In Part 2, I went over what causes panic attacks.

In this part, I’m going to go over how to handle panic attacks.

The symptoms of a panic attack are the following:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feelings of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, light-headed, or faint
  • Chills or heat sensations
  • Paresthesia (numbness or tingling sensations)
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or “going crazy”
  • Fear of dying

You’ll notice the majority of the symptoms from the above list are physical symptoms. Only the last 3 symptoms are psychological. As identified in part 2 of the panic attack series, the main cause of panic attacks are genetics, drugs, and your past experiences. But, panic attacks can come out of the blue and happen for any reason. Whatever the cause of the panic attack is, the cure is the same: Deal with the fear of having a panic attack.

What fuels a panic attack is the psychological fear behind it. From my observation and reflection on my own panic attacks, I noticed the panic attack tends to have two waves to it:

  • First wave: I feel the physical symptoms of a panic attack start to onset and then I start to fear having a panic attack.
  • Second wave: The fear of a panic attack continues to drive the physical sensations and make them even more intense, which further perpetuates the fear and intensity behind the attack.

Deep down, fear continues to drive a panic attack becaused you become scared of the physical symptoms of a panic attack and you feel like you can’t handle it.

I get why you feel that way.

  • There’s fear that you’ll cause a traffic accident while you’re driving.
  • There’s fear you’ll suffocate and die by yourself when there’s no one else to save you.
  • There’s fear that you’re suffering a heart attack and you’ll die by yourself.
  • There’s a fear that you’re going crazy and will be locked up in an insane asylum the rest of your life.

All those fears tie back to feeling like you aren’t capable and not in control. 

So, what is the way through?

I’ve come up with a 3-step framework for dealing with panic attacks:

  1. Face it
  2. Accept it
  3. Chase it

An explanation for each step is below:

Face It

Face your fears head on and walk them down.

When we’re struggling and we’re scared of dying / going crazy / losing control, it’s natural to want to avoid situations we feel have triggered the panic. But, anything at any time can trigger panic. Trying to avoid everything that triggered your panic is untenable. You’ll end up staying at home all the time, and even being at home might still trigger a panic attack.

Avoidance fuels fear.

If you avoid living your life, it will reinforce to your mind that “I’m not good enough to handle this, and panic attacks are this monster that have control over me.” This is a mindset of disempowerment, where you have already acknowledged defeat without seeing panic attacks as what they really are: Unpleasant physical sensations fueled by fear.

Instead of turning your back to panic attacks (which allows it to chase you), turn around and face it head on. I get that it’s scary, which is why I’ve come up with steps 2 and 3.

Accept It

The idea of “accepting” panic attacks may seem strange. Why would you accept something that has caused so much chaos in your life?

Here’s why:

Resistance fuels suffering

Suffering comes from resisting what reality is.

When we’re having a panic attack, we resist the situation and think: “This is not where I want to be right now.” This resistance behind this thought intensifies the negative emotions we feel towards the panic attack. Deep down, the thought “This isn’t where I want to be right now” is rooted in the fear how we don’t feel like we can control the panic attack. If you were in a situation where you had total control, you wouldn’t fear going into that situation. In addition, the fear of having a panic attack is still rooted in resistance as a panic attack isn’t your current reality.

When you accept everything, you learn to be okay with reality (whether it’s pleasant or not).  Accepting a panic attack halts you from adding additional fear to your panic attack.

After suffering from a few panic attacks, I decided I would accept the panic attack in its totality. I would accept it for all of its physical symptoms (i.e. difficulty breathing) as well as its psychological symptoms (i.e. feeling like I’m going crazy or going to die). I was tired of trying to “fight” the panic attacks, and I also realized my avoidance wasn’t working anyways. My acceptance of my panic attacks taught me how to endure the physical symptoms of a panic attack, which increased confidence in my ability to handle them. Acceptance of the panic attacks also cut out the second wave of the panic attack from happening because I no longer added any unnecessary fear to the panic attack. 

Over-identification with fear & emotions fuels panic attacks

For those of you who read a lot of self-help, you’ll constantly see content that goes along the lines of “your thoughts will determine your future”.

Does the following look familiar?

Consequently, people get obsessed with controlling their thoughts because they feel like it’s their reality.

It’s not.

From the years of meditating I’ve done, I noticed it’s not the thoughts that are good or bad. It’s the emotion we attach and fuse to them. Once the emotions are fused to the thought, triggering the thought will continue to fuel the emotion. This can be a positive or negative cycle. In the case of people who have dealt with panic attacks, it has become a negative cycle. We’ve fueled the fear and panic behind a panic attack, and further reinforced the feeling we are not in the driver’s seat of our life.

