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  • Resilient Practice

How to Stop a Panic Attack

Panic attacks are an amplification of our fight-flight threat response.

This response is mediated by the autonomic nervous system which governs body processes that we do not consciously control.

It consists of two pathways; the sympathetic and the parasympathetic nervous systems which continually respond to signals from the brain.

We recognise environmental threats, dangers or stressors and our brain responds by activating the sympathetic nervous system, stimulating the release of the fight-flight chemicals adrenaline and cortisol.

Adrenaline raises our blood pressure, heart rate and respiratory rate; it dilates our pupils to maximise our vision and prepares our muscles for movement.

We become breathless and sweaty: we feel our heart racing and our muscles trembling.

If we needed to run away from a sabre-toothed tiger, these physiological changes would be useful, otherwise they merely serve to make us feel uncomfortable and even unwell.

Cortisol down-regulates the systems we do not need in fight or flight such as our digestion, the immune system and reproduction.

When the threat has gone, activation of the parasympathetic nervous system down-regulates the stress hormones, the physical symptoms settle, and our body processes get back to normal function. This is known as the relaxation response[1]

Thousands of years ago our ancestors lived in a very dangerous world. They had to be alert at all times to potential threats.

For safety reasons, to improve their chances of survival, it made sense for the brain to pay more attention to negative stimuli than positive.

Those whose brains were best at this were more likely to survive and pass on their genes; consequently we have inherited a powerful, fast acting threat response.

We are no longer exposed to the same dangers as prehistoric man.

There may be times when the fight-flight response is required but these are few and far between.

Therefore we have a brain predisposed to notice and respond to negative stimuli and a really fast threat response system designed to prepare us for action.

What does this mean for us?

Well, we have all experienced our fight-flight system in action; we have felt the same symptoms described above when we had to stand at the front and speak, when we had a job interview, or during an altercation.

This is because when we think negatively about a situation we are effectively labelling it as a threat.

Our autonomic nervous system doesn’t know the difference between a clear and present danger and performance anxiety.

If we think about situations and start to perceive them as threats then our brain and autonomic nervous system will keep responding; we can end up almost permanently in the fight–flight response with high circulating levels of the stress hormones.

The system in overdrive can end up with a massive exaggeration of the physical symptoms; racing heart, nausea, chest pain, over-breathing and feeling faint – a panic attack.

Lisa Feldman-Barrett[2], a neuroscientist, teaches that emotions don’t happen to us; they are actually made by us.

Our brains use our past experiences to predict and construct our world.

This is why two people can be in the same situation but have very different reactions or emotions as a consequence of the same circumstances.

The emotions we feel have not been thrust upon us; we have created them.

“We are the architects of our own experience”

The implications of this research are great; to accept that we are ultimately responsible for how we feel is a lot to take on board, but with great responsibility comes great power.

If we have control over how we feel then we can make ourselves feel better.

When we are in the throes of panic, even when we are frightened, we can take control of the situation.

Try this:

The key to terminating a panic attack is to settle the physical symptoms, as they are the main driver the negative cycles of thoughts-feelings-behaviours.

Ujjayi breathing is an ancient Taoist technique:

diaphragmatic breathing stimulates the vagal nerve[3] which activates the parasympathetic system and down-regulates the fight-flight response.

Sit with your spine straight

Close your eyes

Take your awareness to your breathing

Breathe in and out through your nose

Keep the in-breath and out-breath an equal length, measured and controlled

With each breath fill your belly, allowing it to stick out

As you inhale and exhale constrict your throat making a rasping noise (a Darth Vader-like sound)

As little as two minutes of Ujjayi breathing is enough to centre your mind, stimulate you parasympathetic nervous system and terminate a panic attack.

Follow the link to an excellent YouTube video to help you master this technique.

[1] Benson, Herbert (1976). Steps to Elicit the Relaxation Response. From The Relaxation Response. HarperTorch. [2] Lisa Feldman-Barrett (2017). How Emotions Are Made, Brilliance Audio [3] If you found this helpful please share it. Thank you.

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