Copyright (c) 2010 Peter Rubel

Consider panic attack relief under two headings: During an attack and between them. The assumption here is that you have identified your panic attacks for what they are (not a heart attack, and so on).

I. At the Onset of a Panic Attack

When anxiety is first accelerating into panic, find a good place to hunker down. Perhaps a bedroom, washroom stall, even a chair in a low-traffic area if need be.

As quickly as possible, shift to concentrating on slow, controlled breathing as below in this article. Hyperventilation commonly stokes the fires of panic. Focus on slow breathing not only spreads water on the flames, but also distracts one from morbid and scary thinking.

It is also worth saying that you develop the understanding that panic attacks do not mean you are going to die. You are not going crazy. They will pass. That alone provides some relief. During an attack, focus on the light at the end of the tunnel becomes more difficult, but with discipline avoiding the "what if" thoughts and concentrating on getting through is important.

II. Between Attacks

A. Medical Route

Between panic attacks, one can prepare and "attack back" in various ways. If you go to a medical doctor or psychiatrist for panic disorder, they will probably give you some psychotropic (mind altering) drugs. If these have short term positive effect, what about long term side effects? What happens to panic when one goes off the drug? Of course these vary, but your medical professional may recommend or prescribe some kind of therapy or other treatment for added support and long term relief. Therapies may for example include Cognitive Behavior Therapy, Exposure Therapy, or Eye Movement Desensitization Reprocessing therapy.

For some, natural anxiety remedies like herbs and vitamins are also a possibility instead of drugs.

Your physician may give you something to work on between visits. You may be asked to record your feelings daily, especially as they relate to mood and panic attacks. Such attention to detail may prove useful in pinpointing causes and possible remedies either to you privately or with your medical professional in therapy sessions. Of course such a diary is not intended to help one wallow in morbid thinking, but rather to point to a way to stop the panic.

B. Write down your feelings and conditions

Do you fear rejection and loss? Are you anxious lest others think less of you than your reputation? Do you avoid an intimate relationship because you fear the other person might reject you? Do you fear separation from a loved one or loved setting because of job change, divorce, or other change? Do you fear the consequences of a difficult decision you must make? Are you afraid of the consequences of some "big picture" thing (perhaps philosophically speaking) you believe? Did you learn to be anxious in a particular circumstance because your parent was anxious there? Are you more anxious after eating a particular type of food or in connection with some medication you are taking? Are you in physical danger because of violence or disease? Of course you are trying to distinguish between rational and irrational fears. What person or circumstance or responsibility do you avoid? Is there a pattern to your panic or anxiety?

As much as possible, try to identify on paper the source or sources of your anxiety, especially the triggers that set off your panic attacks, whether they have a rational basis or not. Your approach to your anxiety and panic can then be more specifically targeted for solution and relief goals.

C. Rethink the irrational

Relief may come in the form of a rational judgment overcoming an irrational projection. Do you really need to worry about "What if"? Are you really going to faint on the platform when you give a speech? Do you really need to take someone's angry remark personally? Is it OK to have a pounding heart for a little while?

D. Exercises to Stop Panic

Between attacks, practice slow breathing. Ideally you should breathe at about six breaths per minute (twice as fast is common) from the bottom to the top of the lungs through the nose. Work toward that goal. For a five minute session in the morning and five in the evening, breathe in slowly and deeply in for four seconds, then breathe slowly and completely out for four seconds and so on. Expect some experimentation in the beginning. Then work your routine up to ten or fifteen minute sessions. And of course fall back on your routine during a panic itself.

Exercise your body too. Stretching and relaxation exercises before bedtime. Regularly exercise to build muscle and keep the cardio-vascular system running well. Regular exercise directly and indirectly helps with anxiety and depression.

E. Choosing lifestyle issues

You may benefit from changing jobs, diet, living quarters, schedule, or hobbies. Again the object is not to avoid responsibility, but to make life less stressful and more enjoyable. In some cases, anxiety may be exacerbated by mold in the house or industrial toxins; a change may help.

At the end of the day, in most cases combining appropriate methods will prove most effective at stopping panic attacks.