How to manage panic attacks

42-year-old male client tells me: “A week ago, I got severe palpitations, my heart was racing, and I was sweating profusely. My wife and I both thought I was having a heart attack and given that there is a history of it in my family, I began to panic more. We called an ambulance and I got myself admitted to hospital. It turned out that I was having a panic attack. They did the necessary tests and then asked me to get in touch with a therapist. Now I carry this perennial fear that I may have another panic attack.”

Much before the pandemic, there had been an increase in the number of clients, across gender, who talked about experiencing panic attacks. From 2020, though, the number of people who reach out to their general practitioners, therapists and psychiatrists for panic attacks seems to have increased significantly. It’s becoming clearer that more and more younger people are reaching out; children as young as 11-12 are reporting panic attacks.

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The American Psychological Association defines a panic attack as “a sudden onset of intense apprehension and fearfulness, in the absence of actual danger, accompanied by physical symptoms such as heart palpitations, difficulty breathing, chest pain or discomfort, choking or smothering sensations, sweating and dizziness”.

A panic attack can feel all-consuming and it’s extremely scary for the individual experiencing it. Generally, clients report that they feel like it’s never going to end. They may experience a feeling of unease, chest pain, chills and shivering too. A consistent feeling that clients report during panic attack is debilitating fear and a feeling that they are dying. As a result, it’s normal for people to rush to a hospital.

The good thing is that panic attacks can be managed and we can learn how to cope with them using research-based strategies. If you struggle with panic attacks, it would be a good idea to work with a therapist and understand the reasons and tools you can use to deal with it. Secondly, if the panic attacks are extremely frequent and intense, it’s a good idea to see a psychiatrist, who can decide if you need medication along with psychotherapy or counselling.

The first step is to identify and recognise that what you are experiencing is a panic attack and educating your family and loved ones about it. If your loved one is experiencing a panic attack or struggling with it, learn not to panic yourself.

While panic attacks seem long-lasting, it’s important to remember that they do end. It helps to identify and repeat to yourself that you are having a panic attack and you will be fine.

Very often during a panic attack, people end up holding their breath without being aware of it. Don’t do this since it can worsen the panic you are already feeling.

Belly breathing seems to work for some people, though some may not be able to do this at all. For others, holding ice cubes in their palms helps; so does sitting down and slowly sipping cold water. I often hear my clients tell me that their pet’s presence goes a long way in calming them.

I would suggest that you consult your therapist and psychiatrist before trying these techniques; they can advise you, based on your existing medical conditions and history.

Meditation often backfires in the midst of a panic attack and I don’t suggest it.

What’s important to remember is that timely intervention and expert advice can help you deal with attacks, and, in turn, improve your quality of life.

Sonali Gupta is a Mumbai-based clinical psychologist. She is the author of the book Anxiety: Overcome It And Live Without Fear and has a YouTube channel, Mental Health With Sonali.

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