During the past several months, my client Yossi spoke about his feelings and his anxiety concerning the COVID-19 pandemic.“A year in the house with my wife and the kids and all of this social distancing from friends and loved ones is pushing me over the top.“I am collecting unemployment, and my economic future is unclear. I can’t visit my elderly parents until I complete my vaccinations, and I am terrified to send our kids back to preschool nursery and first grade, since I don’t know if my children will become infected.”Yossi reported that he had an anxiety attack the other night after speaking to his aging parents on the phone. They were complaining about their loneliness. Yossi felt overwhelmed, and shortly after his phone conversation his heart started to race and pound, and he felt that he was unable to catch his breath.Yossi was having a panic attack (also called an anxiety attack), and mental health experts are reporting that more and more people are suffering from them during this stressful pandemic year. In Yossi’s case, this was not his first panic attack.What is a panic attack?
A panic attack is a sudden rush of intense fear or intense discomfort accompanied by the presence of four or more of various physical symptoms, including palpitations, difficulty breathing, chest pain or chest discomfort, trembling, choking, excessive sweating, dizziness, and often having a feeling of loss of control or going crazy.Normally when you encounter a threat, your fight-or-flight response kicks in. Your body produces adrenaline, your breathing becomes fast and shallow, your heartbeat speeds up, which rushes blood to the muscles. All these changes, which occur instantly, give you the energy you need to confront a dangerous situation or get out of harm’s way quickly.

With a panic attack, your body goes on full alert for no apparent reason. Researchers don’t know what triggers them, but the physical effects are real.Many people mistake panic attacks for a medical emergency, like a heart attack. The symptoms can seem similar, but panic attacks aren’t life-threatening. Many people, understandably, consult with their physicians and find out that the cause of their symptoms was anxiety. It is estimated that somewhere between 25% and 40% of people will have experienced at least one panic attack in their lives.So what can you do if you have a sudden panic attack?1. Don’t panic about the symptoms. What drives a panic attack to escalate is the fear response that most people have when facing a scary experience. It’s very easy to think of the worst-case scenarios like I am having a heart attack or I am going crazy. This only stimulates more adrenaline and accompanying panic symptoms. So, try to recognize this early on.2. This will pass. A panic attack usually lasts between five to 15 minutes. Knowing this can be very helpful because it can give you a little bit of control as you go through what can be a very terrifying experience.3. Breathing exercises. During a panic attack, breathing could either accelerate (hyperventilation) or become very restricted, causing the person to feel that they can’t breathe. Recommended is the technique of taking deep breaths through your nose, hold the breath in and count to four, and then slowly release the breath out the mouth. Repeat several times until you feel that you are calming down.4. Point of reference. Some people report that focusing on a familiar object like a ring or a piece of furniture or even your hand can help redirect you away from the anxiety thoughts during the panic attack and can help you calm down.5. Know yourself. If you start to identify the moments and triggers of when your anxiety starts escalating into panic, you can support yourself before the panic attack takes place through breathing and other relaxation exercises.I often recommend mindfulness to my clients and teach them how to focus on any visual or tactile stimuli in their surroundings and study it by either feeling it or looking at it with full concentration. Mindfulness is a very powerful tool that can help reduce stress and anxiety.6. Reach out to others. If you are having a panic attack around others, don’t be embarrassed. Let them know. If feeling scared, tell the people you are near that you are scared. In times of crisis, we need to support each other. Panic attacks are common, especially during stressful times like this year has been for so many people.If you are in therapy, tell your therapist about your attack; and if not in therapy, you may want to consider consulting with a therapist to learn how to prevent future panic attacks from occurring.
This past year has certainly posed a mental health challenge for many people. For Yossi, both psychotherapy and the above list of immediate hands-on techniques helped him to feel better and have a sense of control over his anxiety and his life. The writer is a marital, child and adult cognitive-behavioral psychotherapist with offices in Jerusalem and Ra’anana and global online accessibility.
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