"Those who experience panic attacks on a regular basis often feel embarrassed or ashamed because they know, logically, that these attacks aren’t actually going to kill them." - marissa martin
If you have never had a panic attack before, here is one word to sum up the experience: debilitating. When someone is experiencing a panic attack, they experience a faulty trigger of their “fight-or-flight” response that is located in the body’s sympathetic nervous system. Your sympathetic nervous system is what causes your heart to start pounding, your vision to become blurry, and your head to start feeling dizzy. As a result, it is common for people going through a panic attack to start feeling like they are about to die, and make a beeline to the emergency room.
Those who experience panic attacks on a regular basis often feel embarrassed or ashamed because they know, logically, that these attacks aren’t actually going to kill them. But even though they know this to be fact, there is still something inside of them that is not 100% convinced that what they are going through isn’t catastrophic.
Although only 2-3% of Americans face panic disorder each year, roughly ⅓ of all Americans will experience at least one panic attack in their lifetime. It is important to know how to face these debilitating attacks when they happen so that one can save an unnecessary trip to the emergency room. By using the acronym AWARE, we can learn how to face panic attacks when they occur, and prevent the future manifestation of them.
Acknowledge & Accept
The first thing a person should do when experiencing a panic attack is to acknowledge the feelings of anxiety that come with it. Unfortunately, our first instinct in countering a panic attack is to act in a way that will increase the severity of the panic attack: avoidance. When we pretend that our feelings surrounding the panic attack aren’t actually there, we only make the symptoms worse.
When we acknowledge and accept these feelings, we are saying “I am currently feeling anxious and terrified, but I am not in any real danger. I accept these feelings that are currently occurring, and will make an effort to work with them rather than against them.” We should be accepting of these feelings because there is no actual danger surrounding the manifestation of a panic attack. It is important to remind yourself that no one has ever died of a panic attack, so you will not be doing any harm by acknowledging and accepting the feelings associated with panic.
Wait & Watch
Whenever someone feels an intense onset of panic, they may feel a strong urge to leave the situation that they find themselves in. By giving into these urges, we feed into the fear that is manifested by our panic attacks, and it leads to us avoiding these locations in the future. When we utilize “wait” during our panic attacks, we give ourselves time to collect our thoughts and feelings before making rash decisions based on our panic. A helpful way of thinking about the “wait” step is to view it as counting to 10 whenever we feel angry. Allowing ourselves time to process our emotions and thoughts keeps us from making decisions that we will regret later.
After waiting, one should then spend time looking at the panic attack in particular. Filling out a panic diary entry is one way that people can analyze what is happening to them during an attack. By listing all of our symptoms, the time our attack occurs, and all of the environmental factors associated with the attack, we are able to get a big picture look at what goes on exactly during our panic attacks. It is important that we are actually getting this information down on paper, rather than simply thinking about each of the questions. By writing the information down on paper, it allows us to get some distance from our emotions that are debilitating us.
"one third of all americans will experience a panic attack in their lifetime."
Once we have accepted and watched our panic attack, the next step is to act. An important thing to note is that we cannot act in ways to end our panic attacks; we can only act in ways to help ourselves feel more comfortable during an attack. Some ways that can help us calm down include mindfulness meditation, diaphragmatic breathing, and positive self-talk. There are certain mindfulness exercises that are designed to activate the parasympathetic nervous system, which eases our sympathetic nervous system.
Once we start to feel better, we may immediately experience another wave of panic. People often experience this, and feel like the coping mechanisms above didn’t do anything to help. The important thing to do when this happens is to remind yourself that this is normal, and that what we’ve done in the previous steps can help you! Repeat these steps if you start to feel the onset of panic again, and continue to do so until you start to become more relaxed.
This step is here to remind you that all panic attacks come to an end, and that you won’t feel like this forever. Regardless of how you approach your panic attacks, they will eventually face completion, and the only thing you can do until then is make yourself as comfortable as possible. Panic attacks will always pass.
The AWARE model was adapted from Dr. David Carbonell at anxietycoach.com.
Marissa Martin, Counseling Intern