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Key points
- Panic attacks can be scary experiences and how people manage them can impact their severity.
- There are a few strategies that people can use to make panic attacks more manageable.
- It's also important to work on reducing vulnerability to having panic attacks in the first place.
About a week after September 11, 2001, I was in the bathroom of my cousin’s house, hyperventilating and thinking I was having a heart attack. Just before that, I was sitting at the dinner table, and the conversation had become very tense. People were reflecting on the terrorist attacks and wondering if our city, Los Angeles, would be targeted next. I was already stressed out about my dissertation, and this conversation had tipped my anxiety over the edge.
Ironically, I had spent the previous five years working on research studies of panic disorder, including providing evidence-based therapy for clients with panic disorder. Still, I didn’t initially realize I was having a panic attack myself. However, once I was in the bathroom, I realized I was having a panic attack and talked myself down. I decatastrophized my belief that I was having a heart attack by telling myself it was a panic attack. I also refocused some of my attention on noticing the different elements in the bathroom (taking attention away from my physical sensations). In the end, the panic attack resolved relatively quickly. It did not become a more significant problem with recurring panic attacks.
If you struggle with panic attacks, you know how horrible they feel. However, there are some strategies that you can use during an attack to help it resolve more quickly. All you have to do is remember the acronym COPE.
1. C – Change Your Catastrophic Thoughts
It is extremely common to have catastrophic thoughts during a panic attack, such as that you are dying or losing your mind, or that the panic attack will go on forever. Having highly anxious thoughts like these often fuels the panic attack anxiety and intensifies the sensations.
Here are some common catastrophic thoughts and ways to counter them:
- Catastrophic thought: I’m dying, having a heart attack, or a stroke.
- Rational response: This is a panic attack, which is an activation of the fight or flight response, and it is not physically dangerous.
- Catastrophic thought: I’m losing my mind.
- Rational response: Panic attacks do not lead to psychosis. Anxiety and psychosis involve different areas of the brain. Even if it feels like I’m going crazy, it is just a high level of anxiety.
- Catastrophic thought: I’m going to faint.
- Rational response: Even though it feels like I’m about to faint, it’s rare to faint during a panic attack. What happens to the body during a panic attack is the opposite of what happens when someone faints.
- Catastrophic thought: I’m going to do something out of control.
- Rational response: People do not do out-of-control things during a panic attack and I have more control over my behavior than I realize.
- Catastrophic thought: This anxiety will go on forever.
- Rational response: Panic attacks always come to an end; it is impossible for them to continue on forever.
If you are concerned about a medical issue, talk to your doctor. Suppose, for example, you are afraid of having a heart attack during a panic attack. A rational response will be much more potent if you can tell yourself that your doctor said your heart is healthy. However, if you have a history of heart problems, ask your doctor how to tell the difference between a panic attack and a heart attack.
2. O – One Breath at a Time
For some, focusing on slowing their breath or counting breaths can be calming or distracting. Others find breathing hard and worry that they can’t get a deep breath. If so, remind yourself that your breathing will improve soon. Panic attacks always resolve, and breathing will normalize.
3. P – Physical or Sensory Distraction
Some research has indicated that ice or cold water can calm the nervous system during heightened anxiety. Thus, taking a cold shower, drinking ice water, holding a piece of ice in your hand, or putting ice on your face can be helpful for some. The cold sensations might also distract from the symptoms of the panic attack.
Other types of physical distraction could be going on a brisk walk or doing some exercise if that feels doable during the attack. You can also engage other senses by feeling your chair’s fabric, noticing the temperature of your environment, looking around and noticing what you see, or eating a sour candy, for example.
4. E – End-of-Panic Debrief
After the attack ends, ask yourself what you could do differently if you have another panic attack in the future.
- Could I talk back more to my catastrophic thoughts?
- Could I focus more on my breathing?
- Could I distract myself more effectively?
You could also ask yourself if there are ways to make yourself less vulnerable to having an attack in the first place. Is there anything you can do to reduce the general stress in your life? Are you focusing too much attention on your body in general, which also puts you on alert for another panic attack? Or, you can ask yourself if panic attacks interfere so much with your life that it warrants finding a therapist specializing in anxiety and panic.
Although some people might be more susceptible to having panic attacks than others, having more effective coping during an attack can make them less scary and severe.
To find a therapist, please visit the Psychology Today Therapy Directory.
References
Jungmann, M., Vencatachellum, S., Van Ryckeghem, D., Vögele, C.. (2018). Effects of Cold Stimulation on Cardiac-Vagal Activation in Healthy Participants: Randomized Controlled Trial. JMIR Formative Research, Oct 9;2(2):e10257.
