If you’ve ever had a panic attack, you’re probably familiar with the symptoms: Your heart is pounding, hard. Your body starts shaking; your thighs might be trembling, and you can’t stop. The blood is rushing to your head, and you’re getting hot flashes or chills. Your mind feels like it’s swimming. Your breath comes out in shallow gasps, and your chest is tight and heavy. Everything is scary. You feel like danger is closing in on you, or you’re dying.
If you commonly experience these symptoms, or if you’ve been diagnosed with panic disorder, you may be wondering how to stop these attacks. While long-term treatment may include therapy and medication, below are a few short-term ways to stop a panic attack while you’re in the midst of one:
1. Breathe deeply
One well-researched way to calm down is to breathe deeply and slowly. Start from your abdomen, and try to breathe out more slowly than you breathe in. The best ratio is ideally 4 seconds in and 6 seconds out, but if you don’t remember this during the attack, just remember: breathe out for longer than you breathe in. You can keep your hand on your abdomen and feel it expand and contract to make sure you’re breathing correctly. Because a primary symptom of panic attacks is shortness of breath, focusing on your breathing will help reduce your anxiety symptoms. Do this for a minute or two, and you’ll see how much better you feel.
2. Relax your muscles
Start with your face. Tighten all your facial muscles one by one, for a few seconds each, and then let go. Progressively work your way down to your chest, hands, fingers, buttocks, legs, and toes. Curl your fists, and then release. Clench, relax, clench, relax. When you get all the way down to your feet, you’ll see that your entire body feels more loose and relaxed—as if you’ve just given yourself a mini massage.
3. Dunk your face in water
This, like the above two strategies, is also used in Dialectical Behavior Therapy (see TIPP skills) to help teens who are emotionally dysregulated calm down. Lean forward into a bowl of ice-cold water and quickly place your face in it. Or, if you don’t have a bowl handy, just go to the sink or grab a water bottle and splash your face with the coldest water you can get. This is one way to dramatically and suddenly change your body temperature so that your heart rate quickly comes up and goes back down naturally. Surprisingly, this may stop your panic attack from progressing.
4. Engage your five senses
In the middle of a panic attack, you can try to ground yourself using your five senses. Try to think about what you can see, smell, hear, feel and taste. You can focus on a concrete object near you—whether it’s the blue zipper on your jacket or your shoes. If you’re near a chair, hold on to it and focus on the feel of the wood beneath your palms. Clutch your backpack strap, if you’re at school, to ground yourself with its familiar feel. If you have essential oils handy (and it’s good to always have these handy), take them out and sniff them. Lavender and chamomile have particularly soothing effects. (If you’re taking sedative medications like benzos, however, just ask your doctor before you use lavender.) If you have a piece of gum handy, pop one in your mouth. Focus on its taste and texture as you chew it. Taking note of what you see, hear, smell, touch and taste at any given moment is a mindfulness exercise that anyone can practice on a daily basis, whether or not you have anxiety. This helps make you a calmer, more self-aware and reality-focused person overall.
5. Use guided imagery
Imagine you’re lying on the sand in a tropical beach, with the quiet sound of the waves lapping at the shore and the heat of the sun warming their face. Known as guided imagery/visualization, this is one way to calm yourself when you’re in the throes of a panic attack. If a beach doesn’t do the trick for you, think of a relaxing place that does. It might be a certain hiking trail, or a thicket of woods near your house, or even the public library if you enjoy going there for the peace and quiet. Whatever it is, imagine you’ve suddenly been transported there. Guided imagery, a meditation technique, works best if you practice it regularly, even when you’re not having an anxiety attack.
6. Get a cheerleader
if you have a best friend or classmate who is soothing and supportive, call them over (or just phone them) whenever you’re having a panic attack. They can help ground you and cheer you on so that you don’t have to go through the attack alone. They can also give you reassurance. Just saying the words “it will be okay” or “this too shall pass” helps immensely, because many teens feel like they are dying when they are having a true panic attack. You can even prep your friend beforehand to say these things to you later on. (Even though you told her to say it, you’ll probably still feel better.) If you can’t get a point-person for some reason or another, say these encouraging statements to yourself.
Long-term Help for Panic Attacks
While the above tips are some ways to help you get through a panic attack, keep in mind that they aren’t long-term solutions. If you’ve been diagnosed with anxiety or panic disorder, you may need the following interventions:
For panic disorder, two of the most effective types of therapy for adolescents are Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT). DBT’s Emotion Regulation skills teach teens how to reduce the overwhelming feelings that disrupt their daily functioning, whether it’s anxiety, depression, or any other extreme emotion. In CBT, Exposure and response prevention (ERP) will teach your teen how to overcome irrational fears (that trigger panic attacks) and how to manage the thoughts and feelings that play a role in overall anxiety.
Sometimes, therapy isn’t enough. In these situations, a psychiatrist may recommend specific medications to limit your panic attacks. While there are no specific FDA-approved drugs for panic disorder, there are certain medications that will help. The most common ones prescribed are SSRIs (selective serotonin reuptake inhibitors) and Benzodiazepines (otherwise known as benzos). SSRIs are antidepressants, but they are effective too for anxiety disorder since they regulate the levels of serotonin in the teen’s body, which helps regulate mood. For example, paroxetine (Paxil) and citalopram (Celexa) are commonly prescribed SSRIs for adolescents. On the other hand, benzos are minor tranquilizers. They are usually prescribed for short-term treatment, as they can lead to dependence and addiction fairly quickly. Thus, one must use extreme caution when taking benzos and should only take them as directed. Lorazepam (Ativan) and alprazolam (Xanax) are two examples of benzos.
Before prescribing medication, some psychiatrists will recommend trying complementary therapies. Meditation, yoga, mindfulness exercises, and physical fitness all fit in this category. For example, your psychiatrist or psychologist may teach you certain breathing and mindfulness exercises. Then, they may instruct you to practice these techniques every day. (As seen above, breathing and mindfulness exercises are also short-term solutions for acute instances of panic attacks.)
Teen Anxiety Treatment Center
If your panic attacks are severe, frequent, and debilitating to your daily life, you may need more intensive treatment than therapy or medication. You may benefit from an adolescent mental health treatment center that specializes in anxiety. Depending on the level of your clinical acuity, you may need outpatient programs (intensive outpatient or partial hospitalization) or full-time residential care.
Don’t be Anxious About Your Anxiety
Sometimes anxiety is its own worst enemy. It creates a vicious cycle that’s hard to break. You may worry about an upcoming social situation, then get anxious about your inevitable anxiety or predicted panic attack. This can thus cause a vicious cycle. For this reason, try not to worry about your anxiety. Of course, we know that’s easier said than done, but it’s important to try.