Panic disorder affects 2 to 3 percent of people in the United States per year, and it is twice as likely to occur in women than in men. Individuals with panic disorder tend to have spontaneous panic attacks, and they therefore become preoccupied with the fear that they may happen again, at any time.
The condition can interfere with many aspects of the person's life, causing them to avoid work or school and avoid situations wherein they fear a panic attack may occur.
Many people with panic disorder are embarrassed or afraid to tell anyone about what they experience, instead distancing themselves from family and friends who could be supportive.
Panic disorder is highly responsive to treatment. Building a toolbox of self-help strategies can be effective in helping you to manage your symptoms without living in fear.
1. Gain knowledge of panic disorder
The first step in overcoming your panic disorder symptoms is to understand what is happening in your body when you experience an attack. Gathering knowledge about the disorder and working out your underlying triggers can be a starting point for dealing with the condition.
Anxiety is likely to cause the worries and physical feelings you feel as a part of panic disorder. Anxiety is a normal part of the body's "fight-or-flight" response to uncertainty, feeling unprepared, or trouble, which prepares us to act quickly in the face of danger.
Panic disorder results from misinterpreting sensations linked with the fight-or-flight response as dangerous, which triggers an uncomfortable and often frightening barrage of symptoms - also known as a panic attack.
Living in fear of having a panic attack and therefore avoiding situations that may cause them can often create more situations and more avoidance in a never-ending cycle of fear and anxiety.
Although scary, panic attacks are harmless; they are the body's alarm system kicking in and are not designed to harm you in any way.
While the response may make you feel as though you are going crazy or dying, you are not. Your body would have the same reaction if you were facing a physical threat, such as coming face to face with a bear.
Once you understand what panic disorder is and why you are experiencing the symptoms, you can begin to learn to cope with them. The goal is not to eliminate the attacks, but to find a way to manage them without fear.
2. Learn relaxation techniques
Relaxation techniques can help to calm your body down, relax your muscles, and help you to think more rationally. Relaxation strategies can also halt the production of stress hormones such as adrenalin, which proves that we are not in any danger.
When we are anxious, we tend to breathe faster, or even hyperventilate. This is commonly called overbreathing, and it can cause us to feel lightheaded and dizzy, and even more anxious as a result.
Calm breathing can help to reduce some of these physical symptoms. Try practicing calm breathing twice per day for at least 5 minutes.
- Inhale slowly through the nose for 4 seconds.
- Pause for 1 or 2 seconds.
- Exhale slowly through your mouth for 4 seconds.
- Pause for a couple of seconds before taking the next breath.
Calm breathing regulates your intake of oxygen and prevents the dizziness, lightheadedness, and tingling sensations that are connected with overbreathing.
Deep muscle relaxation
The goal of deep muscle relaxation is to learn to eliminate muscular tension and stress. Deep muscle relaxation should be practiced every day as a prevention mechanism, not just when you feel panic and stress.
First, you need to tense particular muscle groups in your body, such as your neck and shoulders. Next, you need to release that tension. Set aside around 15 minutes to complete deep muscle relaxation.
- Tense the target muscle group.
- Deep breathe and tense the muscles as much as possible for 5 seconds.
- Release the tension and exhale.
- Remain relaxed for 15 seconds before moving on to the next muscle group.
It is important to focus on the difference between how your muscles feel when they are tense and how they feel when relaxed.
3. Challenge your thoughts
The thoughts associated with panic attacks are grouped into two categories: overestimating and catastrophizing. To break the cycle of panic attacks, we first need to change the way that we think and then change our actions.
To challenge your overestimating thoughts, you first need to understand that overestimating thoughts are guesses about what will happen - they are not facts. Next, you need to assess the evidence for and against your thoughts.
Some questions that you can ask yourself include:
- How often have I had this thought during a panic attack?
- Has it ever actually happened?
- Next time I have this thought during a panic attack, is it likely to happen?
It can be helpful to remember that your fears are highly unlikely to happen and while you have had these thoughts many times, your fears have not come true.
To challenge catastrophic thoughts, imagine the worst possible thing that could happen and then figure out how you would cope.
Some questions that you can ask yourself include:
- What is the worst that could happen?
- How bad is it, really?
- Would it affect my life in a week or a month from now?
- What actions could I take to cope if it did happen?
- Has this occurred in the past? Did it make a difference to my life?
It can be useful to realize that some of the things you fear are more of a minor annoyance than something to be distressed about, and there are ways that you can cope with every situation.
When you feel anxious or feel the need to escape a situation, you can challenge your unhelpful thoughts. Writing them down can sometimes help.
4. Make coping cards
However, it can be tough to challenge unhelpful or scary thoughts in times of severe anxiety, so it might be useful to make coping cards.
Coping cards can feature realistic thoughts about panic attacks to challenge your thinking. You can use an index card or piece of paper, write down some realistic thoughts, and carry them around with you throughout the day.
Everyone's fears are different and personal, but here are some examples of general coping statements that might help you.
- This is a hassle, not a horror.
- I'm falling into a thinking trap.
- I've confused a thought with a fact.
- People cannot tell that I'm anxious.
- It won't last forever.
- I can handle this.
In addition to reading these cards when you feel anxious, it can be beneficial to read these cards daily to remind yourself to alter your thinking.
5. Face your fears
The final step in coping with panic disorder in the long-term is to face what you fear, including the unpleasant body sensations and situations, places, and activities that you have been avoiding.
Through a process called desensitization, your exaggerated responses to certain triggers can be reduced, so that they no longer activate the same involuntary anxiety reaction.
Facing feared body sensations
People with panic disorder are often sensitive to sensations such as dizziness, blurred vision, and increased heart rate. These sensations need to be brought on repeatedly so that eventually, they no longer make you anxious.
To expose yourself to the panic disorder sensations that you fear, you can do the following exercises.
- Racing heart: run on the spot for 1 minute.
- Chest discomfort: run up and down stairs for 1 minute.
- Breathlessness: breathe deeply and rapidly for 1 minute.
- Choking sensations: pinch your nostrils and breathe in and out through a small straw for 1 minute.
- Dizziness: shake your head from side to side for 30 seconds.
- Blurred vision: stare at a ceiling light for 1 minute and then try to read something.
Start with the sensation that you fear the least and work your way up to the sensation that you fear the most.
Facing feared situations and places
You need to overcome situations, places, and activities that you have been avoiding due to the fear of having panic attacks.
Make a list of situations, places, activities, and objects that you fear in order from the least feared to the most feared. Begin with exposing yourself to the thing that you fear the least and repeatedly engage in that activity until you feel less anxious.
Exposure can be brief at first and then extended. Perhaps you could go to the place with a friend or family member to begin with and then tackle going there on your own.
It is important to plan your exposure exercises to feel in control of the situation. Work out what you are going to do and when you plan to do it.
Facing the things you fear most can sometimes be frightening. Take your time and go at your own pace, and you will eventually overcome anxiety.