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Taking deep breaths can help, talking to someone, taking a cold drink can help.
1) Let the panic know who's boss
"Stopping panic attacks is all about taking back control. To help beat panic attacks, I want you to think about them in a very specific way," I told Kathy.
Panic is powerful but stupid. We're all born with the capacity to panic, but panic is 'blind'. That means it doesn't know what to fear, so it takes its lead from you. If you avoid or run from something (say, the library in which the panic attack happens), then your panic response will tag that place as threatening.
If the panic gets just one hint that a situation is really not dangerous, it will 'call back' its big investment of energy. Breathing will slow down again, blood pressure will return to normal, the sweat response will calm down, and clear thought will return. Like fire fighters returning to their depot after discovering that it was a false alarm.
So you can let your panic know it's not needed by practicing the next tip:
2) Stop running to stop panic attacks
If you panic in a supermarket and flee the scene, then your panic response will conclude that the supermarket holds life-threatening horrors because you ran away from it. It will try to be 'more helpful' by spreading the fear to perhaps all supermarkets or even all situations that have lots of people in them, a bit like supermarkets.
If you panic but stay in the situation until you calm down, your panic response will learn that it's not the situation causing the panic. In nature, we avoid what is dangerous. And the more you avoid something, the bigger the fear builds.
Panic Under Control
The more 'normal' you act, the more panic gets the message it's not needed. By imagining being in a situation in which you fear you might panic whilst you are relaxed, you teach your mind and body to feel relaxed about being in the situation for real. See the free audio that comes with this article.
The next tip shows you how to control breathing - often the fist physical change before a panic attack starts.
3) A breath of fresh air
When we panic, we breathe quickly and high in the chest. This is because your body wrongly assumes it needs to exercise and so breathes as if you were running hard. When we breathe in this way when we are not exercising, we may call this hyperventilation.
Hyperventilation is not serious, but it feels dramatic. Symptoms of hyperventilation include light-headedness, giddiness, shortness of breath, heart palpitations, and feelings of weakness.
"Yes," said Kathy, "I feel like I can't breathe!" It may feel as if you haven't got enough air, but this feeling actually occurs because you have been taking in too much.
To 'switch off' hyperventilation you can:
Hold your breath. Really? Am I kidding? Seriously, holding the breath for as long as you comfortably can will prevent the dissipation of carbon dioxide. The feeling of not having enough air isn't caused by not breathing in enough oxygen but by breathing out too much; so holding your breath prevents this happening. A period of ten to fifteen seconds, repeated a few times, is sufficient. This will 're-set' your breathing to normal.
Then do deep diaphragmatic breathing: slow, deep breathing right down to the bottom of the lungs. Breathing should be through the nose, with the out-breath taking longer than the in-breath. You can quick count in your mind to 7 as you breathe in and 11 as you breathe out (the 7-11 technique). Practice this everyday to get very good at relaxed breathing - because it's impossible to breath like this and panic at the same time.
4) Stop panic attacks by 'acting normal'
"So Kathy, if you do have another panic attack, I want you to make a conscious effort to carry on as if nothing out of the ordinary is happening. Pretty soon the panic will 'get bored', realize it's not actually needed, and drift away."
You wouldn't carry on talking if a hungry lion was about to pounce on you. So keep talking - keep acting as if nothing untoward is happening. You may not feel like 'acting normal', but remember your panic is pretty dumb (even if you have a PhD in astrophysics) and is looking for cues from you as to whether it's needed or not.
With that in mind, on to the next tip.
5) Keep thinking
Keep thinking or doing something that is methodical. During times when panic is really required (a hungry, fractious lion coming right at you), the thinking part of the brain becomes much less active. This happens because we need to become purely physical - to run or to fight.
But if you purposefully start counting backwards from one hundred in jumps of three - '100, 97, 94, 91...etc.' - you force your thinking brain to work, which actually dilutes the panic response. Making yourself do a crossword or read the paper, even grading your own anxiety from one to ten (see: Overcome Fear and Anxiety) - all force your thinking brain to work, which again sends the message: "This is not a real emergency, so butt out!"
Kathy actually did this. She thought she might panic (again when driving), so she started to count backwards and very soon found that she felt normal again.
6) Use the AWARE technique
I gave Kathy a little card we call the AWARE card. (Make one for yourself.) She was to carry it around with her and, if she started to feel panicky, to take it out, read it, and follow the simple instructions:
A: Accept the anxiety. Don't try to fight it.
W: Watch the anxiety. Imagine it is outside of you and you are just observing it.
A: 'Act normal'. Carry on as if nothing is happening. Panic will soon 'get bored'.
R: Repeat the above steps until you start to relax again.
E: Expect the best - it will pass quicker and quicker the more times you do this.
Write these steps down on a card and if you ever feel you might panic, take them out, follow them, and you'll soon calm down.
Now the last tip is perhaps the most powerful.
7) Prepare not to panic
"This is all good advice!" said Kathy. "And I do feel a bit better. But in the heat of the moment, I'll know I'll forget it all!"
This is why I worked hypnotically with Kathy. Sure she could use all the above (and she did), but we wanted her mind and body to naturally feel calm again.
Mental rehearsal whilst very relaxed helps automatically re-jig your responses so that calm naturally starts to replace panic. You just start to find you naturally feel more relaxed.
The best way to do this is to relax deeply with your eyes closed, imagine being in a situation in which you fear you might panic, and just see yourself controlling it; even enjoying the situation and forgetting to think about panic.
What helps me usually sometimes I just think of a light switch turing off or a traffic light going red and other things like that that is what my therapist said to do but every one is different and sometimes you just need to let is happen :)