Techniques to help manage panic attacks

Often it is hard to know what to do when a person is experiencing symptoms possibly related to the beginning of having a panic attack.

This practical guide can be used by you and also your family and loved ones to help reduce the symptoms of a panic attack.

This guide is usually used to help prevent a full panic attack. Therefore, it may be difficult to use all elements if panic has already started.

It is a good idea to practice these techniques initially while you are feeling calm and relaxed. This can perhaps become a regular part of your bed time routine.

When you find what works for you and your loved one, write it down for a quick and easy reminder.

Signs of a panic attack

• Heart beats fast.
• Fast breathing.
• Sweaty hands.
• Dry mouth.
• You may feel dizzy.
• You may feel faint.
• Butterflies feeling in your belly.

How can I support my loved one/relative when they are struggling?

It is very difficult to watch someone struggle to breathe and this often results in them having a panic attack.

Here are some practical prompts for you, as a loved one/relative, to consider using to give a sense that you are doing something to help.

Firstly, it is important to know that often the person who is struggling is probably receiving unhelpful messages to their brain caused by a rush of chemicals that can block logical, practical and constructive thinking.

You can help them by reminding them of the methods which help them to dampen their reaction to the situation they are in, which often results in unproductive breathing patterns. This may be a combination of exercises which work for them, including encouraging regulation of their breathing, for example, rectangular breathing, grounding exercises or relaxation.

Breathing exercises

Rectangular breathing

1. Look for a rectangle in the room – a window/small TV. screen/drawer/bricks in the fireplace.
2. Follow the rectangle with your eyes.
3. Breathe in on the short side.
4. Breathe out on the long.
5. Make sure your breath out is longer than your breath in.  Counting can also help, for example, in – 1,2; out 1,2,3,4.

Fan therapy

1. Get in a comfortable position – leaning forward.
2. Hold fan about six inches/15cm away from your face.
3. Aim the draft of air around the sides of your nose and just above your top lip.

Calming hand

The Calming hand is a particularly helpful tool when you suffer with feelings of panic. It also works well with episodes of breathlessness, when you feel like your breathing is out of control.

Look at your hand and go though the following steps:

1. Recognition/acceptance (thumb)
   Firstly recognise the signs that you are starting to panic. Hold your thumb firmly and remind yourself of what to do next to regain control. This will help to calm your breathing.
2. Sigh out twice (index)
   As this relaxes your shoulders, arms, and upper chest (remember to flop and drop). If possible, try to breathe out for longer than you breathe in.
3. Inhale (middle)
   Take a slow and gentle relaxed breath in, focusing on filling your lungs with air.
4. Exhale (ring)
   Take a slow and gentle relaxed breath out, until your breath comes to its natural end. Relaxed breathing helps to relieve the sensation of breathlessness.
5. Stretch hands (little)
   Relax and stop. Stretch and relax your hand, as a reminder that you can and will regain control. Hand stretching is helpful when having an episode of panic.

Grounding exercises

If you or your family/loved one has noticed symptoms that may be attributed to an increase in your anxiety levels use the following steps to help dampen this response. This is call grounding.

Grounding may help to distract you and calm you down.

5 - 4  - 3 - 2 - 1 Senses

If you are feeling worried, say out loud:

5 things you can see

4 things you can hear

3 things you can feel or touch

2 things you can smell

1 thing you can taste.

If in a panic attack already it can be hard to follow all aspects of the technique. It is important to try simplifying the above to still gain the benefits of grounding.

Instead try to focus on one thing that you can touch (for example, something cold - such as a metal object is always good and easy to find like a frame of a chair or a fence, when out and about.

Touch ice packs and focus on the cold feel of the ice.

A-B-C around the room

Look around the room and name something you can see that starts with A, then B, then C and so on.

A = Apple

B = Bowl

C = Cat

If you can say to yourself I am here and I am safe. This helps you to become focused on where you are in space in time and it can start to bring your thinking back to the here and now. As often when experiencing a panic attack your brain becomes overwhelmed with thoughts and feelings, foggy and/or confused and can make you feel out of control, which can often lead to an increase in symptoms. This simple grounding technique helps you gain a sense of control again.

Techniques that help me relax

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