The Covid-19 pandemic and now the post-pandemic return to 'normalcy' in some places, has contributed to a significant surge in stress and anxiety levels across the globe.
One of the major byproducts of living with this severe pandemic-induced stress and anxiety has been a sharp increase in panic attacks. According to a 2021 survey, three-quarters (32.5%) of Americans have experienced a panic attack since the start of the pandemic. Meanwhile, separate research published last year in the Journal of the American Medical Association (JAMA found that there has been a huge spike in Internet searches for "panic attacks" and "anxiety attacks" since the beginning of the pandemic in March 2020.
"Anxiety disorders are at an all-time high," says Aimee Rubin, New York-based licensed clinical therapist specializing in anxiety, OCD and depression. "I have noticed that people who have never formally been diagnosed with an anxiety disorder now are. And I'm finding a lot of individuals who have developed generalized anxiety disorder (GAD), which has been turned into obsessive-compulsive disorder (OCD), panic attack disorder and anxiety attacks," she adds.
First things first, what exactly is a panic attack?
"A panic attack is an episode of intense fear or intense discomfort that typically occurs out of the blue," says Dr. Ernesto Lira de la Rosa, licensed clinical psychologist and member of the media advisory group at the Hope for Depression Research Foundation. "It's accompanied by uncontrollable physical and psychological symptoms that may include shortness of breath, chest pain or discomfort, sweating, trembling or shaking, nausea, heart palpitations, numbness and fear of dying or losing control," he explains.
"Given the sudden onset and the intensity of the physical and psychological symptoms, many people think they are having a medical emergency," adds Dr. Lira de la Rosa.
Genetics, major life changes such as the loss of a loved one or past traumatic experiences are some of the most common factors that can contribute to a panic attack. "Sometimes, the environment can also be a significant contributor. This is especially true for people who may be overworked and stressed and with little time and energy for themselves," says Dr. Lira de la Rosa.
Sometimes, people tend to confuse panic attacks with anxiety attacks and refer to them interchangeably, however, they aren't the same.
"An anxiety attack can best be described as the sudden increase of anxiety symptoms. These symptoms include racing thoughts, restlessness, unwanted or intrusive thoughts, difficulty in concentrating and potentially physical symptoms like rapid heartbeat, fidgeting, nausea and sweaty palms," explains Amanda White, founder and clinical director of Therapy for Women Center, Philadelphia.
Here's how you can stop a panic attack:
Panic attacks are extremely distressing. However, if you can understand the physiological response behind your panic attacks, you can find ways to get through them, reduce the intensity of future panic attacks and even prevent them from happening, says Dr. Lira de la Rosa. Here are five expert-approved strategies to overcome panic attacks:
- Reassure yourself that you are safe: "One of the most important things is to remind yourself that you are having a panic attack and aren't in physical danger," says White. "Panic attacks can feel so intense that we feel as though we are dying and remembering that you are safe is crucial," she adds.
- Try to change your perspective: One way to look at a panic attack is by imagining that you have both a gas and a brake pedal in your body. When you experience a panic attack, your body senses danger and your sympathetic nervous system (SNS) is activated rather quickly. It’s like someone stepping on the gas pedal of a car and flooring it. What you want to do, in this situation, is to help the body step on the brake pedal—which is the parasympathetic system (PNS) that is responsible for the rest and digest response, explains Dr. Lira de la Rosa. However, it's important to understand that, unlike the sympathetic nervous system, the parasympathetic nervous system does not function like a reflex and it takes time to kick in. You can help the PNS (brake pedal) kick in by engaging in relaxing strategies such as reconnecting with your breath. You can engage in deep, belly breathing as a way to help activate the parasympathetic nervous system. This type of breathing helps your body recognize that there is no real danger and the alarm was a false one. For others, using their imagination to visualize peacefulness and tranquility might help activate their PNS. I would encourage people to use both deep breathing and imagination together. Every time you inhale deeply, imagine feelings of calmness and tranquility going into your body. And picture all the little traces of panic leaving your body through your exhale, suggests Dr. Lira de la Rosa.
- Go somewhere quiet: "If you are in a crowded area, try to find someplace where you can have a moment to pause and be alone," suggests White. If you need to leave the grocery store and go to your car, do that, or see if you can go to the bathroom or go outside. Once you are alone, try to engage your senses, so your body can recognize that you are safe and can help bring you out of your head. "I love the 5,4,3,2,1 technique where you look for five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste," explains the mental health expert. "If you find yourself having frequent panic attacks, bringing some things with you that feel safe (like lavender oil, worry stones, etc.) can also be helpful," White adds.
- Try box breathing: If your heart rate is really high, White recommends trying deep boxed breathing. This breathing technique involves regulating your heart rate by breathing in to the count of four. Simply hold your breath for the count of four and breathe out to the count of four. "If you are at home or have access to it, holding ice cubes in your hands can help channel your feeling of panic by jolting you into the present moment because of the intense sensation," she explains.
- Understand your triggers: "Panic attacks may seem to come out of nowhere, but if we slow down and recount what we were doing that day and how we were feeling, we may be able to understand the clues that led up to it. Make a list of when and where you have had panic attacks," notes White. We often end up with panic attacks repeatedly in the same environment (such as on a plane or in a crowded place). Make a list of what you will do if you have a panic attack there and how you will handle it. "If you have a history of having a panic attack in a certain place, try to not avoid those places altogether, but instead practice going in small doses," she suggests. For example, if you tend to have panic attacks at the grocery store, practice going to a smaller grocery store. Or during odd hours when there is less footfall. "You could even practice driving there but not going in. This way your body starts to build a tolerance to go without having a panic attack to cope," says White.
And here's how you can you help someone else experiencing a panic attack:
"Panic attacks can be difficult because they often do not make logical sense. So the best thing you can do to support someone who struggles with panic attacks, is to not try to 'talk them out' of their reaction", says White.
Don’t tell them how they should or should not feel. Instead, ask how you can help. "Often one of the best things we can do when someone is struggling with a panic attack is reminding them that they are safe, offering to do grounding skills with them or giving them some time alone," she notes.
Even doing simple breathing exercises with them in a quiet place may help, suggests Rubin. "Inhale for four seconds, hold two seconds, and exhale for six seconds. The point is to regulate the individual's breathing as well as decrease their anxiety," adds the therapist. Here are a few more relaxing deep breathing exercises to try together.