What should you do when experiencing an anxiety or panic attack?

Are you reading this because you’ve been experiencing anxiety or panic attacks or supporting someone with these? Then please keep reading, because knowing the right things to do will help you or them get through and learn how to manage better the next time.

I’ve written this with two narratives. One is directed to the person going through a fight or flight response, and the other is for a companion assisting a person going through it. The narrative to the companion is also good knowledge, if you’re taking yourself through the process alone. It shows why each step is done.  If you’re reading this while having an attack, just read the bullet points and come back to the whys another time.

  • The first thing, if safe to do so, is to stop whatever it is you might be doing. This process is going to take a good few minutes.

Stopping may seem easy and will be easier for some than others. Please remember, though, if you are supporting someone, everything in their body and mind is on high alert and perceiving imminent danger. Go slowly, and be as patient as you can be. When you’re talking with them, slow down your sentences and talk in a calm voice. Let them know you’re happy to stay with them.

  • Now concentrate on your breathing, making your out breath longer than your in breath. If this is difficult, start by only thinking about your out breaths, making them slow and long. You can be sure your breaths in will come naturally.

Asking them to concentrate on their breathing, as above, not only helps bring their focus onto something different, but will also slow their breathing down, which also helps slow their heart rate.

As they do this, reassure them in a slow and calm voice, tell them they are doing well and to take their time, continuing to concentrate on their breathing.

  • Next, we are going to concentrate and focus on what the floor feels like through your feet. If you’re at home, you might want to take off your shoes, but you don’t have to. Wiggle your toes and feet so that you can feel the connection with the floor, at the same time still keeping your out breaths longer than the in.

All too often, someone going through a panic attack can feel like they are floating away. Here, we’re keeping your companion grounded. As they do this, let them know they are doing well.

  • Take your time. When you’re ready, I would like you to take a moment and slowly ask yourself the following questions:

“Physically, where am I at this moment in time?”

“What is the time and date?”
(If you don’t know the exact time or date, it’s OK, today at this moment is just as good.)

“At this moment in time, am I safe?”

It’s very important you’re only thinking about this moment in time when you ask yourself the above questions. Take your time, and slowly go over them again.

  • Now I would like you to put the answers together in one sentence and to say it out loud. For example:

‘At this moment in time, I’m in my office at the Latton Bush Centre. The time and date is 9.45am on Thursday 17th December 2020, and at this moment I’m safe’

Or

‘At this moment in time, I’m in my office at the Latton Bush Centre, and now at this moment today, I’m safe.’

These questions may seem very simplistic or even somewhat patronising, but please understand they’re very important to ask in such a way in order to ground someone in the state of fight or flight.

It might help here to understand that the fight or flight response is a survival instinct that’s instigated by the unconscious mind on detection of a threat. This is in spite of the conscious part knowing there isn’t a threat.  So, seeing as we’re getting the conscious mind to reconcile with the unconscious mind, it’s very important we keep the language very simple and don’t work with negative words. For example, we should never use the term, ‘You’re not in danger’ because, when reconciling with an unconscious mind, it will hear ‘danger’ first, and is therefore more likely to  perceive a threat.

  • Take your time and bring your focus back to your breathing. You might just want to focus only on your out breath, or you might be ready to take this to the next level. Remember, there’s plenty of time.

When you’re ready and if you’re able, take your next breath in through your nose, then release long and slow through your mouth. There’s no rush, and if it feels uncomfortable then just concentrate on making your out breath longer than your breath in.

If possible, breathing in through the nose will give the right shot of air to the lungs. Breaths through the mouth can contain too much air, which will also make its way to the stomach. This can enhance a sick feeling that’s already likely to be there as a symptom of the fight or flight response.

There’s no need to move them on to the next level of breathing through their nose if this is uncomfortable. They’ll still reach a state of calm if they continue to make their out breath longer then their breath in. Keep telling them they are doing well. Tell them this moment will soon pass.

Keep remembering to assist with a slow calm voice — even though they should be starting to calm, it’s really important to keep giving them time to focus. For some, this might be enough, but others will need to continue and keep repeating, always coming back to their breathing.

  • Next, I’d like you to fix your concentration onto one object: a cushion or a piece of clothing, even a plant or any object you can touch. In your own time, use all your senses to investigate this object. Take a moment on each of the following:

Think about what it looks like.

Think about what it feels like.

Does it have a sound when you move it or raise it to your ears?

Really focus on what it is you’ve chosen to study. It’s OK to take a good few moments with each sense. While you do this, keep your out breath longer than your in.

Here we’re introducing a distraction from patterns of thinking that could easily reinitiate the fight or flight response. Keep telling your companion they’re doing well. Let them know you’re still there and that you’re both doing well.

Things you might want to do to help along the way. You might want to ask your companion where they want you to be. They might want you close, or they might feel safer having you at a distance.

It’s very likely they’ll be feeling hot, so ask them if they want a window open or to move closer to the window.  If they do need you to do something, try not to rush but move calmly.

  • It’s very likely, if you’ve followed the above instructions, you’ll be feeling a lot calmer. However, no two people are the same. If you need to, go back to the beginning and go through this process again.

When someone has gone through an anxiety or panic attack, they’ll often feel like they have just made a fuss about nothing. Yet the feelings, physical and emotional, are extremely strong. Try to remember that, just because you can’t fully understand the trigger or understand why you or they were so frightened, it doesn’t mean this was a fuss about nothing.  

You might find this exercise is enough to reduce, control or manage future anxiety. If not. I’d recommend seeking some counselling privately or through your GP.