Coping with Panic Attacks – 1 of 2

Symptoms of anxiety are common following major life event such as a brain injury. This can sometimes result in a panic attack. The following methods can be used to help.




During a panic attack you are extremely likely to breathe very fast and/or deeply.  This will have the effect of reducing the amount of carbon dioxide you have in your lungs which  in turn will create a lot of unpleasant body sensations which are likely to make you more afraid.  A vicious circle of fear leading to over breathing which leads to unpleasant body sensations (tingling, headaches, racing heart, flushes, nausea, chest pain, etc.) which cause more fear which leads again to over breathing,, gets established.  To stop this very nasty process you have to raise the carbon dioxide amount in your lungs.  You can do this in two ways:


A)   If you have a paper bag handy hold it tight over your nose and mouth so that no air can get into your lungs from outside the bag and breathe the air in the bag for several minutes until you calm down.


B)   If a bag is not handy or it would be embarrassing to use one (say in a supermarket) then you should change your breathing so you breathe in less air in a given period of time.  You can probably do this most easily by slowing down your breathing in small steps.  Attempt to breathe in smoothly and slowly and to let your breathe out just as slowly.  As you slow your breathing down you are bound to increase the depth of each breath.  However, try to avoid a very big increase in depth because that would undo the good work you have done by slowing down.  The ideal you are aiming for is SMOOTH, SLOW, REGULAR and fairly shallow breathing.  If you have managed to slow down for a few seconds but feel out of breath* and a stronger urge to take a quick gulp,  DON’T.  Resist it by swallowing a couple of times, that should get rid of the urge;  if it doesn’t then go ahead, take a gulp BUT once you’ve let the air in HOLD IT in for about 5 seconds and then let it out SLOWLY.  If you can hold a gulp for a few seconds you prevent it from lowering the carbon dioxide level.


To sum up, breathe in and out as slowly and evenly as you can and avoid any big increase in depth as you do so.



Count to yourself while breathing.  To start off with you might say “one thousand” to your self while breathing in and “two thousand” while breathing out so your breathing would be:


IN                     OUT                        IN


“one thousand”     “two thousand”      “one thousand”    etc.


and soon you might be able to say more to yourself while breathing in and out and so take longer to do it.


For example,


IN                                                 OUT


“one thousand, two                       “three thousand,  four

thousand”                                     thousand”



*  The feeling of being out of breath that people sometimes get when anxious is paradoxically often caused by breathing too much air.  Taking in less air for a little while will often make it go away.  We don’t know why some people become breathless after over breathing but it is a well established fact that they do.