Effective Strategies to Overcome Panic Attacks

Panic attack refers to sudden or unexpected onset of fear or terror that often seems to come out of the blue.  The episodes of these attacks can occur anytime and anywhere. The panic attacks are often emotionally overwhelming and are accompanied by physical symptoms. The person experiencing them may feel that he or she is having a heart attack or is going crazy and is often concerned about having another attack or about the consequences of having such attack. Another characteristic of panic attack is that these episodes occur in situations where they are least expected like during sleep or during relaxation and often last for not more than thirty minutes. However, in some instances, panic attack can be situationally predisposed, occurring only in certain situations such as being in a crowd or while driving. If left untreated panic attacks can develop into panic disorder and other difficulties and can become quite disabling. If you have experienced one or two such episodes without any further episode or complications in the past month, chances are that you are not suffering from panic disorder, and there’s nothing to worry. However, if you have been repeatedly experiencing such episodes along with fear of having another attack combined with major behavioral changes, for at least a month, then you might be suffering from panic disorder or at the risk of developing panic disorder.

Symptoms of panic attack include:

  • Shortness of breath
  • Heart palpitations
  • Chest pain
  • Sweating
  • Shaking or trembling
  • Nausea
  • Dizziness
  • Depersonalization (a feeling of being detached from one’s body) or derealization (a feeling that external world is strange or unreal)
  • Fear of dying
  • Numbness or tingling sensation
  • Fear of “going crazy,” or of “losing control”
  • Hot or cold flashes
  • Choking feeling

Here are some effective strategies to handle panic attacks:

Breathing exercise: Panic attacks can often cause rapid breathing and this hyperventilation can actually worsen the symptoms. Hyperventilation leads to light-headedness, dizziness, palpitation, tingling sensation in feet and hands, and breathlessness, which can actually make the experience more overwhelming and terrifying. Engaging in breathing exercises, however, can really help you ease yourself and control the related symptoms. Engaging in diaphragmatic breathing can actually help calm yourself as you start to experience the symptoms. Close your eyes and slowly inhale deeply through your nose and exhale slowly through your mouth. You can count to five as you breathe in and out. Try to concentrate on your breathing.

Avoid alcohol, smoke, and caffeine: Eat a healthy balanced diet and avoid consuming caffeine, alcohol, and smoking as these have been shown to make the symptoms worse.  Furthermore, avoid medicines that contain stimulants.

Relaxation techniques: Engage in relaxation techniques like progressive muscular relaxation, yoga, and meditation. Make them a part of your daily routine as these activities tend to calm mind and body, and help keep anxiety symptoms in check while inducing feelings of happiness in general.

Exercise: Exercise has been shown to release feel-good hormones and hence, works as a natural anxiety buster. You can engage in walking, running, or simple aerobic exercise for at least 30 minutes daily. Even dancing for 30 minutes can help relieve anxiety symptoms.

Sleep: Lack of proper sleep can also worsen the symptoms of panic attack, so try to get seven to eight hour sleep daily. But there’s another side to it also—symptoms of panic attacks or fear of getting another panic attack can actually damage your quality of sleep.

Learn mindfulness: Mindfulness can help your control the symptoms of panic attack. Depersonalization and derealization are some of the symptoms of panic attacks that can be quite distressing. Mindfulness can help you stay in touch with the reality and present. Concentrate on the physical sensations, like texture of clothes on your body and your feet touching the ground etc. These can help you stay in your present reality.

Concentrate on the objects: As your experience symptoms of panic attack, try to focus your mind on some object that is in your sight.  Try to observe all the details of the object. This can help you distract your mind. As you concentrate you may feel the symptoms are settling.

Acknowledge: Since most of the symptoms of panic attack are often physical and the person experiencing them can feel that he or she is having a heart attack or is about to die, it is important to first and foremost acknowledge that you are having a panic attack. It is important to rule out any medical condition, and once that is done, you should educate yourself about panic attacks. Learn about the symptoms and find out any cues that act as a trigger. This can help you manage your condition more effectively. You might experience that the symptoms are not as overwhelming as they used to be. Once you acknowledge that you are having a panic attack you will be able to calm yourself more quickly and effectively.

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Step-by-Step Guide to Diaphragmatic Breathing

The purpose of various relaxation techniques like diaphragmatic breathing, meditation, yoga, mental imagery is to help the body reach homeostasis in states of heightened arousal. Whenever, we face a stressful or anxiety provoking situation, our body reacts by going into state of heightened physiological arousal both at neurological as well as hormonal levels, and the sole purpose of these techniques is to help reach physiological calmness. Diaphragmatic breathing is one such relaxation technique and perhaps the easiest one to learn and practice in day-to-day life. It is easy because breathing is an act that we perform without any hesitation or thought. But factors like stress, poor posture, clothes that cause restriction of movement, lead us to breathe from our chest instead of from diaphragm. Diaphragmatic breathing is controlled deep breathing and involves the movement of lower abdomen, whereas, normal breathing emphasizes on the expansion of the chest.

