Your mind suddenly explodes in a hyper-aroused state of intense fear. You breathe faster, you think faster, your heart beats faster, your hands are sweating and trembling, your chest cries out in pain and you may even feel like you are losing control of yourself. As a specialist in clinical neuropsychology, I hear such stories increasingly more often in my clinical practice. Even in the general public, research suggests that the rate of anxiety-related concerns has spiked in the wake of the coronavirus pandemic American Psychological Association. Read on to learn what is happening to your body when you are having a panic attack.
Each person experiencing a panic attack will describe a unique set of terrifying thoughts, feelings and physical symptoms. Even though there is no clear and present danger, your brain has tripped all the “Red Alert” switches to prep for an impending catastrophe.
The good news is that your body is working as it should in the face of an emergency; the oddly “bad” news is that there is no emergency—it’s all a false alarm. The experience is terrifying—you obviously don’t want it to happen again. Let’s check out what’s going on, what you can do about it when it happens, and what you can do to avoid it in the future.
To simplify, you can think of your mind and body in everyday mode as a car driving at normal speed on the highway. If you need to pass someone ahead of you, you press on the gas to increase your speed (in your body, it’s your Sympathetic Nervous System—SNS—that speeds you up). If another car is merging ahead of you and you need to slow down, you let up on the gas (in your body, it’s your parasympathetic nervous system—PNS—that slows you down). Ideally, the SNS system (energize/activate) and the PNS system (chill/relax) are working together—but opposite to each other — to maintain the perfect balance of activation needed to get you safely to where you want to go in the desired amount of time.
Using this car analogy, what happens in a panic attack is that the gas pedal is suddenly slammed to the floor—with your SNS system pumping adrenaline through your veins like a renegade booster rocket. Not good. Think of a cat walking around minding its own business, and a huge, growling dog suddenly jumps out from nowhere in attack mode. Feel your hair stand on end? That’s what the cat is feeling at that exact moment, and likely what you feel during a panic attack. In a panic attack, however, there is no attacking dog or clear and present danger triggering your body’s natural fight-or-flight response.
So when panic strikes and a trigger in your head slams the pedal to the metal without any apparent reason, what do you do? Well, first of all, I don’t like the term “panic attack.” The reason is that nothing is attacking you (it’s an official diagnosis, so the wording is out of my control). What’s happening is that your mind has triggered a DEFCON 5 alert without there being any threat or danger at all.
So first thing to realize is that there is no need to be terrified (easier said than done); and you will need to get your PSN system in play to get your mind and body back in balance (sad fact: the PSN is slower to calm you down than the SNS is to rev you up). Here’s how to do it.
But before you do anything: make sure you get to a safe place, because you need time and space to recover. Pull off to the side of the road, get to the sidewalk if you are crossing the street, or grab hold of someone who can watch over you while you deal with the frazzled thoughts and feelings raging inside you.
After you get to a safe space, the best advice is to start focusing on your breathing. It is usually quite easy to gain control over. Start taking deep breaths in through your nose counting to at least five and feel your stomach and chest filling deeply with air; then breathe slowly from your mouth counting a bit longer to six or seven, and feel your stomach and chest empty completely of air. Bringing mindful focus to any of your sensory modalities during your hyper-aroused state will help you get more grounded and allow your PNS system to begin slowly down-regulating your activation level.
As you breathe in through your nose, see if you can identify any scents that you might be registering (the idea here is to get your thoughts onto something concrete—is that a bakery close by…). You can also use your hands to help calm your racing thoughts. Rub your hands together focusing on the texture of your skin, and rub your hands on your knees to get your body bending and stretching your muscles.
You can rub your head and temples with your hands, and run your fingers through your hair (is your hair dry or oily, should you be using a conditioner; again, get your thoughts onto any thought that can distract from the feeling of terror). Some people experiencing an attack close their eyes to allow their other senses to become the more dominant input source (touch, feel, smell, sound).
If you are daring, let yourself stay present in the panic mode and let it wash over you like a wave at the beach—knowing that it will only last for a few minutes and there is no real danger at all. Some are able to activate thoughts that are calming and soothing—but these techniques usually need to be practiced in advance (more about this below). Anyone experiencing sudden strikes of terror can develop their own bag of techniques to take charge of and down-regulate a renegade SNS response.
After the event, you need to think about what happened, why and what to do about it. You might uncover a trigger, like a mass gathering of people, an open space or something that reminded you of someone who has been mean to you. Maybe you are experiencing a phobic reaction or reliving a traumatic experience?
Kjell Tore Hovik, PsyD, Ph.D., is a specialist in clinical neuropsychology and co-author of When Crisis Strikes: 5 Steps to Healing Your Brain, Body and Life from Chronic Stress.