Overcoming Panic Attacks - A Case Study and Practical Tips

To the uninitiated, panic attacks look like inconsolable hyperventilation. To the person experiencing one, it feels like a heart attack.

Physical pain, extremely rapid heartbeat, a sense of imminent dread, the feeling of having a huge weight on one’s chest and numbness in the limbs are common symptoms. Attacks tend to last 10-15 minutes but as anyone who’s had one will tell you; it feels like an eternity.

A person who experiences a panic attack will inevitably develop fear of when the next episode will strike.

Medication, Coping and Internal Conflict Resolution

Medication used on an as needed basis is commonly offered to those who experience panic attacks. Ativan, Xanax and Klonpin are heavily prescribed and often without warning for their addictive qualities or concern for the danger of combining them with even small amounts of alcohol. Taking these meds in the midst of a panic attack is akin to taking antacids for heartburn – it’s reactionary and does nothing to prevent the next occurrence.

Panic attacks are generally the culmination of repressed fear and anxiety. Overcoming them requires not only healthier coping, but also resolution of internal conflicts and locating the origins of specific fears. This is no small undertaking. Most folks who come into treatment have experienced numerous episodes and their willingness to go to these lengths is born of desperation.

Avoiding Perpetuates the Problem

Those who experience panic attacks tend to avoid people, places, and things associated with past attacks. I worked with a man years ago who only came into treatment because he ran out of grocery stores within a 60 mile radius of his home. Each time he had an attack in public, he simply wouldn’t return to that location. Avoidance resolves nothing. It simply provides a false sense of security in which we falsely view the specific experience as causal.

Agoraphobia was the catalyst for his panic attacks. Feeling exposed and vulnerable in public places spiked his anxiety to unmanageable levels. Living in a rural area made leaving home a necessity and so ultimately his fears were not avoidable at all.

Perspective Is Vital

Old adages ring true, “It’s all in how you look at it.” In public places, my client was “white knuckling it.” He was simply forcing himself to get through what he feared by maintaining tunnel vision and moving through it as quickly as possible. What he wasn’t noticing was that for the most part, he wasn’t exposed at all. No one was staring or even taking an interest in him. They were attending to their own needs.

The difficulty was that he was viewing the world through the eyes of a child. My client’s trauma history occurred primarily around age eight. He found that when he was triggered, he no longer felt like a competent adult, but rather like a very small and frightened boy

Learning Effective Coping Strategies

You can manage panic attacks by learning coping strategies, such as:

1. Mindfulness

By implementing basic grounding strategies (using our five senses to stay in the here and now) he was able to manage his emotions as an adult. When he feels like an adult, he knows that he has the ability to protect himself and that he can leave any situation if it becomes unmanageable. He is able to consider problems and process information rationally and effectively.

2. Managing the Physiological Response

Like all people who live with anxiety, my client wanted to feel like he was in control. I urged him to notice the physical manifestations of his fears and to see this as the foundation of self control. By slowing his breathing, releasing physical tension, and walking at a relaxed pace, he was able to feel far more comfortable and calm. Maintaining awareness of the stress in his body made managing his thoughts and emotions vastly more manageable.

3. Managing Negative Self Talk

He learned that managing his self talk was something that made everything easier. When he was overwhelmed, his subconscious mind ran his self talk and he would revert to catastrophizing (making things seem worse than they are). By consciously choosing to talk to himself (in his mind in public and out loud when alone) he was able to talk himself through things the way he would help a friend who was feeling anxious.

Get on the Same Page with Yourself

Try to find the root causes of your anxiety.

My client learned that his fear of having conflict with others had everything to do with being conflicted internally. He referred to “keeping things on the back burner.” These were issues he’d not been able to resolve and in talking about them with me, he realized that each time he placed something on the back burner; he wouldn’t return to it until it boiled over. In this way, he was only addressing things when he felt compelled and was overwhelmed while trying to do so.

Having a manageable life requires dealing with things as they happen. By pushing things to the back of his mind, he was giving himself things to feel anxious about later. Coping with the feelings he had in the moment ensured that he would not develop further resentments and it allowed him to work through old issues one at a time by choice instead of necessity.

He Found Success - You Can Too

According to the postcards I receive, my client has not experienced a panic attack for years now. Clients who present with severe and persistent anxiety are sometimes given poor prognoses and the focus of treatment is geared toward minimizing rather than overcoming. Anxiety disorders are not genetic and can be overcome given holistic treatment.