If you have ever experienced a panic attack, you know how awful it feels. It would make sense if you did everything possible to prevent having another one.
Unfortunately, the things that people do in between panic attacks to prevent them often end up keeping them trapped in the cycle of panic attacks. Thus, the key to preventing panic attacks is not doing things that reinforce them.
If you have panic attacks, see if you engage in any of the following common behaviors. If you do, you might want to consider addressing them in order to break the cycle of panic attacks.
Panic attacks can feel so awful, and people often think they are dying, about to faint, or going to lose control of their actions or their minds. In reality, panic attacks are not dangerous. They are the fight or flight response that evolved to protect people, not harm them.
Why catastrophizing is a problem: The more you have catastrophic thoughts about panic, the more anxious you become, and the more likely you are to have another attack.
What to do instead: Remind yourself that panic attacks are not dangerous and do not have horrible consequences. Often, accepting that you could have another attack and that it’s not the end of the world can be helpful.
People with panic attacks tend to be hyperaware of their bodies in between attacks. They might mentally focus on their heart rate or breathing or use devices like a watch, pulse oximeter, or blood pressure machine to monitor their bodies.
Why body monitoring is a problem: When you actively focus a lot of attention on body symptoms, you are more likely to pick up on minor and normal fluctuations that would otherwise go unnoticed, which could lead to increased anxiety and panic. In addition, by monitoring your body, you are reinforcing the notion that panic attacks are dangerous. It is almost as if you are saying to yourself, “panic attacks are so scary that I have to be on alert for them.” When you reinforce the belief that panic attacks are fearful, you are more likely to have another attack.
What to do instead: If you are monitoring your body with a device, you can ask your doctor if they think it is necessary to do so (chances are it is not, unless they explicitly told you to). If it’s not needed, consider stopping doing it altogether. If you are paying mental attention to your body between attacks, try to be aware of when you are doing it. Then, try to shift your attention to something else in your environment, such as something on the wall or the texture of your chair. Or, even better, do an activity that is more meaningful or important than monitoring your body. I wrote more extensively about this issue in this blog post.
People with recurring panic attacks commonly avoid places that they associate with them. For example, it’s common to avoid going to the grocery store, driving on the freeway, or eating in a crowded restaurant if you have ever had a panic attack in that situation.
Why it’s a problem: The more you avoid, the more you reinforce your panic attacks. Similar to body monitoring, you are giving yourself the message that you can’t handle panic attacks. Thus, you need to avoid certain situations. Also, avoidance can become such a big problem that some people’s world becomes smaller and smaller because they avoid so many situations.
What to do instead: Work on decreasing avoided situations. It might be helpful to break down avoided situations into small steps. For example, suppose someone is avoiding going to the grocery store. In that case, they might first practice going to the grocery store and sitting in the parking lot to get used to that. Then they might go and buy one item, or go in with someone else, and build up from there. The eventual goal would be to be able to get all of your shopping done alone, without rushing through it for fear of having another panic attack.
Many people with panic attacks carry things with them that make them feel safer should they have a panic attack, such as anti-anxiety medications or a paper bag to breathe into. Sometimes, they will not go anywhere alone for fear of having another panic attack, and the other person is like a safety object.
Why safety objects are a problem: Like with the above behaviors, safety objects reinforce the panic attacks and keep you in the cycle of panic.
What to do instead: If you want to become someone who doesn’t worry about panic attacks, you can imagine someone you know who does not struggle with panic attacks. Would that person, for example, be carrying anti-anxiety medication with them? The ultimate goal is to act like someone who does not struggle with panic attacks. Similar to the above example about exposure to avoided situations, decreasing safety behaviors can occur in stages, such as first not taking the medications to places that seem more manageable. If the safety object is another person, they might be helpful to assist with going into feared situations, which is fine at first. However, to fully recover from panic, it is preferable to have the goal of not needing to have another person around.
For many people with panic attacks, it can be daunting to do this on your own. I have panic attack resources on my website. Some might benefit from finding a therapist who specializes in anxiety and panic. Recovery is possible.
To find a therapist near you, visit the Psychology Today Therapy Directory.
References
Pompoli, A., Furukawa, T. A., Efthimiou, O., Imai, H., Tajika, A., & Salanti, G. (2018). Dismantling cognitive-behaviour therapy for panic disorder: a systematic review and component network meta-analysis. Psychological Medicine, 48(12), 1945–1953. doi:10.1017/S0033291717003919
Wenzel, A. (2017). Basic strategies of cognitive behavioral therapy. Psychiatric Clinics, 40(4), 597-609. doi: 10.1016/j.psc.2017.07.001
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