There are a lot of resources online for stopping a panic attack in its tracks. One of the problems when you are in the midst of a panic attack, however, is that you don’t really have access to the part of your brain that will contain all of the tips you may have found online.
So, if this is a struggle for you, I have created an image that you can take a screen shot of, store it, and then have access to any time you may need it. I have tried to include relevant icons to represent each tip to help you better connect with the tip in the midst of a panic attack.
Some of these tips are subtle enough to be done discretely. Many people suffer in silence from panic, completely unknown to those around them. If that is you, please know you are not alone and there is help available. You can text HOME to 741741 to be connected 24/7 with a crisis counselor who can, in real time, walk you through a panic attack.
Here are the 10 tips with explanations about why they work.
1) Cold water
You can either submerge your face in cold water, splash cold water on your face, or place an ice pack over your face.
There is an innate response that humans have to immersion in cold water. It’s called the mammalian diving reflex. The shock to the system communicates to your body and mind that there is an immediate need to redirect biological and mental functions elsewhere. Our system thinks we are about to be under water so oxygen is conserved and heart rate slows. Both of these biological responses interrupt panic.
2) Circle in the palm
Breathe deeply while you slowly draw a circle in the palm of one hand with a finger from the other hand. Watch your finger as you do this.
This will help you shift your attention from the feelings of panic to the feeling being generated by your finger on your palm. It narrows your field of vision and draws your focus away from what is happening in other parts of your body.
3) Pleasant smell
Our minds create connections between things that become associated with one another. This is true for scents as well. There may be a perfume that reminds you of your grandmother or a scent of a food that reminds you of your childhood. If there is a scent that you find very relaxing, place it on a small scrap of fabric and keep it in a ziploc bag in your pocket or purse. Smell it any time you find yourself in the midst of a panic attack.
If you don’t have a scent that has any meaning for you, you can create one. Find a smell that you like (essential oils are a good option) and smell it during times of peace, calm and safety. If you feel peaceful sitting outside on your deck, grab scent-filled scrap of fabric and breathe deeply. Do this a few times and you will have a scent association you can access in the midst of a panic attack.
This technique will require some practice in order to access it during a panic attack. Spend some time thinking about a real or imagined place that brings you great joy and peace. Take a mental snapshot of this place and commit it to memory. Think about how it sounds, smells and feels to you. This creates an “escape path” when you are in the midst of a panic attack. Escape and avoidance are not healthy as a daily coping mechanisms, but it is very useful in the moment for addressing panic.
To use this tip, close your eyes, take a breath and imagine your peaceful place. Examine it from top to bottom or side to side and focus on the image in your mind. What do you see, hear, and smell? If you find that this is hard in the moment, you can alternatively keep a photo or copy of a peaceful place and then take it out and focus on the image when you need to.
5) Label what you see
This is another way to shift attention in the midst of a panic attack from what is happening in your body and in your mind to your surroundings.
Take a breath, look around the room or your surroundings and then name all the blue objects, then name all the red and so forth. It’s helpful to say the names of the items out loud if you are able. The sound of your own voice, calm and measured, can communicate to your brain that you are safe and there is nothing to panic about.
6) Progressive muscle relaxation
This tip takes what is already happening in your body, focuses it and then releases it. When you are in the midst of panic, your fight, flight or freeze mechanism kicks in, activating various muscles groups so they are ready to respond. By taking over the muscle activation, you take control over the tension so that you can then be in charge of releasing it.
Starting at your feet, tighten the muscles in your toes, hold for a couple of seconds and then release. Tighten your legs and release. Do this with paired muscle groups going up the body until you get to your head. You can repeat this several times. You may find that you naturally do it slower and slower with each cycle as your muscles fire and then relax to a resting state.
7) Box breathing
We all know that slowing our breathing is a great way to interrupt panic. However, it can be very hard to access in the moment. The box breathing technique provides visual context to the breath so that you are engaging more than just your lungs.
Slowly draw a box in the air or on the table in front of you with a finger. Breathe in slowly as you trace an imaginary line up the left side of the box, hold your breath as you draw across the top, breathe out as you draw down the right side of the box, and hold as you draw along the bottom, back to where you started. Repeat this process as many times as needed.
It is important to do this slowly. It’s okay if you start out drawing the box quickly, but don’t stay in that place because rapid breathing will exacerbate the panic. You may notice a feeling of tightness in your chest or increased heart rate as you breathe in. This is completely normal and how the human body works. Simply remind yourself of this fact if your attention is shifted to this.
Anxiety and panic can create a free-floating feeling. You may feel light headed, dizzy and a bit disconnected from your surroundings. In order to interrupt this experience, focus on the concrete materials interacting with your body.
This can be the chair you are sitting in or the ground you are standing on. You can say to yourself or out loud, “I notice the chair is hard” or “I can feel the strap of my sandal on my foot.” You can close your eyes as you do this or you can look at the object you are describing. It will help decrease that free-floating feeling.
9) Alternate tapping
A lot of the physical sensations experienced during a panic attack are felt in the head or in the core. This tip will help you soothe the parts of your body that are most activated during a panic attack.
One option is to place your elbows on the table in front of you and place your palms on either side of your face. You can very gently and alternately tap your cheeks with your fingertips. The face is full of nerve endings and by doing this gently you can activate those nerves, turn your attention, and calm your nervous system.
Alternatively, you can cross your forearms over your heart so that your fingertips are at your collar bone. Tap your fingers against your collar bone alternatively.
There is no magic in either of these techniques. It’s just a method for self-soothing. We all need strategies that help us feel soothed when stressed. They may or may not work for you and that is okay. Try to experiment and see if there is another gentle way you can self-soothe during a panic attack.
10) Breath prayer
This is a prayer that will help you focus on God during your episode of panic while enabling your body to shift to activate the parasympathetic nervous system.
As you take a deep breath in through your nose, say: “God is with me.” As you breathe out through your mouth say: “He will never leave me or forsake me.” You can use any prayer or Scripture that is meaningful to you, but just be sure the second phrase is longer than the first. It will help to relax your nervous system.
I hope at least a few of these tips resonate with you and will be helpful if and when you experience a panic attack.
While these tips are helpful for putting the genie back in the bottle so to speak, it does not address the root cause of the panic attack. That will likely require some deeper work with a trained professional. If you think you might need therapy, Psychology Today is a great resource for finding a therapist in your area.