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Your heart is pounding. You’re pouring sweat. You feel like you can’t breathe. Your stomach may get into the act, too, causing nausea and/or diarrhea. You might feel lightheaded and unable to think clearly. These are all possible symptoms of what people often call an anxiety attack. The clinical term is panic attack, but whatever you call it, it’s deeply unpleasant.
Episodes like these — when fear or anxiety manifest as physical symptoms — are common. Krystal Lewis, clinical psychologist at the National Institute of Mental Health’s Section on Development and Affective Neuroscience, estimates that about a third of all adolescents and adults will have an anxiety disorder at some point in their lives, and panic attacks — or anxiety attacks if you prefer — often occur with anxiety disorders.
If you’ve had a panic attack, there are a few things that Lewis, who is known as “The Courage Coach,” wants you to know:
1) Panic attacks are intense but brief. This will pass.
2) You can handle this. As scary as it is, panic itself is not harmful.
3) Effective therapies are available to help cope with these episodes.
Read More: What is Anxiety and How Can Worries Overpower Us?
Cognitive Behavioral Therapy (CBT) is a well-studied and effective treatment for anxiety and mood disorders. Lewis describes CBT as “a structured, goal-oriented psychotherapy, which essentially aims to identify the relationship between unhelpful thoughts, physiological feelings, emotions, and behaviors.”
Lewis uses several CBT methods to help people with panic attacks. Relaxation techniques and grounding tools are very helpful for calming anxiety in the moment, she says, and these are useful for panic attacks, too.
One strategy is deep breathing, or what is sometimes called 4-7-8 breathing, a method where you breathe in for four counts, hold it for seven and then breathe out for eight.
Grounding tools include techniques such as using your five senses to bring you back to the present moment. At the onset of a panic attack, you notice five things you see, four things you can feel, three things you can hear, two things you can smell, and one you can taste. This can be done in any order, though. The key thing, says Lewis, is to reorient your attention and bring yourself into the present moment.
Read More: 5 Facts You Might Not Have Known About Anxiety and How to Treat It
With panic attacks, explains Lewis, the amygdala, a part of the brain involved in emotions, is triggered. Then your body goes into a parasympathetic state, which is a heightened stress state, she says. The goal of therapy is to disrupt that process by calming it.
“So if you’re having short, shallow breaths, and it’s hard to breathe, we work on regulating that, so slowing the breathing down,” she says. “If all of your muscles are tense and tight, we work on muscle relaxation. In the moment when those things are happening, you’re just countering those physiological responses.”
Read More: Can You Predict a Panic Attack?
These techniques are useful for dealing with panic attacks on the spot, but if you’re troubled by panic attacks, Lewis recommends working with a psychologist or other trained therapist. They can teach you how to engage in interoceptive exposure, a standard technique in treating panic attacks. This simply means learning how to intentionally activate the anxiety and then learning to get it under control.
“I might have one of my patients run in place as hard as they can for one minute to get their heart rate going. You’re kind of creating those symptoms they usually have when they’re panicked,” Lewis says. “And then we work through managing that anxiety in the moment. It takes a few sessions to learn how to do it and feel safe.”
Learning how to cope with panic attacks can do more than just help you pull it together when they happen. Learning to control your panic attacks can lead to an overall increase in self-esteem and self-efficacy, says Lewis. “You’re stronger than you think in these moments.”
Read More: How to Improve Your Mental Health
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Avery Hurt is a freelance science journalist. In addition to writing for Discover, she writes regularly for a variety of outlets, both print and online, including National Geographic, Science News Explores, Medscape, and WebMD. She’s the author of “Bullet With Your Name on It: What You Will Probably Die From and What You Can Do About It,” Clerisy Press 2007, as well as several books for young readers. Avery got her start in journalism while attending university, writing for the school newspaper and editing the student non-fiction magazine. Though she writes about all areas of science, she is particularly interested in neuroscience, the science of consciousness, and AI–interests she developed while earning a degree in philosophy. Find her on socials @AveryHurt