How to cope with panic attacks: Breathing and other simple tips

Anxiety is a natural reaction to stress that everyone experiences at some point – whether it’s before a big presentation, a difficult conversation, or the anticipation of an event. It’s your body’s way of preparing for danger, whether real or imagined (American Psychological Association, 2020). While anxiety can help us respond to threats, it can sometimes become overwhelming, leading to excessive worry and avoidance. In some cases, anxiety can escalate into panic attacks – intense, uncontrollable feelings of fear (Craske et al., 2017).

Both anxiety and panic attacks stem from the body's fight-or-flight response, which evolved to help us react quickly to danger (Öhman, 2013). However, in today’s world, this response can be triggered by everyday stressors, like a work deadline or a crowded room, making you feel fear even when there’s no real threat (Klein, 2018). This is why learning to regulate and manage stress through self-care and relaxation techniques is so important – it helps regulate your body’s stress response and prevents it from becoming overwhelming.

What’s happening in your body?

Anxiety often builds gradually, triggered by ongoing stress or worry. You might notice your heart rate increasing, your muscles tightening, or your thoughts racing – signals that your body is preparing for action (Gorman et al., 2000). Sometimes we don't notice we are anxious at all. These reactions are normal in short bursts and help us respond to challenges. However, when anxiety becomes chronic, it can take a toll on both your mind and body. That’s why it’s crucial to use stress-management strategies to help you stay balanced and prevent anxiety from taking over (Bandelow & Michaelis, 2015).

Panic attacks

Panic attacks often strike unexpectedly. One moment you’re fine, and the next, you’re overwhelmed by a wave of fear. Symptoms can include a racing heart, tight chest, and difficulty breathing – and trying to control your breath can sometimes make it worse (Mayo Clinic, 2021). Panic attacks typically peak within 10 minutes but may take hours to fully recover from. While breaking free from the cycle of panic can be challenging, with the right tools and support, it is possible to regain control (Craske et al., 2017).

What triggers anxiety and panic attacks?

Triggers for anxiety and panic attacks vary from person to person. Common triggers include:

• Stress: Ongoing stress from work, relationships, or life events can increase anxiety.
• Health concerns: Worrying about health can turn minor symptoms into major fears.
• Past trauma: Unresolved emotional experiences can heighten sensitivity to stress
• Biological factors: Genetics or brain chemistry can make some people more prone to anxiety. 

The fight-or-flight response

Both anxiety and panic attacks are rooted in the body’s fight-or-flight response. This response evolved to help us react quickly to real threats by releasing adrenaline, which makes the heart race, muscles tense, and breathing shallow. While this response is useful in life-threatening situations, in today’s world, many stressors are not life-threatening – like a busy workday or a crowded social event (Klein, 2018). However, the body reacts to these situations as though they are, causing anxiety even when there’s no real danger (Craske et al., 2017).

Getting stuck in the cycle

One of the most challenging aspects of panic attacks is how easy it is to get stuck in a cycle of fear. If you’ve had a panic attack in a particular place or situation – whether it’s a specific room, a crowded street, or even a certain store – just thinking about that place can trigger anxiety. Your brain starts to associate that location with the fear you felt during the attack, and this association can cause anticipatory anxiety, even before you enter that space (Craske et al., 2017).

Over time, this can lead to avoidance behaviour, where you begin to steer clear of situations or places that have triggered panic attacks in the past. The more you avoid these places, the stronger the anxiety becomes, creating a vicious cycle that can be hard to break (Bandelow & Michaelis, 2015).

Breaking the cycle

The key to breaking the panic cycle is gradual exposure – slowly and safely reintroducing yourself to places or situations that trigger your anxiety. This helps retrain your brain to understand that these environments are not inherently dangerous.

Start small: You might begin by imagining the triggering situation while practising relaxation techniques, like deep breathing. Once you feel comfortable with this, try visiting the location briefly when it’s less stressful, and focus on staying calm. Each small step weakens the fear response, making it less intimidating over time (Klein, 2018).

How to cope with anxiety and panic attacks

Managing anxiety and panic attacks can be tough, but there are effective strategies that can help reduce their intensity and give you more control over your reactions. Here are some proven techniques to cope with both anxiety and panic attacks:

1. Deep breathing exercises

One of the quickest ways to calm yourself during a panic attack is deep breathing. Try the 4-7-8 technique:

• Inhale for four seconds.
• Hold your breath for seven seconds.
• Exhale slowly for eight seconds.

This helps regulate your heart rate and sends a signal to your brain that you are safe, reducing panic symptoms (Kabat-Zinn, 2013).

2. Grounding techniques

Grounding exercises can help distract you from anxious thoughts and bring your attention back to the present moment. Try the 5-4-3-2-1 technique:

• Five things you can see.
• Four things you can touch.
• Three things you can hear.
• Two things you can smell.
• One thing you can taste.

This technique helps shift your focus from overwhelming feelings to your surroundings, grounding you in the present (Bandelow & Michaelis, 2015).

3. Cognitive reframing

Anxiety often comes from negative or irrational thought patterns. Cognitive reframing involves identifying and challenging these thoughts, then replacing them with more realistic ones. For example, if you think, “I can’t handle this,” challenge that thought with: “I’ve handled tough situations before, and I can manage this one too.”

Ask yourself:

• What evidence do I have that this thought is true?
• How likely is the worst-case scenario to happen?
• How can I reframe this situation in a more realistic light? (Beck, 2011)

4. Progressive muscle relaxation (PMR)

Progressive Muscle Relaxation (PMR) involves tensing and then relaxing different muscle groups to release physical tension. Start with your feet and work your way up, tensing each muscle for five seconds, then relaxing it for 10-20 seconds. By practising PMR regularly, you’ll become more aware of areas of tension in your body and learn how to release it before it becomes overwhelming (Jacobson, 1938).

5. Mindfulness and meditation

Practising mindfulness helps you stay in the present moment, reducing worry about the future or dwelling on the past. Simple practices, like focusing on your breath or observing your surroundings, can help reduce anxiety. Meditation can also calm your mind. Even just a few minutes each day can make a big difference over time (Kabat-Zinn, 2013).

Taking control

Anxiety and panic attacks can be difficult, but they don’t have to control your life. Techniques like deep breathing, grounding exercises, and cognitive reframing can help you manage your reactions to stress and anxiety. The goal isn’t to eliminate anxiety completely – since it’s a natural and protective response – but to learn how to manage it so it doesn’t overwhelm you. With time and practice, you can reduce stress and find more peace in your daily life.

Finding support

Remember, you’re not alone, and help is available. If anxiety and panic are taking over, with the right tools and support from a therapist, you can break free from the cycle of panic and anxiety. Therapies like hypnosis and cognitive behavioural hypnotherapy (CBH) can offer effective ways to manage and overcome anxiety.

References 

• American Psychological Association, 2020. Anxiety. (online) Available at: https://www.apa.org/topics/anxiety (accessed 6th November 2024)
• Bandelow, B. and Michaelis, S., 2015. Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), pp. 327-335.
• Beck, A.T., 2011. Cognitive therapy: Basics and beyond. 2nd ed. New York: Guilford Press.
• Craske, M.G., Stein, M.B., Eley, T.C., Milad, M.R., and Holmes, E.A., 2017. Anxiety disorders. The Lancet, 388(10063), pp. 3058-3070.
• Gorman, J.M., 2000. The role of the amygdala in anxiety and panic disorders. American Journal of Psychiatry, 157(3), pp. 400-407.
• Jacobson, E., 1938. Progressive relaxation. Chicago: University of Chicago Press.