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"Just Relax" and Other Panic Attack Mistakes

March 22, 2017

Friends and family mean well when they see you in the throes of a panic attack.  As scary as a panic attack is to experience, they can be just as scary to watch:

a fun-loving person turned into a terrified, hyperventilating mess in a split second.   So our loved ones want to fix it, and fix it fast!  But if they've never experienced a panic attack, they most likely won't understand what is happening and may even get frustrated when their attempts to talk you down don't work.  While people generally don't like to admit to having panic attacks, it can be helpful to educate those closest to you (your panic attack support team) about what's going on and how they can best help should a panic attack arise.

 

First, what NOT to do:

  • Say "just relax."  During a panic attack, a person's body floods with stress hormones like cortisol and adrenaline, so in that moment, it is physiologically impossible to "just relax," and the command to do so makes most people panic more.  

  • Say "it's no big deal."  Panic attacks feel like a gun to the head.  The terror feels that real, even though the anxious person recognizes logically that it is not.  This is a great frustration for people with panic attacks.  They usually know that the trigger is harmless (or not life-threatening at least), but their body does not cooperate.   So reminding them that "it's no big deal" can further embarrassment and frustration, contributing to more stress and panic.

  • Meditate, without training.   Meditation is a powerful tool in preventing and eventually dealing with panic attacks.  However, if you are not trained in meditation and how to apply mindfulness tools to a panic attack, you can set yourself or your loved one up for more anxiety.  Trying to meditate while having a panic attack is like a first time surfer hitting the big waves in Tahiti.  Those monster waves can be surfed (and conquered!) but your loved one needs the skills to apply them first; otherwise, they'll feel like their drowning.

What to do:

  • Move into a safer space, away from people, if possible.  Anxiety attacks are very difficult to manage around other people, only because the stress of hiding them can prolong the discomfort.  Sometimes getting away from people is not possible, and that's manageable too, but for the quickest recovery, give your loved one space to ride it out without the eyes of other people upon them.  Still, most people won't even know that a panic attack is happening.  (Though they feel like a train wreck, panic attacks typically present as a largely internal phenomenon.)

  • Help focus externally, not internally.  No more "just relax" or "calm down" or "focus on your breath."  Help ground your loved one in the present moment: "Hey, look at those trees.  It looks like the flowers are starting to bloom."  The physical symptoms of panic are overwhelming and create hyper-vigilance in the body.  By focusing externally, a person experiencing panic can interrupt the cycle of hyper-vigilance and help the attack pass faster.

  • Talk about something other than panic.  And then check in occasionally.  When an intense experience arises, the instinct is to talk about it: "What's happening now?  Your heart's beating fast?  Let's work on slowing it down."  As said above, this line of questioning feeds hyper-vigilance.  Ask about plans for the week.  Talk about funny movies or memories.  Anything that focuses the mind elsewhere or sneakily nudges the brain towards positive feelings.  Then, after five or ten minutes, ask a generic question: "How do you feel now?"  Don't ask about symptoms specifically, such as "Has your heart slowed down?  Have you stopped shaking?"  That brings attention to the sensations again.  But checking in does let your loved one know that you're taking this seriously and care.

  • Touch them, if that helps.  Some people don't want physical touch during a panic attack.  It makes them feel claustrophobic or clammy, so ask if a hand hold or hug would be helpful before you try.  Touch releases oxytocin, nicknamed the "love chemical," in our bodies which reduces stress hormones like cortisol.   Flooding the body with calming hormones can help short-circuit the adrenaline explosion that causes so many uncomfortable panic attack symptoms, like a racing heart and tremor.

  • Get in therapy.  Talk therapy with a panic attack specialist along with relaxation techniques and panic attack education are extremely effective in stopping panic attacks before they start, and nobody will ever have to say "just relax" again.

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