Congratulations! You've just had a panic attack.

Everything Is Stressful and I’m Dying: How to Survive a Panic Attack

Everyone has their own special mental weirdness. And your humble, almost perfect Bitches are no exception. (I know. Try not to die of shock. My sincerest apologies for ruining the illusion of our all-encompassing perfection.) And since May is Mental Health Month, we’re going to lay our personally atypical brain chemicals and lessons learned from life experience all over you!

Recently Kitty and I were talking about how our personal mental weirdnesses have affected our lives. Financially, emotionally, physically. And we realized we had a lot to say on the topic, a lot that our darling readers might relate to or take comfort from. Being an adult is stressful as fuck! And brains are complicated organs full of chemicals doing unpredictable things. So why not share with the rest of Bitch Nation?

A few years ago, I was diagnosed with anxiety. This didn’t come as a surprise to me, as I’ve always been prone to stress, hyper-focusing on mildly important stuff to the point of panic and despair, and constant worrying about small stuff. But it did come as a surprise to my familiars, since over my lifetime I’ve become pretty damn good at hiding my symptoms.

I just wasn’t good at actually dealing with them.

An anxiety disorder is a mental condition in which a patient tends to… well, to freak out more than is normal. A clinical anxiety disorder is not only bothersome, but it interferes with your life. It’s not only unpleasant, but constant and overwhelming. And while everyone feels stressed or panicked from time to time, the thing that sets those with clinical anxiety disorders apart is that their stress, their anxiety and panic attacks, are completely uncontrollable, disproportionate, and inappropriate to the situation.

There is no “just relax” to someone with anxiety. We literally cannot relax when in the throes of a panic attack or anxious episode. That’s kind of the problem.

No, YOU should see a doctor!

So anxiety is my mental weirdness. I take medication to help with it now, and I’ve developed many artful, ninja-like ways of dealing when my anxiety gets really bad. Or when I have a panic attack.

Which brings us to you! Dealing with a panic attack is terrifying and difficult. It can be even worse if you don’t understand what’s happening or how to make it better. So I want to help.

When I first started my Anxiety Odyssey, all the resources I found online stopped at “You should go see a doctor!” Which was… helpful in the long-term because I am a financially stable person with health insurance and access to great hospitals and medical care, but not particularly useful in the moment. In fact, it’s a bit of a slap in the fact to someone currently experiencing a panic attack. “Calm down enough to call a medical professional and schedule an appointment,” is completely unrealistic advice when your body is going:

And it’s even worse for those who don’t have access to or the funds for medical care. Even with insurance, a trip to the ER can cost hundreds of dollars in copays. Some medical professionals are guilty of minimizing anxiety and its insanely dangerous symptoms. Seven in ten bosses don’t believe that anxiety is a valid reason to ask for time off. And minors are particularly vulnerable to authoritarian parents who don’t believe their illness is legitimate and won’t facilitate care.

So while the advice of an Internet money blogger is by no means a perfect substitution for the care of a doctor who spent roughly nine million years in school learning to take care of brains and bodies, I still want to share my advice and experience.

If you can’t get medical attention right away, or even if you’re receiving medical attention but it’s not cutting it, here is some advice on how to deal with the worst aspect of anxiety: a panic attack.

Recognizing the signs of a panic attack

Congratulations! You’ve just had a panic attack. The good news is your amygdala is working. The bad news is you’re probably under a lot of stress right now. But you probably knew that.

Basically what has happened is your primordial fight-or-flight instinct kicked in hardcore. You turned into a Late Triassic prey animal with the scent of a Tyrannosaurus Rex in her nostrils. But you’re a person and there was no way to actually fly away from your predator nor to fight it, so shit just got really unpleasant for a while.

From what my doctor tells me, panic attacks can manifest in a few different ways depending on the person and the situation. The main symptoms to watch out for are related to vision, heartbeat, and breathing, but all kinds of other fun things can signal that you’re in a panic attack too. A by no means comprehensive list:

  • Rapid breathing or hyperventilation
  • Tunnel vision, dilated pupils, or pinprick pupils (basically, if your eyes do weird stuff)
  • Tingling in the extremities (sometimes due to lack of CO2 from hyperventilation)
  • Extremely pronounced heartbeat or rapid pulse (it can feel like you’re having a heart attack or sprinting for miles)
  • Dizziness (sometimes resulting from hyperventilation or lack of CO2)
  • Sweating or chills
  • A weird sense of being disconnected from your body
  • Feeling like you’re literally dying
  • Abject terror (my favorite)

If you have a condition like anxiety, you’re more predisposed to panic attacks than most, but even a person without anxiety can have a panic attack due to extreme stress or emotions. It’s totally normal to react to a stressful situation (like receiving a huge unexpected bill or losing your job) with a panic attack. But if it happens again or if you have questions, you should find a way to go see a doctor.