There are lots of benefits of diaphragmatic breathing and it plays an important role in meditation which helps in managing stress, anxiety, lack of sleep, posttraumatic stress disorder (PTSD) etc. It also helps lower heart rate and has been highly recommended for patients with chronic obstructive pulmonary disease (COPD). The beauty of diaphragmatic breathing technique is its simplicity; it can be performed anywhere and at anytime and does not require special equipment.

Here’s step by step guide to diaphragmatic breathing:

1. Take a comfortable position: Start by taking a comfortable posture. With your eyes closed you can either sit in a comfortable chair or preferably lie down on your back on the floor. It is recommended for the beginners to wear loose clothes, especially around the neck and waist. To begin with, it is recommended that you keep your hands on your stomach so that you can feel the rise and fall of your abdomen. Once you have mastered the technique, you can perform diaphragmatic breathing almost anywhere and at any time—while driving, standing, or while talking to someone.

2. Concentration: Just like other techniques of relaxation, diaphragmatic breathing also requires concentration. For the beginners, it is recommended to practice the technique in a quiet place with less interruptions and noise. While practicing, you might experience that your thoughts begin to wander. This is normal. Whenever you feel this happening, bring your attention back to breathing. You can in fact imagine these thoughts leaving your body as you exhale metaphorically.

Whereas, normal breathing is an involuntary and not-a-conscious activity, diaphragmatic breathing is a conscious and voluntary one. Concentration can be enhanced by focusing your attention on the components of each breath. Each breathing cycle is composed of four phases–inhaling; slight pause; and exhaling; followed by another slight pause before inhaling again. When performing this technique, isolate and recognize each phase and try to control the pace of each phase-breathing thereby regulating your breathing. During the phase of exhalation, body experiences the highest form of relaxation, so try to focus on this phase and experience how light and relaxed your body feels during this phase.

3. Visualization: This can be easily attached to diaphragmatic breathing and can enhance the effects of this breathing technique. The two most commonly used visualizations along with suggestion are discussed below:

(i) Breathing clouds: Start by closing your eyes and try to focus all your attention on your breathing. As you inhale, visualize the air being inhaled as pure, clean, fresh, rejuvenating, and with healing power. Imagine this whole air traveling throughout your body from your head to toe. Now as you exhale, visualize the air leaving your body as some dark cloud of smoke comprising stressors, tension, and toxins that are inside your mind and body. During each phase of inhalation and exhalation, feel the clean, fresh air with healing power circulating though out your body and all the stress and tension leaving your body as you exhale. Repeat this breathing cycle for five to ten minutes. As you perform the breathing technique, observe that your body becomes more relaxed, stress-free and tension-free. Also, the color of the exhaled cloud becomes light in color from dark to light, which is a symbol of your body becoming relaxed and cleansed from all the negativity.

(ii) Alternate nostril breathing: This technique may require some practice. Start by closing your eyes and concentrate on the breathing. Inhale through your nose or mouth and feel the air entering your body and reaching down your lungs and experience a rise in your stomach as you breathe in. Now feel your stomach descending as you exhale. As you become relaxed, through breathing, take a slow deep breath again. This time exhale solely through your left nostril. After you take out all the air from your body through left nostril, begin inhaling only through your right nostril. Repeat this breathing cycle for fifteen to twenty times. Breathe in through your right nostril and breathe out through your left nostril. After fifteen to twenty cycles, now shift the passage of breathing cycle; start by slowly inhaling through your left nostril and exhaling through the right one. Repeat the cycle for fifteen to twenty times. As you do, visualize the air as it flows through your body. Use your fingers to control inhaling and exhaling, it will also helps you better visualize the air flow.

(iii) Energy breathing: This is a breathing technique in which you breathe not only through nose or mouth, but through your whole body. This helps vitalize the body. In this breathing, the whole body in a sense assumes the role of one big lung. This technique can be performed while sitting or lying down on the floor. This technique has three phases. First, attain a comfortable position; now imagine a hole at the top of your head. As you inhale, visualize energy entering the top of your head in the form of a light beam. Now as you inhale, take this energy down to your abdomen. As you breathe out, let it (energy) go out from the top of your head. Repeat this ten times. As you perform this technique, let the light touch all the inner parts of your upper body.

Now move on to the next phase; visualize that the center of each foot has a hole. Again imagine energy in the form of a light beam. As you breathe in from your diaphragm, let the flow of energy move up to your abdomen from your feet, while focusing only on the lower parts of the body. Repeat this ten times. As you do, let the energy in the form of light reach all the inner parts of your lower body.

Now uniting the movement of energy from the top of your head and feet, direct it to the center of your body while inhaling with the diaphragm. Then allow the flow of energy to reverse direction as you breathe out. Do this ten to fifteen times. Every time you circulate the energy in your body, feel each body part and each cell getting rejuvenated. This technique, however, requires practice.

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