You don’t have to be in a scary situation to have a panic attack. You could be out for a walk, at a restaurant, or asleep in bed – literally anywhere and the signs of an attack can come on.

What are the signs?

All of a sudden you get a strong surge of fear. This triggers physical symptoms like a pounding heart, sweating, shortness of breath, nausea, chest pain, or trembling.

It can last 5 to 20 minutes but once you learn to recognise when attacks are coming on, you can find ways to stop them.

It’s understandable that you’d want to avoid a panic attack at all costs. But it’s important not to let fear control your life.

How to manage an attack

It is important you don’t avoid places where you’ve had panic attacks in the past. If you have one, stay where you are, if it’s safe.

When the attack is over, you’ll realise that nothing terrible happened.

Try self talk when you feel a panic attack coming on. Remind yourself that you’re feeling anxiety, and not real danger.

You can even try directly addressing the fear. Practice an early remembered response like, “I am not afraid” or “This will pass.”

Acknowledge what’s happening because although it is tempting to try to focus your mind elsewhere, the healthiest way to deal with a panic attack is to acknowledge it.

Try not to fight your symptoms, instead keep reminding yourself that they will pass.

Focus your breath because an attack may make you take quick, shallow breaths, so get your breathing under control.

Close your eyes. Put your hand between your bellybutton and the bottom of your ribs. Inhale through your nose slowly and deeply. Then let all that air out gently through your mouth.

You’ll feel the hand on your belly rise and fall and if it helps, you can count from 1 to 5 on each inhale and exhale. After a few minutes, you should start to feel better.

Stay present and try to notice five things you can see around you. Then, four things you can touch. Three things you can hear. Two things you smell. One thing you taste.

When you stay grounded in what’s going on around you, it gives your mind something better to do than focus on fear or bounce from one worry to the next.

H.A.L.T. your attack  and that stands for hungry, angry, lonely, tired — four feelings that bring out the worst in everyone.

If you’re prone to panic attacks, they can turn into triggers do when symptoms start up, check in with yourself: Am I hungry? Am I angry? Once you pinpoint what’s going on, you can take steps to fix it.

Progressive relaxation is a technique that can be very helpful when you feel a panic attack coming on — or are in the middle of one.

Just isolate and tense one muscle at a time and then relax it. Repeat this everywhere until your whole body is relaxed.

Stop projecting worst case scenarios as panic attacks feed on thoughts of “what if.” What if I can’t do it? What if I run into my ex? What if everyone laughs at me?

Acknowledge that fear, then shift from “what if” to “so what?” Sometimes the worst-case scenario isn’t as bad as it seems.

Put a number on it by rating your fear as you can feel your mind scrambling.  Rate it on a scale of one to 10 every few minutes.

This keeps you in the present moment. It’s also a good reminder that you’re not on a 10 the whole time.

Watch for common triggers as caffeine can make you feel nervous and shaky. It can also keep you awake, which can trigger tiredness later.

Nicotine and alcohol can make you feel calm at first, then make you jittery as your body processes it.

All three can trigger panic attacks or make them worse so if you are prone to high anxiety then it’s best to avoid them.

Exercise helps because physical activity lowers stress, which is one of the main causes of panic attacks.

A workout, especially the kind that gets your heart pumping, can also get you to a calmer place. No time for that, the even a 10-minute walk can help.

Slow down your body, and your mind will follow. Practices like yoga and tai chi use slow body movements and train the mind to be calm and aware.

Helpful information: 

Hormone imbalance also plays a part in helping keep you calm you as progesterone is known as a relaxant. If you are under hormonal stress that won’t help your general anxiety levels so check yours are in balance and symptoms under control.

You may need progesterone or a combination of that with oestrogen if anxiety is severe and your other symptoms indicate it.