I suffer from panic attacks.  They used to come once every few months, but in the past year they have been increasing in frequency, duration, and intensity.   When they first started, I figured out what usually caused them (tight spaces, crowded rooms) and simply avoided those situations.

But now I’m not always sure what causes them.  I can be sitting comfortably in a favorite restaurant talking with friends, and all of a sudden I feel this wave of panic come over me.  My mind starts racing, my heart pounds, my palms become sweaty, even my vision becomes impaired.  When these attacks occur, I feel helpless and frightened.  I fear these attacks may start affecting my ability to function normally.  Help!

Panicky Pamela

Dear P.P.,

First, get a medical exam to rule out a thyroid condition, or a combination of medications that may cause attacks, or social phobias.  There is no substitute for proper diagnosis and treatment.  Anti-anxiety and anti-depression medications can help stop panic attacks.  But what else can you do to help yourself?

The eastern practices of meditation and mindfulness can help you recognize anxiety before it becomes panic.  Early signs of anxiety include irritability, tense muscles, “butterflies” in the stomach or chest.  Practicing proper breathing – taking deep breaths that fill the lungs – can actually change the chemistry in the body, making an attack less likely.

Avoid caffeine entirely, and limit sweets to once or twice a week.  These substances stimulate the nervous system, which make it more prone to panic. 

Practice relaxation techniques.  You can’t have a panic attack with relaxed muscles.  A method called progressive muscle relaxation has long helped people get to sleep.  It also is useful to tune into your muscles when you feel anxious, and will them to relax.  Envision individual muscles groups, starting with your toes, and will them to relax all the way up your body.  At first, progress slowly, concentrating on each group – your calves, your thighs, buttocks, diaphragm, arms, fingers, neck.  This exercise becomes easier and can be done more quickly with practice, but don’t rush it, and stay focused.

If you feel the panic washing over you anyway, don’t fight it.  Resisting can help enhance the panic, because when you react to panic with more fear, the panic gets worse.  Tell yourself, “Come on panic, let’s get it on and get it over with.”

Practicing these techniques should help optimize your professional treatment.