In Case of Panic Attack: (by guest Emma Rose)
Hello, I am having a panic attack. My body is producing too much adrenaline. I am most likely dizzy, shaking, hyper-ventilating, and/or crying. I may not be capable of talking or walking. I am not dying. I am not being overly dramatic. This attack may last only a few minutes or a few hours. It would greatly help if you could do the following:
- Do NOT ask “What’s wrong?” “What happened?” or “What can I do?” The answer is usually “Everything” “Nothing” or “I don’t know.” Even if there is a particular cause, this is not the time to try to talk about it. This is an emergency situation in which the only goal is to get me to relax and breathe normally.
- Speak in a calm tone, not condescending or patronizing, not aloof, but calm.
- Do not appear busy, annoyed, overly concerned, or too affectionate.
- If you are busy, annoyed, overly concerned or too affectionate, just leave me alone. Seriously.
- Get me away from people and noise.
- If I am standing, have me sit down. If I am lying down, have me sit up.
- Bring me water. Try to get me to drink it, but do not insist upon it. Do not insist upon anything. Remember, this list are only suggestions. Things might not work!
- Do not touch me or at least proceed with caution. Sometimes a gentle hand on the shoulder is nice, but sometimes it is suffocating.
- Model deep breathing for me.
- Remind me that my body and mind just became overwhelmed.
- Remind me that I am not dying and that I am not being overly dramatic.
- Remind me that these feelings will eventually pass.
- Tell me it is okay to cry.
- Distract me by telling a (short) funny story or something about your day.
- Try to get me talk about something that does not upset me, like where did I get my shoes? Did I see the football game yesterday?
- Do NOT try to get me to talk about my feelings.
- Pay attention to my breathing. I may calm down at first, but relapse into taking too many breaths.
- Take me through breathing exercises again before I get too upset again.
- If I tell you to go away, tell me you will leave but that you will check on me in twenty minutes.
- Check on me in twenty minutes.
This next section is more about depression and self-harm, but I think a lot of it can apply to anxiety attacks as well. Depression and anxiety really are different beasts altogether, but one can often lead to the other:
Lesson #1: Depressed/anxious people cannot nor should they be expected to “snap out of it.”
They are not weak. They are in pain and dealing with that pain is unspeakably difficult.
The first type of advice I always hear is: force yourself out of bed, exercise, and change your diet. Those are all wonderful suggestions. Yes, if someone is depressed, their depression will, generally speaking, be partially eased by a healthy dose of exercise and diet. No one debates that. But chances are, just like someone who smokes cigarettes is aware that cigarettes are unhealthy, a depressed person knows that lying in bed all day avoiding the world is not helping their depression. However, if the person were able to get out and about in the world, then they most likely would not be suffering from depression. So, that advice, while well-meaning generally has one effect: it makes the person feel guilty, weak, and therefore, more depressed.
Lesson #2: This feeling will pass.
The first thing I tell myself every day now is that everything and anything I am feeling will eventually pass into a different feeling/experience. This is comforting because it forces me not to take everything so seriously.
Things to do instead of hurting yourself
The key is to focus your attention away from the pain both mentally and physically. Usually an attack of depression (or panic) is caused by overwhelming, huge concepts crashing down on you. Therefore, give yourself a small, insignificant, manageable project to do. You need to regain control of your mind. Also, busying your hands physically will prevent your body from harmful spasms. Some of these activities may seem juvenile, but that is the point. You need to simplify your environment. Be silly to counterbalance the trauma that is happening inside you.
- Color: For many years, I kept a panic attack sketch book and a small box of crayons with me at all times. Art of any kind is great therapy, but often a person puts too much pressure on themselves to create something that looks good. Crayons are associated with being a kid, and drawing just for fun. In fact, you don’t even have to draw anything. Just scribble different colors. I find drawing a series of different sized boxes is surprisingly calming for me. Coloring busies your mind and your hands. It also produces somewhat of a “reward.” Even though it as simple as seeing colorful lines appear on a page, you are able to see yourself accomplish something, produce something. This helps you regain control.
- Cut up construction paper: This is very similar to the idea of coloring. Cutting (or tearing) paper helps channel some of the anger and violence that you are feeling. Take the frustration that you want to impart on yourself and inflict it on something inanimate, like paper. While cutting or ripping at random is an option, it is more effective to give yourself a specific shape to cut (even if it is just a square or circle) or go through a magazine and find pleasing images. Once again, this helps focus your attention on a manageable task rather than letting your mind go rampant with negative thoughts.
- Cold water therapy: This is a less harmful way of shock therapy. If you want to experience pain, stick your hands in a bucket of ice until you can’t stand it anymore. Take a freezing shower. Even just splashing cold water on your face will draw the attention of your senses outward instead of in. Cold water can give focus to the pain and release the tension. If you are in public, you can use the restroom to splash cold water on your face. If available, ask a server or whomever for a cup of ice and suck on individual ice cubes.
- Play a game or solve a puzzle: This depends on your interests and perhaps your educational level. Still, most people have some sort of brain teaser that they enjoy, whether it is a cross-word puzzle, Sudoku, word jumble, Solitaire, etc. Phones and computers have a plethora of ridiculous games at one’s fingertips. Once again, the goal is to force your mind to try figure something out that is not going to send you into a metaphysical tizzy.
- Feed yourself something small: As with everything, please practice moderation (which I know is stupid to stay to someone experiencing manic symptoms, but hey, I have to have a disclaimer). Personally, attempting to cook is a sure-fire way for me to feel suicidal, so please do not attempt anything out of your skill set. However, I find that putting peanut butter on a cracker, pouring a bowl of cereal, or mixing tuna for a sandwich is within my abilities. This is another way to reward yourself for a small project. In addition, even if you do not think you are hungry (maybe you feel downright nauseous), your body obviously isn’t being sensible. Food keeps your internal organs busy. Hopefully, this means your stomach and teeth will stop clenching and start digesting. It’s hard to hyperventilate while chewing.
- Have a go-to movie or TV show: This isn’t always the best option, because it can become addictive and generally, if you are depressed, you want to battle lethargy as well. However, when in times of crisis, the most important thing is to calm down and to not physically harm yourself. Most people have a movie or show that can completely engross them. Personally, I become lost in the world of Moulin Rouge or any Harry Potter movie. However, it is always good to try to laugh, so I try to find a Big Bang Theory or Parks and Rec episode to watch. Society often condemns television for turning people into mindless, hypnotized couch potatoes. Great. Use that to your advantage. If you cannot focus your mind onto a project, shut your mind off. Press reset. Lose yourself in an alternate reality. BUT, SET A TIMER. Two hours is a good cut off point. Allow yourself time to calm down, steady your breathing, get to a place where you may actually be enjoying Then turn it off and find a small project to do. Return to the previous options.
- Force yourself into a public place: This may seem like the last thing you want to or are even capable of doing. And, of course, this depends on your environment and physical state. However, you are much less likely to make a scene or hurt yourself if people are watching. Go to the store and just pace the aisles for twenty minutes. Sit in a coffee shop or bar and people watch. Often, when we get in our own heads, we forget there is a functional world out there. We have lost touch with a general sense of reality. Sometimes, watching other people go about normal activities demonstrates that the world is not in fact ending. Also, being inconspicuously in public proves that we are not the abhorrent monsters we imagine in our head. We like to imagine we are terrible vile people that deserve punishment. Having someone like a friendly barista treat us with a smile (even if they are getting paid to do it) offers a counterargument to our thoughts.