How to Overcome Anxiety and Panic Attacks

It’s enough to make you crawl in bed, pull a blanket over your head, and stay there until next year. There is a way to keep calm and carry on, says Felicia Gould, Ph.D., a psychologist with the University of Miami Health System.

“Anyone can experience symptoms of intense anxiety, but we don’t want it to dominate our lives,” Dr. Gould says. She acknowledges that 2020 rolled out a perfect storm of stressors. “We’re being deprived of things that enhance our mental health. The pandemic requires us to take new safety precautions and fear things that used to be commonplace in our lives, which creates anxiety. We can’t see it, but we know it’s there.”

Although people with post-traumatic stress disorder (PTSD) may experience panic attacks, PTSD has its own set of symptoms, diagnostic benchmarks, and treatments. Panic attacks by themselves do not necessarily translate into any one specific mental health disorder.

What does a panic attack feel like?

When we feel threatened, Dr. Gould says, “Our autonomic nervous system gets revved up.” Whether you experience a fleeting moment of panic or a full-blown attack, one or more of the following symptoms may suddenly happen: 

• Rapid heartbeat (tachycardia)
• Shortness of breath
• Feelings of choking
• Dizziness
• Trembling or shaking
• Sweating
• Numbness or tingling
• Abdominal distress

Why is this happening to me?

What triggers a panic attack is as different as the people experiencing it. Anything from a car accident to public speaking, undergoing surgery, or only grocery shopping during a pandemic could provoke an episode. 

How long will the anxiety attack last?

Symptoms usually last five to 20 minutes. Dr. Gould says 15 minutes is average. Though some episodes may last up to an hour, that’s less common. “Your nervous system can’t sustain a full-throttle state for long periods.” Knowing there is an end in sight is key to coping with the situation. 

Although most attacks are short, they are incredibly unsettling. “If you have an intense fear of losing control or dying from the symptoms, it further escalates the attack,” Dr. Gould says. Living in a chronic state of anxiety and dread with respect to panic attacks could lead to an actual panic disorder.  

Is this a one-time occurrence or a chronic problem?

How do you know if you’re feeling intense anxiety, a panic attack, or panic disorder? 

Dr. Gould says a true panic disorder has four characteristics:

• You are intensely fearful. 
• You avoid activities because they might trigger an attack. For example, an increased heart rate is one of your symptoms, so you avoid exercise because it raises your heart rate. 
• You experience a panic attack, then persistently worry over the next month that you will have another.
• Your attacks are frequent, disabling, and disrupt your life. 

When should you seek professional help?

If any of those situations apply to you, Dr. Gould recommends getting medical help. Start with your primary care doctor, who will rule out other conditions that could be exacerbating or mimicking panic-related issues. 

Once any underlying medical issues are ruled out, see a psychologist or psychiatrist. “Panic attacks occur in many different situations. It’s important to see a professional and get properly diagnosed. Therapists can design a treatment plan using cognitive behavioral therapy (CBT) and Exposure Response Prevention (ERP). Over time, they build up your confidence, increase your ability to tolerate stress, and help you regain your normal life.” 

12 ways to calm down

While panic attacks and disorders are emotionally and physically disturbing, therapy and practicing specific calming techniques help. 

Acknowledge your feelings. 

Tell yourself, “‘This is a panic attack. It’s going to end, and I am not going to die from it.”’

Pay attention.

Panic attacks don’t happen as randomly as they may seem. Pay attention to your stressors.

Breathe.

Practice and become skilled at diaphragmatic relaxation breathing.  

Release tension.

Muscle tension and shallow breathing can trigger an attack. Deep breathing and stretching relieves stress and induces relaxation.

Move.

Exercise significantly increases physical and emotional health. If an increased heart rate triggers your anxiety, start gradually with gentle yoga, tai chi, moderate walking, swimming, or cycling.

Decaffeinate.

Caffeine and stimulants increase heart rate and increase muscle tension. Reduce or eliminate your consumption. 

Don’t doomscroll. 

Practice good mental hygiene. Avoid scrolling through headlines or watching the news first thing in the morning or before going to bed. Take an occasional news break if necessary.

Sleep.

A good night’s sleep relaxes the mind and body and puts things in perspective.

Eat right.

Feed your body and brain nutritious foods. An occasional treat is fine, but try to maintain a healthy weight and good nutrition. Foods with high sugar content or caffeine and caffeinated foods can increase jitteriness. 

Write vs. worry.

Can’t sleep or focus due to worrying? Get those troubling thoughts out of your head and down on paper. You can discuss those thoughts later with a therapist, counselor, or even a trusted friend or jot down items to address at another time.

Socialize safely.

Engage with others outside, while wearing a mask, and staying at least six feet apart.

Change the scene.

Healthy outdoor activity boosts your mood and energy. Get out in nature and see something besides your house. 

Anxiety is here to stay. We may complain about 2020 stress levels, but at least we’re not running from saber tooth tigers like our ancestors.

“Anxiety is there to protect us. Although it is part of our D.N.A., we’re in an unchartered territory (with the pandemic). We can’t isolate for over a year and let our mental health deteriorate. There are ways to engage in healthy social activity, and there is help available.”  

Nancy Moreland is a regular contributor to UMiami Health News. She has written for several major health care systems and the Centers for Disease Control and Prevention. Her writing also appears in the Chicago Tribune and U.S. News & World Report.

Tags: anxiety, Dr. Felicia Gould, panic attack