Dealing with panic attacks

The surest way we can coach the young people in our care to overcome panic attacks is to train them to respond to the panic in an accepting and calm manner.

They may be experiencing very real fear and this fear will show itself in their breathing; in their muscles; in their heart beat and in their stomachs. It is real fear so avoid saying things like: ‘It is all in your head.’ ‘It’s all in your imagination.’ The symptoms are real and are caused by the release of hormones into the bloodstream.

They may be thinking: ‘If I am afraid, I must be in danger.’

But is this always true? I have heard panic attacks explained using a car alarm metaphor. They panic because their alarm system is just more sensitive than other people’s.

Reassurance that they are not going mad or going to die is paramount. Their bodies are just doing what they have evolved to do!

They experience all the symptoms and respond as if they really were in danger. This is what gives the panic its power over them.

The traditional FIGHT, FLIGHT, and FREEZE responses are very effective.These are instincts that we have developed as we evolved in a world full of predators. Even though we are the most dangerous species on the planet, we still have the nervous system of a prey animal.We are always on the lookout for danger and always ready to be triggered into that FIGHT FLIGHT or FREEZE response.

What to do:

  1. The first thing you need to do is get the student to answer is: ‘Is this a real DANGER or is it just DISCOMFORT?’

We can train our students over time to ‘float’ through the attacks by using the 5 steps of the AWARE model (see below for step by step instructions.) Gradually the panic will loosen its grip but it will take time. Be prepared to be patient...it can take many months!

  1. ACKNOWLEDGE AND ACCEPT

The surest way to overcome panic attacks is to train the young person to respond to the panic in an accepting and calm manner.

The fear of the anxiety attack is in their breathing; in their muscles; in their heart beat and in their stomachs. It is a real fear. So avoid saying things like: ‘It is all in your head.’ ‘You are just imagining it.’

They may be thinking: ‘If I am afraid, I must be in danger.’

But is this always true? I have heard panic attacks explained using a car alarm metaphor. They panic because their alarm system is just more sensitive than other people’s.

Acknowledgement and acceptance is where progress begins.

Coach them to have these helpful thoughts instead of the negative ones from the past.

I acknowledge the present reality that I am afraid and starting to panic.

I will ignore it.

I will not struggle to distract myself.

I accept that I am afraid but NOT in danger.

The thought that I am in danger is just symptom of my anxiety.

It is not a useful thought; it is just my anxiety talking.

I don’t fight the feeling.

I accept it in the same way that I might accept I have indigestion.

Although it feels awful, it is NOT dangerous.

What is the worst that a panic attack can do?

Make me feel afraid, well I already feeling that so let’s just ride out the storm.

  1. WAIT, WATCH AND WORK

Wait! Leaping into action too quickly is a big obstacle in coping with panic attacks. Encourage them to stay where they are. You do not need to run away to get relief….relief will come to you.

Watch how the panic works and how you respond to it. They can fill in a diary or use The Thought Diary App. As they record their thoughts they are in the role of the observer and this distances them from their emotions. Encourage them to record their thoughts during the attack.

Work Encourage the young person to stay in the present and to carry on with the task. Try everything you can to encourage them to stay in the classroom or exam room etc.

  1. ACTIONS TO MAKE YOURSELF CALM

The most effective action to take is to go into belly breathing like this….

BELLY BREATHING

● Put one hand on your chest and the other on your belly.

● Start with a long, slow breath out.

● Focus on what your hands are doing. The hand on our bellies should be being pushed forward as we inhale and it should sink as we exhale.

● It is not hard but it takes practice….we all started out as belly breathers when we were new born but we have got out of the habit.

● Practice it regularly...whenever you boil the kettle etc

TRAIN THEM TO HAVE THESE CONVERSATIONS IN THEIR HEADS

● Is this danger or discomfort?

● Fine! Let’s have a panic attack. It is a good opportunity for me to practice my coping techniques

● What if….. So what! I AM afraid right now but I will calm down later.

● It is ok to be afraid.

GET out of your head and interest yourself with something in the present. The feel of chair beneath you; the warmth of the coffee cup in your hand; the sound of birdsong etc.

  1. REPEAT UNTIL YOU FEEL COMFORTABLE AND IN CONTROL

They may very well have to do more than one round of the AWARE model. That’s ok because they are learning a new skill and it will take time.

  1. EXPECT THE BEST; IT WILL END BY ITSELF

You do not need to make your panic attack end. It will do so by itself whether you do anything or not! You just have to experiment and see if you can make yourself a little more comfortable whilst you wait it out.How to deal with panic attacks using the AWARE model.

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