possible. In your head say  ‘I’m having a panic attack and as awful as this is going to be I will not die from it and it will end’.

As you are learning to ‘float’ through you panic, work with it and try to be present.  If you were engaged in an activity before the panic attack, go back to it.  If you were walking, keep walking. If you were shopping, keep shopping.

Most importantly, don’t fight your panic, it will make it worse.  You will feel short of breath and your natural instinct will be to gasp for air. When we ‘gasp’ for air our oxygen and carbon dioxide levels are upset which results in the heart racing, dizziness, stomach churning, etc.  So again, we need to do the opposite of what our instinct tell us and rather than gasp for air we need to ‘belly breathe’.

Regulating your breathing will help your panic attack come to an end. 

Here is the basic procedure for Belly (diaphragmatic)  breathing:


1. Put a hand on your chest and a hand on your stomach.

2. Breathe in through your nose for about two seconds. You should experience the air moving through your nostrils into your abdomen, making your stomach expand. During this type of breathing, make sure your stomach is moving outward while your chest remains relatively still.

3. Purse your lips (as if you’re about to drink through a straw), press gently on your stomach, and exhale slowly for about two seconds.


4. Repeat these steps several times for best results.

The more we expose ourselves to situations that make us panic the more the mind learns to cope.  Remember the scary movie analogy…… the first time you watch a scary movie, you’ll experience fight/flight symptoms such as a racing heart and butterflies.  If you watch the movie over and over again, (without adopting safety behaviours, such as looking away) your mind learns to cope and the symptoms will be less intense.   

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