Panic attacks are sudden, extreme, and wholly terrible. Defined as “the abrupt onset of intense fear or discomfort that reaches a peak within minutes,” according to the Anxiety and Depression Association of America, a panic attack can leave you shaking, out of breath, instantly nauseous, and feeling completely out of control. The physical discomfort and fear of something larger at work, like your lungs giving in for no reason or an actual heart attack, can lead people to more fear, and even a hospital trip.
Gary Brown, PhD, a therapist in Los Angeles who works with teenagers who experience anxiety and depression, told Teen Vogue that “these attacks often come without warning. They produce difficulty breathing to the point that some people can actually pass out. The feelings associated with them can be really scary.” Stress is the leading cause of panic attacks, he adds.
The best way to prevent a panic attack from happening is to recognize the stressors that trigger one, and then find the stress-management practices that work for you. Plus, realize that eating not-good-for-you food and not getting enough sleep can make you more vulnerable to stress.
If you’re experiencing a panic attack, there are some things you can do, Brown says. Here’s his step-by-step guide to calming down and carrying on until the moment passes.
Control your breathing
Since panic attacks typically begin with rapid breathing, or hyperventilation, it’s best to settle down your breath before anything else.
“You want to take control and specifically, you want to take control of your breathing,” he says. “During a panic attack, we take in too much oxygen and do not release enough carbon dioxide. This increases the feeling of panic.”
His advice: “The moment you feel a panic attack coming on, cup your hands tightly over your nose and mouth. Try to get a good seal so that you are taking in less oxygen. This will allow you to expel more carbon dioxide and lessen the degree of panic.”
Talk to yourself (seriously)
“The second thing to do [in this situation] is to literally order yourself to control your breathing by consciously slowing your breathing down,” says Brown. “You want shorter inhales and longer exhales, and slowing your breathing will help immensely.”
He also recommends holding your breath for at least five to 10 seconds to help slow down hyperventilation.
Once you’ve started talking to your breath—which sounds weird, but just trust us on this—get the rest of your body into the conversation. If you can lie down, lie down. Start with your toes, feet, legs, and move all the way up to your head. It’s a total yogi trick to order your body to calm down, but it can also be applied to real-word situations.
Remember you’re not alone
Brown stresses that panic attacks aren’t rare, particularly in young people, who often try to downplay the amount of stress they’re experiencing. Once you’ve got your breathing and physical self together, he says it’s important to focus on the bigger picture.
“Understand that panic attacks can happen to anybody. You are a normal person, having a normal reaction, to an accumulation of stress and anxiety in your life,” he says. “You are not crazy just because you have one or more panic attacks.”
He also says that ending panic attacks comes more from practice and awareness than anything else, but notes that if they’re becoming constant in your life, it might be time to get some outside help.
“Panic attacks always end,” he says. “If the panic attacks continue and they are impacting your life at home, at school, or in social situations, ask your parents to help you find a therapist who can help you with this.”
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