Coping with a panic attack

Here are some coping techniques that sometimes work for me. Key word being “sometimes” because they don’t always work, in which case you just have to wait for it to end. Have fun!

Lie down but don’t close your eyes. Curl into a ball or the fetal position if it’s comfortable for you. The idea is to make your body feel protected, but aware to danger. Lying down will also prevent you from falling down if you get dizzy or start seeing in tunnel vision, and is therefore much safer than standing and waiting it out.

Repeat a mantra. Remember that scene in Frank Herbert’s science fiction classic, Dune? Where Paul Atreides, the Muad’Dib himself, is chanting “Fear is the mind-killer”? That’s the idea here. I tend to use “Invictus” by Henley, but anything rhythmic and easy to memorize will do. (Full disclosure, the doctor who taught me this suggested I try the Prayer of Saint Francis, but I’m a filthy heathen so that wouldn’t do.)

#thebookwasbetter

Slowly drink a glass of water. Don’t gulp. Drink it sip by sip, breathing in and out slowly between sips. Water is always good for you, and this repetitive action will have a lulling effect on your brain and body.

Distract yourself. Have a conversation about something completely unrelated. Read a book, play a video game—whatever will take your mind off things in the immediate moment. I always find it helpful when there’s someone there to force me to concentrate on their conversation.

Swaddle yourself tightly in a blanket burrito. There’s a reason babies find it comforting.

Try a muscle isolation routine. You can find many excellent tutorials online (the Companion app is a favorite of mine), but the one I do usually involves tightening and concentrating really hard on each of your muscle groups one by one, starting with your feet and moving up to your neck. If you’re just generally stressed, this one’s good too. I do it when I feel a stress migraine coming on.

Sympathetic breathing. I used to just think of this one as getting a gentle bear hug from my giant bear of a husband. This is always the fastest solution for me. But he’s not always around and hence the other methods in this list. Basically, I lay on top of my husband and he just hugs me and we breathe together. You can do this while sitting with your back against someone’s chest, or standing in a hug. The idea is that their steady, non-panicked breathing rhythm will help steady your own breathing and give you something to focus on. Plus hugs are nice.

Managing daily anxiety

Things like yoga and meditation don’t work for panic attacks (at least not for me), though I hear they’re good for managing daily anxiety in the long-term. They’re good stress relievers. But when you’re literally panicking and feeling like you’re going to die, the last thing you want to do is lay flat on your back with your eyes closed, exposed to unknown dangers and asked to just “be present” in this terrifying fucking moment.

Same goes for cardiovascular sports. I started running as a way to manage my daily anxiety and it works like a charm. All that pent-up adrenaline gets released when I’m pretending I’m running away from a horde of the cannibalistic undead. I go to sleep too exhausted to feel anxious, and my ass looks fly in a mini dress. But as a solution to a panic attack… running is not exactly helpful.

Plus actually running from zombies is more likely to induce a panic attack than stop one.

If you have repeated panic attacks and constant, steady anxiety completely disproportionate to the level of stress and excitement in your life… you should see a doctor. You might have a full-blown anxiety disorder, and they can prescribe either counseling or drugs to help you cope. Personally, I love my anxiety medication, but I understand that meds aren’t right for everyone in every situation. So seek personalized advice from Actually A Doctor if you can.

Any fellow anxious types in the house? Tell me about your best coping methods with a comment!

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14 thoughts on “Everything Is Stressful and I’m Dying: How to Survive a Panic Attack

  1. Hi, i loved what you wrote but i just think mantras might be a bad idea or at least, they might not be for everyone. If it works on you, great! but when i try mantras they all turn into “im a piece of shit” which, as you can guess, makes it worse. So if you have any trigger words try to notice them. They might help you out of the situation. Distraction is always a good idea out of this. Asking yourself questions you know the answer to, “what color is my room? Whats my mothers name? What is 2+2?” Are all good questions. Hope this helps y’all. Stay safe stay sane

    1. This is excellent advice! And I think my whole post can benefit from the disclaimer “this is what has worked for me but it might not work for you and that’s ok.” I’ve seen the asking-simple-questions method deployed with children too, which is really great to see. Anxiety affects people of all ages, and the more coping methods we have to share, the better off our community will be.

  2. Thank you so much for posting this!! It’s v important to spread awareness about this kind of thing. Something that worked really well for me was a bed tent – I know it sounds weird, but it’s like this tent sort of thing you put on your bed frame and your mattress goes in it. It’s marketed for keeping out light and stuff, but it makes me feel protected during panic attacks (and is extra helpful for ptsd-related nightmares!)

    1. No no, that doesn’t sound weird at all! My husband and I go camping a lot, and I’ve always said that I never sleep better than when I’m in our tent. It’s not just the darkness and silence of the wilderness, but that womb-like closeness of the tent just feeeeeels safe. I never thought of using that technique at home, though! Thanks so much for commenting.

