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The UnPanic Button: Two Strategies for Interrupting an Anxiety Attack Without Drugs

Your heart pounds.  Your breath comes fast and shallow.  Lunch is a hard, unmoving lump in your stomach.  Cold sweat trickles down your spine.  Nails dig into your palms as your fists clench.  Your eyes are wide as visions of doom dart through your thoughts.  Maybe an urge to flee overwhelms your thoughts, maybe you feel a need to lash out at whoever is closest, maybe you can’t seem to make your limbs do anything at all.  It’s a panic attack.

When your brain hits the panic button, it’s time to hit the Backspace button in a hurry. (Thanks John* for the photo.)

Sometimes there’s a very good reason for such a strong fear response; although the fear itself is more likely to kill you than save you in the modern world.  See Paranoid Prepper’s recent post from Escape from New York:  Sure being in a skyscraper when a plane slammed into it and set it afire made such fear very reasonable, but he wouldn’t have made it out of the city if he’d given in to panic and simply fled, or started a fight, or been paralyzed by fear.

Other times there’s no good reason for the fear, so far as your conscious self can tell.  Three percent of the U.S. population suffers a ‘panic attack’ (what we call these episodes when they aren’t sparked by a clear and present danger) each year.  That’s 3% a year when in a fairly peaceful and settled nation where many people have access to medications to help them regulate such problems.  What do you think will happen to the incidence of such attacks when people face a lot more danger, deprivation, and uncertainty, with less access to mental health services?

The amygdala is an evolutionarily old, primitive part of the brain, much similar among every creature with a backbone from fish to human.  It’s also a very cautious structure, triggering the flee/fight/freeze response whenever something seen, smelled, or heard matches a remembered time of fear. Those panic attacks aren’t really for no reason, they’re just for no logical reason.  If you smelled lilacs right before you were attacked by a dog as a toddler, lilac odor might trigger panic attacks to this day, without your conscious self even remembering that detail of the scary event.

Here’s a back view of an MRI of a brain during a panic episode. The false colored area – very active- is one of the two amygdala. Its central position indicates its primitive nature.

Once an attack starts, for a good obvious reason or no, it’s often in one’s best interest to stop it.  Every diver (should) know; malfunctions don’t kill, panic kills.  Even when it’s not dangerous, it’s a miserable experience that’s doing you no good.  The good news is, there are a couple of good ways to interrupt a panic attack, shortening its duration and giving you control back.  The bad news is, the way most people naturally try is not one of them.  (I’m neither a psychologist nor physician; but a science geek who happens to have read up on this … so as always, take this as information not a prescription.  Although many sources over many years contributed to what I’m sharing here, the book Rewire Your Anxious Brain, by Pittman and Karle, was very useful and has many practical suggestions.)

More full explanations and practical exercises are found herein.

Wrong, but thanks for playing:First, the obvious but ineffective approach:  Being reasonable.  Reason and logic come from the cerebral cortex.  It’s much larger than the amygdala; complex, nuanced, capable of subtle and thoughtful responses.  It’s also much slower to act and much less directly wired to your physiological control.  Once the amygdala takes over with a panic responses, the cerebral cortex is no longer in charge and all the wisdom in the world won’t stop the reaction.

The frontal lobes are great for ‘higher’ brain functions like logic, but they’re not driving during a panic attack.

How can you make your brain relax?What does work is coming in the back door.  Our bodies and minds are interconnected by many, many feedback loops, which collect information about how we’re functioning and adjust accordingly.  The surprising part is that, although the brain is definitely running the body, through these feedback loops the brain is also watching what the body is doing and using that as an indicator of how you should feel.  “Fake it till you make it” is a real thing in physiology.

When researchers spent months intentionally activating particular facial muscles to generate smiles (they were studying expression of emotion), they found themselves happier.  When they had to practice scowls, they got crabby.  Similarly, during a time of stress you can use what small bit of voluntary control the fear response leaves you to intentionally do a couple of very simple physical actions that naturally occur when you’re relaxed — and the brain notices and decides it should be more relaxed.  Sometimes life is stranger than fiction.

Breathe deeply

It’s a natural reaction to speed breathing when we’re anxious.  Hyperventilation is common in anxious people.  This over-breathing gets rid of too much carbon dioxide.  Our blood pH rises and the brain starts to malfunction.  This is the source of the dizzyness many feel during panic attacks.  Intentionally changing to slow, deep breaths gets our pH back where it belongs.  It’s also a breathing pattern the brain associates with calm, so when your brain sees you breathing that way….it gets more calm.  I know, it sounds a little like circular reasoning, but feedback loops enjoy their circular reasoning.  It’s especially useful to concentrate on breathing with the diaphragm (where you abdomen moves in and out with the breaths) rather than using chest movements.

The diaphragm lies just below the lungs. Concentrate on using it for deep, calming breaths. Thanks to Cruithne9** for the image.

Relax the musclesThe stress reaction increases muscle tone, making your muscles tight.  Your cerebral cortex can override that, forcing muscles to relax.  This override works best if you concentrate on one area of your body at a time.  Most protocols suggest starting at the feet and moving up, first tensing then relaxing each muscle group in turn.  The reduced muscle tension is reported to the brain, which apparently thinks “Oh look, I’m relaxed, I better turn off this emergency response.”

Do it even when there’s no panic attack

These approaches won’t flip off the panic attack like a light switch, but they have been shown to significantly shorten their duration and the discomfort and dysfunction they cause.  Moreover, doing the deep breathing and intentional relaxation practice often helps reduce one’s underlying level of anxiousness, so fewer attacks occur.

*By John (Flickr: Panic button) [CC BY-SA 2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

**By Cruithne9 (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons

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