How To Stop a Panic Attack

Most Panic Attacks Can Be Controlled in Under 60 Seconds

What is a Panic Attack?   A panic attack is a sudden and intense burst of arousal with multiple physical symptoms accompanied by fear, fear of dying, or fear of losing control.   Most panic attacks are produced by alterations in breathing which produce a sudden change in circulating carbon dioxide, CO2. Panic attacks are real, biological events, not just psychological symptoms.   Risk factors for panic attacks include: caffeine, sleep loss, hormonal variation, loss, and negative emotions.

Respiratory Retraining for Panic Attacks:   This is an effective three-step procedure that has proven effective in controlling the majority of panic attacks.  It is intended to be used in combination with cognitive therapy.    

Note: This information is for the use of my patients to help them remember an assigned technique. It is not offered as treatment to others, but only for educational purposes.

Step 1.  Take in a normal-sized inhalation. Do not fill the lungs completely.    Step 2.  Hold the air in your lungs for two seconds.
Step 3.  Release the breath slowly through the nose or pursed lips.

Allow about 10 seconds per breath.

Practice producing a series of 6 breaths 15 -20 times a day for 3-4 days
until it feels natural.  Then continue to practice 3 – 4 times a day to
maintain your skill.  The hardest part often is to remember to use this
breathing technique at the start of an attack.


How Does this Work?
   Most panic attacks are caused by overbreathing which releases too much carbon dioxide (CO2) from the body.  Breathing too deeply, too rapidly, frequent sighing, or suspending the breath before taking an inhalation can all produce panic symptoms. This techniques rapidly restores the balance ofCO2 in the blood stream. 

Biofeedback:   A biofeedback capnometer is used during office visits to observe these changes and perfect your technique. You can actually watch the levels of CO2 respond as you practice the procedure.  That is the magic of biofeedback.

Small pocket-sized biofeedback devices have recently become available that are excellent for learning how to breathe in ways that are not only very relaxing, but also help prevent panic attacks.  These devices cost between $200-300 currently. Contact me for more information or revisit this site in the future.  I will be including much more information for you about this exciting new development. 

Cognitive Therapy;   Cognitive therapy teaches you how to gain control over your anxiety symptoms by attending closely to your thoughts, feelings, and actions.  The therapist acts as a coach and helps explore alternative ways of solving problems, restoring balance in your life, and reinterpreting events and symptoms.  

Relaxation:   Relaxation training is an important aspect of anxiety management. Customized recordings of relaxation instructions are made for you to use between visits.  In a relatively short time you no longer need the recordings and can produce the relaxation response easily on your own.

Read a research article on respiratory retraining and panic here (PDF file).

Go to the Anxiety Disorders Association of America here to learn more about anxiety and panic attacks.

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