  3. This is awesome! I recently got dx with anxiety and depression. ?!?! I just assumed everyone freaked out, fought with their husband every day, and couldn’t leave their bed for days on end from sheer terror haha! Turns out, most of my friends have the same mental health issues! I thought that was just adulting.
    I tried yoga, did nothing 🙁 finally got on meds, and feel better.
    It sucks to be diagnosed with something that doesn’t show up on a body scan, lab work, or has any other objective signs. I kept going to the doctor and saying “no it’s my thyroid” “no it’s fibro” but nope, all came back negative. it’s depression/anxiety damn it.

    1. Isn’t it a relief to get a diagnosis? To learn that you’re not just “stressed out” but there’s actually something legit going on with your brain chemistry? So glad you’re on meds now and feeling better.

      Oh, and fuck yoga.

  4. Before therapy: Breathing into a paper bag until hyperventilating stopped.

    After therapy (and also that one time before therapy when the phlebotomist couldn’t find my vein, this is what a nurse had me do): Sit down, head between my legs, start automatic breathing (in through the nose 2 3 4, out through the mouth 2 3 4). I am happy to say that I did this *automatically* when my bubble got invaded at the first Women’s March, so all that CBT practice and training to make it automatic (more than 15 years ago) stuck.

    1. Hurray for automatic breathing! And what a relief that you automatically knew to use this coping mechanism in a crowd. Oof, that must have been such an uncomfortable experience. Crowds don’t trigger panic attacks in me, but I’m definitely not someone who enjoys being touched in excess, especially not by strangers.

  5. This post hits close to home for me. I’ve suffered a couple of panic attacks in the past (although not for many, many years). Worse, I suffer from nearly-constant low-grade depression and anxiety. This may or may not be related to my diagnosed ADHD. In any event, I’m able to cope with it most of the time. It’s been a part of my life since sixth grade, so I have coping mechanisms…when I remember to use them.

    The real trouble comes when I get slammed by full-on, hard-core Depression. I never see it coming. And I generally don’t realize it’s hit me until I’m deep in a funk. The tough part with Depression, of course, is that even when you know you’re suffering, it’s tough to fix it. You KNOW what the fuck you’re supposed to do — you always know — but you cannot make yourself do those things. It sucks. It sucks big time.

    Anyhow, I should go see a doctor. Seriously. During my divorce, my then-wife made me promise that I’d see a therapist as a condition for her signing the papers. I saw a therapist. She diagnosed me with ADHD (and ADHD-related anxiety). She had my MD prescribe some pills (Vyvanse), but I don’t like to take them because they make me feel totally wired. As a result, I’m that patient you always hear about who has been diagnosed with something yet fails to take their medication. Haha. Except that it’s not funny.

    I guess my comment has no point other than: I feel you.

    1. It took me years to actually get a diagnosis because simply making an appointment with a mental health specialist, explaining my symptoms, and asking for medication felt overwhelmingly daunting. How do you get help with panic attacks when seeking help for panic attacks triggers a panic attack?

      So yeah. I feel you too. <3

      The double-whammy of anxiety AND depression fucking blows. I can't imagine what you're going through. And since we've made the point in the last two articles, I'm the LAST person to recommend therapy as a cure-all. But consider this your encouragement and inspiration to do what you need to do to improve your mental health by whatever means feels comfortable and safe. You can do it. And it's ok to take your time.

  6. Ahhh … I now realize that I’ve had a couple of panic attacks in the past, but didn’t know what they were at the time. So while I only have an inkling of what you deal with daily, I do have a 3 year old who is in the midst of learning to control her amygdala. I’m going to use your coping tools for her next meltdown; that way I can help her to calm down until we can solve the initial problem (i.e. pain, hunger, tiredness). Thank you for this post.

  7. Panic attacks are the fucking worst. I had one once in a MASSIVE and packed club one night while I was studying abroad. Guess who totally knew she hates clubs but went anyway because that’s what her friends were doing that night and then tried to hide it until she could pull herself away to go sit in a dark corner to try to get things under control.

    I had a very, very weird, low-grade panic attack at the end of 2016 that lasted for about 24 hours. I have never in my life experienced that and it’s still hard to describe. Because it wasn’t PANIC and I couldn’t pinpoint anything specific (other than Real Life Dread Because Being an Adult Who Doesn’t Know What She’s Doing With Her Life Fucking Sucks) but the erratic breathing and heart rate were all there. That was sufficiently off-putting enough to finally convince me to go see a therapist and eventually start on medication. I’m just thankful that my double whammy of depression and anxiety doesn’t come with more frequent panic attacks. The general low-level, constant existential dread is enough to deal with already, thankyouverymuch.

    (Also fuck yoga!)

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