Experiencing a panic attack can be a profoundly unsettling experience, marked by a sudden onslaught of intense fear or discomfort. We understand that anyone, including affluent individuals, can be affected by these overwhelming moments of anxiety. A 2006 US National Comorbidity Survey Replication study found that 22.7% of adults had experienced panic attacks without meeting criteria for panic disorder or agoraphobia; this was one subgroup, not the overall lifetime prevalence of panic attacks. With numbers that high, it’s important that we understand what we can do in the moment if we are experiencing one, or what to say to a loved one going through it. We sat down with our Head of Psychotherapy, Gita Chaudhuri, to discuss what panic attacks are, her psychotherapy approach, and five tangible tips for tackling them in the moment.
A panic attack is a rapid surge of fear that peaks within minutes, and is accompanied by physical symptoms such as a racing heart, sweating, trembling, or even feelings of choking. These symptoms are understandably frightening, and can lead to a detachment from reality. Panic attacks themselves are not life-threatening, but similar symptoms can have medical causes. Seek medical assessment for a first episode or symptoms that are new, different or unexplained; do not assume they are panic. Seek emergency medical help for severe or persistent chest pain or discomfort; chest pain that spreads to the arms, neck, jaw or back or occurs with sweating, nausea or breathlessness; severe difficulty breathing; or fainting with incomplete recovery or chest pain. Any unexplained fainting should be assessed. Panic attacks can occur without a clear trigger or identifiable preceding thoughts, including during sleep. Once symptoms have been assessed as panic, recognizing the pattern and responding without judging yourself may help.
For an affluent individual with a high-profile or high-intensity career, pressure is part of the everyday. When you find yourself in a position of power, it’s normal to want to seek control over situations. The problem, of course, is that so much is outside of our control. It’s not uncommon for someone in this kind of position to find themselves in a state of panic. A panic attack does not necessarily mean you have another disorder. Recurrent unexpected attacks, persistent worry about further attacks or avoidance warrant assessment for panic disorder and other possible causes.
Psychotherapy includes many approaches. The terms top-down and bottom-up are sometimes used to describe an emphasis on thoughts and beliefs or on bodily sensations, but they are not an exhaustive classification. One evidence-supported treatment for panic disorder is cognitive behavioral therapy, or CBT, which addresses thoughts, behaviors and responses to bodily sensations. Somatic Experiencing is a body-focused approach studied in PTSD; that research does not establish it as a treatment for acute panic or prove that trauma is physically stored and released. The tips below are optional coping strategies, not a course of psychotherapy or a substitute for assessment and treatment.
- Grounding
Grounding directs attention to your present surroundings. Sit comfortably with your feet on the floor and notice the support beneath them. You do not need to remove your shoes or strike your chest. If this feels helpful, remind yourself that you can take one small step at a time; you do not have to force the sensations to stop. - Engage your Senses
Panic involves the body’s fight-or-flight response. You can try gently directing attention to a comfortable sensation, such as the texture or weight of a coat or blanket around you. Intense or painful stimulation is not necessary. Do not put ice cubes or hot chilli peppers in your mouth as a panic-management technique. - Breathing & Counting
Try breathing gently and regularly, without forcing a deep breath or holding your breath. Breathe in through your nose and out through your mouth if comfortable. Counting slowly during each breath may help, but use a comfortable pace rather than a fixed target. A loved one can count with you if you find that reassuring. If the exercise increases dizziness, air hunger or distress, stop and let your breathing return to its usual rhythm. - Try Gentle Muscle Relaxation
Progressive muscle relaxation involves gently tensing and then releasing muscle groups. If comfortable, try this while seated, without straining or holding your breath, and notice the difference between tension and release. Skip painful areas and stop if symptoms worsen. This is an optional relaxation strategy, not a proven way to stop a panic attack; strenuous wall sits are not necessary. - Respond Without Forcing
If symptoms have been assessed as panic, try allowing the sensations to pass without trying to force them to stop. Remind yourself that the episode will pass, although no mental trick can guarantee immediate relief. Deliberately provoking feared bodily sensations is different: it can form part of planned exposure work in CBT and should be discussed with a suitably trained therapist, rather than improvised during an unexplained episode.
A panic attack is an overwhelming, isolating feeling – but that doesn’t mean you have to deal with them alone. These coping strategies may help some people manage distress, but they are not all established treatments for panic disorder and cannot guarantee that an attack will stop. An isolated panic attack does not necessarily indicate another disorder. Seek professional assessment if attacks recur, cause ongoing worry or lead you to avoid everyday activities; evidence-based care includes CBT and, when appropriate, prescribed medication. But you do not have to suffer alone. Professional support can provide you with more tools like this, and help you find answers as to why they are coming up in the first place. THE BALANCE HealthCare Group offers multi-disciplinary programs tailored to affluent individuals that are struggling with their mental health, or want to learn how to live a more balanced lifestyle. We hope that these techniques provide you with your first steps to finding mental clarity and confidence.