We’re not our thoughts. Just because we think of something doesn’t mean we are or will become what we thought (whether positive or negative). If you believe that your thoughts will become your reality and are a reflection of what / who you are, you’ll desperately try not to think bad thoughts or feel bad things.  This puts a lot of pressure on yourself and ends up adding to your anxiety. Trying to fight off negative thoughts and the feelings of panic only feeds the beast because you’re attaching even more negative emotion to the feelings of fear, shame, and helplessness.

Here’s a story from Buddhism I find very relevant:

The night before the Buddha’s enlightenment, he fought a battle with the demon god Mara. Mara attacked him with everything he had – lust, greed, anger, doubt etc. but didn’t succeed. Even after the Buddha achieved enlightenment, Mara would continue to show up unexpectedly. Rather than ignoring Mara of driving him off, Buddha would invite him to sit with him and have some tea. Mara would stay for a while and then go, but the Buddha remained undisturbed.

When you accept every thought that comes your way and observe it, you are less likely to have a panic attack because you take all the negative emotion out of the thoughts you are having. Being able to watch your thoughts and feelings behind them gives you space as an observer, and allows you to not identify with the negative emotions behind certain thoughts.

Acceptance of whatever thought comes your way is rooted in the belief that you are not your thoughts and you are not a slave to your thoughts. This belief reduces the anxiety / fear we feel towards our thoughts, and is another ax chop to the fear fueling panic.

Chase It

Once you’ve learned how to face the panic attacks and accept them, you effectively take the wind out of the sails from panic attacks. Now, it’s time to go one step further: Tell panic attacks to give you their best shot. When you face your panic attacks and dare them to give it their all, you automatically change your role from a victim to an empowered individual. The panic attack no longer is a threatening situation, but an opportunity.

There was a point I was so sick of being scared of panic attacks I thought: “Fuck it, come at me. Give me your best hit. Whatever happens, will happen. If you win, so be it. But, I won’t go down without a fight.”

Here are some examples of how I’d respond to the fear associated with a panic attack:

  • Fear: “Oh no, you’re going to cause a car accident.”
    • My response: “Fuck it, if I cause a car accident and die so be it. I’d like to see you try panic attack…is that all you got?”
  • Fear: “You’re going to suffocate by yourself in your apartment.”
    • My response: “Then I die then. Go ahead and see if you can choke me out. I dare you.”
  • Fear: “You’re going crazy”
    • My response: “I know that’s not true. But, I’d like to see you try to make me crazy panic attack. if it does happen, so be it. At least I won’t have to pay for shit the rest of my life.”

You’ll notice my general attitude toward the panic attack fears boiled down to: I don’t give a fuck…show me what you got.

When you start chasing your fears, you call its bluff and realize that it’s all bark and no bite.

—–

Here are a few important things to consider when you implement my framework for dealing with panic attacks:

  • Treat this as a practice. Do not beat yourself up if you don’t successfully deal with panic attacks every single time. Every person is different, and some people will need more time to be able to effectively face the panic attack, accept it, and then chase it. Beating yourself up doesn’t help in reducing your fears. Be kind to yourself. For those of you who are thinking right now: “I feel pressured to not put pressure on myself when a panic attack hits to use this framework as practice”, just know that trying is enough. We can’t control the outcome, but as long as you attempt to try, then you should consider that a success.
  • Have realistic expectations. Given how much bewilderment and fear panic attacks can cause, it’s natural to never want to experience them ever again. That’s why you’re still reading this, right? Well, having these expectations can actually cause more anxiety and fear because you’re wondering if you’re “cured” forever after you effectively deal with one or more panic attacks. The reality is, most of us may experience a setback that may happen weeks, months, years down the line. And, if we have the expectation that panic attacks will never happen again, having one happen again will shatter that sky-high expectation of never having a panic attack. This fuels the panic & fear machine. When you reach this point, go back to acceptance (step 2). Accept that it’s a possibility that a panic attack may happen in the future. Know that you have the tools to deal with it if it does happen again. You’ll know panic attacks no longer control you when you no longer worry about them happening again because you know you can handle them if they do occur.

I hope the simple framework I gave you will help you effectively manage any panic attacks that may come your way. If any questions or comments, please leave them in the comment section below.

Peace and courage,

Jeremy