How to control panic attacks when they happen, according to psychologists

Hyperventilation, chest pain, sweating and a racing heart are just some of the terrifying symptoms of a panic attack.

One in 10 Americans will get one this year alone, according to the Cleveland Clinicand about one in 50 will experience several.

Many patients say they feel like they’re about to die, have a heart attack, or “go insane,” while others say they feel like they’ve lost control of their bodies.

But talked to three psychologists about how to prevent seizures naturally — without medication — and how best to deal with them when they happen:

Mental health experts Dr. Ian Stanley, dr. Karen Lynn Cassiday and Dr. Carolyn Rubenstein (pictured left to right) spoke to about some time-tested methods for fending off attacks. They include actually identifying a panic attack when it hits, slowing your breathing, and distracting yourself from physical symptoms


While getting hackneyed directives like “take a deep breath” may sound trite to someone experiencing a panic attack or panic disorder, it really works, according to Dr. Ian Stanley, a University of Colorado psychologist.

He recommends exhale for a few seconds longer than inhale. When one begins to rise, try to inhale for a count of four and exhale for a count of six.

Inhalation is linked to the sympathetic nervous system which activates the “fight or flight” response. It is, in a sense, the accelerator.

Meanwhile, exhaling is linked to the parasympathetic nervous system, which affects our body’s ability to calm down.

Lengthening the exhalation automatically puts more emphasis on the side of the nervous system that provides rest and relaxation.

“It just trains the body to slow down and then provide some physiological feedback that the threat isn’t as acute as a panic attack makes someone think it is,” said Dr. Stanley.


Have you tried any of these techniques and do they help?

  • Yes 124 votes
  • No 100 votes
  • Only sometimes 61 votes


Dr. Carolyn Rubenstein, a psychologist from Boca Raton, Florida, recommends sharpening your senses on something external to distract from the physical and emotional panic.

“What I really try to recommend to people, because it’s kind of creative, is think about the rainbow.

“And think about looking for three red things [in the room or your surroundings]three orange things and three yellow, green and blue things.

“And you can even expand that and look for gold and silver and white and black and just really kind of engage with it. It even works when you are driving or on an airplane.

“It’s very useful in terms of de-escalation because it keeps you engaged and it takes some time.

“And it really forces you to broaden your perspective and get out of your body for a few minutes so you can calm down.”

Other helpful distractions include listening to feel-good music, dipping the face or hands in ice water, or getting some fresh air.


For many people, simply identifying the approaching panic can be soothing.

Telling yourself very calmly and soberly that the body’s reaction to a strange stimulus is a miscalculation is in many cases enough to disarm the panic.

Dr. Rubenstein said, ‘You label it, you look at it, instead of reacting to it. You come from a place of control, rather than symptoms controlling you.

“It’s a mental trick we use, it involves logic, rather than letting the emotions rule the roost.

“The tagging is really important in getting that control back and it puts you back in the driver’s seat for a second, which can be incredibly helpful when you feel like you’ve completely lost control.”

Panic attacks are not deadly in themselves, but experiencing them can feel like a heart attack or even death.

Symptoms vary widely and depend on the individual, but some include chest pain, dizziness, nausea, trembling, sweating, rapid heartbeat and hyperventilation, and a deep fear of losing control.

They usually come on quickly and can last between five and twenty minutes.

The period after a panic attack when body and mind are recovering can feel like a nasty hangover.


Dr. Karen Lynn Cassiday, general manager of the Anxiety Treatment Center of Greater Chicago, told that people prone to panic attacks should maintain good posture and sit upright.

Altered breathing caused by poor posture causes and exacerbates the level of anxiety.

She said, “What people do, and animals do too, when they’re in chronic stress, they get into this fear attitude and you make it hard to breathe naturally with your body and all of a sudden you exhale too much carbon dioxide.”

Standing or sitting in a confident posture with a puffy chest and broad shoulders has a psychological boost, improves self-confidence, mood and energy levels and reduces stress, anxiety and depression.


While the 4:6 method helps you hit the brakes in a panic, Dr. Cassiday also warns against breathing too deeply during a panic attack.

Many people in the throes of a panic attack will remember the often-given advice to take deep or deep breaths to stabilize their heartbeat. But with hyperventilation, that’s easier said than done and actually exacerbates the problem.

That’s because hyperventilation occurs when people breathe so fast and deeply that they expel an unusually large amount of carbon dioxide, which in turn causes intoxicating symptoms such as dizziness that are characteristic of a panic attack. Those symptoms simulate the feeling of suffocation, which creates a vicious cycle of breathless panic.

Dr. Cassiday said, “The worst thing you can do is take a deep breath, because that will only lead to even lower carbon dioxide levels. Breathe slowly and gently through your nose so that it is as quiet as possible and you can barely hear it in the back of your throat.’


Anxiety is a common ailment, and psychologists and licensed social workers are trained to guide people through it.

There are numerous treatment options for panic attacks and panic disorders. Cognitive behavioral therapy, often called talk therapy or psychotherapy, is the first line of treatment for panic disorder and panic attacks.

CBT allows the patient to better modify their thought processes and actions to face and disarm intrusive thoughts that lead to panic attacks.

Therapy can not only help a person better understand what to do when a panic attack strikes, but also how to modify behaviors and thinking patterns that could lead to a panic attack in the future.

Dr. Karen Lynn Cassiday said a panic attack is “like the time when you were a kid and someone’s older brother held your head underwater in the pool and you thought you’d never surface.”

“Having four or more of those symptoms is really overwhelming, which is why a lot of people might think, I’m having a stroke, I’m going crazy, I’m going to die, something is terribly wrong with my body. And in fact they’re right, it’s just none of those things I just mentioned.’

Many people who experience panic attacks have a constant fear of being caught off guard by an attack while performing normal life functions, such as shopping or driving.

Some people will never experience a panic attack. Many people will experience one or two in their lifetime. But an unfortunate 4.7 percent of Americans have panic disorder, chronic anxiety that includes frequent panic attacks.


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