"I had a panic attack while in line to grab a bagel. It was terrifying, and I haven't returned to the restaurant since because I'm scared I'll have another while I'm there. It's been nearly two years, but I just can't make myself go back."

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According to the Cleveland Clinic, 11% of Americans experience a panic attack each year, and approximately 2-3% of those individuals will develop panic disorder.

If you've ever experienced a panic attack, you know how frightening and all-consuming it can be. At the drop of a hat, it feels like your world has turned upside down - your thoughts spiral, your body feels strange, and you just want the feeling to stop, but you fear it will never end.

There's never a good time or place to have a panic attack. Sometimes the comfort of our own homes can help us feel a bit safer versus a public environment, but neither is ideal, and knowing how to ground yourself from panic can help reduce the length and severity of an attack.

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What are the symptoms of a panic attack?

Panic attack symptoms tend to be intense and exhausting. It’s not uncommon for people to fear they are having a heart attack or stroke. Understanding the key warning signs is important for both you and loved ones.

Common symptoms include:

• Might come on suddenly with little to no warning
• Lasts around 30 minutes, with a peak in less than 10 minutes
• Sweating or chills
• Increased heart rate
• Rapid and short breathing
• Feeling of impending doom
• Lightheadedness
• Tingling or numbness in the hands and fingers
• Feeling a loss of control

Panic attack symptoms sound reminiscent of anxiety because anxiety and panic attacks do overlap emotional and physical symptoms. And if not grounded, anxiety attacks can sometimes turn into panic attacks. 

What causes panic attacks, and how can you avoid them? Researchers don't exactly know what causes panic attacks, but certain risk factors can prime the body to wrongly activate the fight or flight response. 

Intensive physical exercise, excessive caffeine intake, a sudden change in environment (such as being in a crowded store or changing temperatures drastically), acute and chronic stress, and certain medications can increase your likelihood of experiencing a panic attack. Additionally, people with anxiety disorders may be more susceptible to experiencing panic attacks.

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What are the symptoms of an anxiety attack? 

• Anxiety builds up gradually
• Can last for an extended period of time
• Trouble concentrating
• Restlessness
• Emotional distress
• Apprehension and worry 

Having a toolbelt of grounding techniques can help you feel more in control of both anxiety and panic attacks. 

5-4-3-2-1 grounding technique

You've probably heard of the 5-4-3-2-1 grounding technique if you've ever experienced or read up on panic attacks. This technique works to bring you back into the present moment by acknowledging your surroundings through the power of your senses and helping your brain recognize where you are.

5 things you can see

Look around and notice 5 things you can see in your present environment. Maybe it's a pencil, the framed piece of art on your wall, a car parked on your street. Pick five objects around you and acknowledge their presence.

4 things you can feel

Notice 4 things you can feel. Touch the fabric of your shirt or the hem of your pants. Squeeze a soft pillow or a blanket. Pet your cat or dog and feel their coat under your hands. You can even touch your skin or hair.

3 things you can hear

Listen to the noises around you. Acknowledge the hum of the ceiling fan. The birds or crickets outside (depending on the time of day). Or the faint sound of the television in the other room.

2 things you can smell

You might need to get up and move around for this but find something soothing to smell. It could be a candle, a bottle of perfume, or even the hand soap in your bathroom.

(pro tip: the scent of lavender can be very calming. Consider getting a lavender candle or aromatherapy oils).

1 thing you can taste

If you don't have anything nearby to taste (or don't want to taste anything), think about your favorite food or drink. Maybe it's the sandwich from your local deli, the delicious bitterness of your morning coffee, or the pumpkin pie your grandma made every Thanksgiving. Focus on the taste and textures of that food or drink.

If you live with roommates or a loved one, consider teaching them this easy-to-remember grounding technique so they can help you if necessary during a panic attack. You can also write it down on a flashcard or in a note on your phone for a quick reminder. 

Mantras And Positive Affirmations

Amid a panic attack, your thoughts might move very fast, jumping from one thing to the next. Your body is in fight or flight mode, your hands are clammy, and the weight of the "impending doom" can feel like you're going to die. All of this can feel overwhelming, and it can feel challenging to bring yourself back into reality. 
Our words and the way we speak to ourselves are powerful all the time, but they can also help ground us when it feels like we're spiraling out of control. 

Repeat mantras and positive affirmations that remind you you are safe:

• "This is just a feeling, and it will pass."
• "These emotions are only visitors, and they're not here to stay."
• "My brain thinks I'm in danger, but I know I am safe."
• "I will be okay."

Whether you say the above out loud or in your head depends on what works best for you. ‍

Pro tip: write these affirmations down and have them easily accessible on your phone's notes app or stowed in your purse or wallet. 

4-7-8 breathing technique

The 4-7-8 breathing technique helps to regulate and calm your breathing through long, deep rhythmic breaths. This method is easy to remember and can even be used to help you sleep.

1. Sit with your back straight against a chair or wall
2. Place the tip of your tongue against the ridge of tissue behind your upper front teeth
3. Exhale through your open mouth, making a whooshing sound
4. Close your mouth and inhale through your nose to a count of 4
5. Hold your breath for a count of 7
6. Exhale through your open mouth, making the same whooshing sound for a count of 8
   

Repeat the cycle as necessary.

If you haven't tried this technique before, we encourage you to practice while you're grounded since it can cause lightheadedness.

Other ways to combat panic attacks

For some, there is seemingly no direct trigger for their panic attacks. Regardless, it can be helpful to acknowledge any circumstances that are increasing anxiety in your life and work to lower internal and external stress.
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Consider:

1. Set and maintain healthy boundaries in your work and personal life (Read our blog on long-term relationship boundaries)
2. Eat healthy, balanced meals
3. Get enough sleep
4. Reduce caffeine consumption and drink enough water
5. Exercising regularly.
6. Implementing more mindfulness throughout your day. 
7. Writing down your anxiety triggers and practicing alternative coping skills to manage stress when it arises. 
8. Tell someone about your panic attacks and seek their support when you are struggling.

Panic attacks can lead to panic disorder, a condition characterized by ongoing anxiety about when the next panic attack will strike. Panic disorder may cause you to isolate or avoid attending certain events or locations. Over time, it may seriously compromise your quality of life.

If you struggle with frequent panic attacks, we encourage you to reach out to your doctor or mental healthcare professional to discuss treatment options, including therapy, medication, and lifestyle changes. Grounding techniques are helpful, but you don't need to suffer alone. Panic attacks may not be entirely avoidable, but certain steps can mitigate or reduce their intensity.

Have you learned effective ways to lower or better manage your panic attacks? We'd love for you to share tips that have worked for you with our community! 

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