On Panic Attacks and How to Help
I was browsing reddit and I came across what looks to be a couple of helpful comments about panic attacks (there will be a link to the comment thread after the quotes for those interested).
First, why panic attacks are such a big deal:
“A panic attack is a strange thing, your brain kind of ends up in a weird cycle.
It initially decides that some input is super dangerous and life threatening. This initial thing could be a physical sensation like a pain in your chest/elevated heart rate, or sensory- maybe you saw a quick flash of light that your brain decides is a physical attack, or stress related- you're worried about someone not liking you which elevates your stress hormones enough that it causes a danger response. It can be anything really. The tricky part about this is that it's your "lizard" or basal brain that is monitoring your safety, so there's no conscious control involved in setting off the chain reaction, and you are often never aware of what the triggering event is.
Once your brain senses imminent, life threatening danger, it jumps into superhero mode. It releases stress hormones, speeds up the heart rate and breathing rate, you can get a flood of adrenaline, senses become heightened, etc. These things are all awesome if you were, say, being chased by a bear, but when you're hanging out alone in your bedroom they end up really messing with your brain, which is what contributes to the physical sensations of a panic attack. You feel your heart racing, like you can't breathe (your body is trying to pull in more oxygen), you get shaky, you get tunnel vision, you become acutely aware of every part of your body and every tiny twinge in it.
The rational part of your brain does try to kick in at some point, but it doesn't really help the situation. One part of your brain has flashing lights and sirens and is in full blown panic mode. The "smart" part of your brain starts to try to figure out what's going on by doing a quick scan. It doesn't see a bear, there's no knife wielding madman, you're not falling out of an air plane. But wait! Your heart is racing! You can't breathe! You can't see right! You're getting dizzy! You're body is shaking! There's a pain in your side! Your brain takes all this in, the terrible symptoms, the warning lights - which it is hard wired to trust and respond to- and the lack of a visible threat, and concludes that there is some terrible physical event happening and that you are truly dying.
Of course, the irony is that that reinforces the stress responses and continues the cycle until you are able to disrupt it. Truly the whole point of a panic attack is that your brain has decided that you are, in some fashion, dying. It can be a really terrible feeling.” - (reddit user) cow_girl_up
How to help, as explained by (reddit user) acgk on how they help their girlfriend:
First things first: attitude. You cannot help her until she begins to help herself. You are guiding her, not fixing her. Don't even think about fixing or problems. There's nothing wrong. Your demeanor should be "this is happening and I am being supportive," not "there is a problem and I am fixing it."
Ask her to look at you as best she can. Eye contact is best, but it might be too hard. If she can't, let her know that it's okay and pick something easier, like an inanimate object comparable in size to a human (e.g., not something tiny like a pen or huge like the night sky or ocean). It should be unique, though. And it definitely shouldn't be fragile or broken. Look at it with her, but pay her the occasional glance to monitor her condition. If she just needs to keep her eyes shut, let her and reassure her that's okay, too.
Ask her to describe what she's feeling. Ideally, only let her move up the order of preference before: if she was looking at a lamp and now she's looking at you, that's a good sign. If she was looking at a lamp and now she's got her eyes shut or she's looking at her feet, that's bad. Don't comment on it, but make a mental note.
Now you can help. Make her understand that she is safe. Food, warmth, soft things, and hugs are all good things here, usually, but not for everyone. If she gets claustrophobic when she has an anxiety attack, it may be better to go outside with her. Read the situation. If she's still got a full on anxiety attack, maybe take some vital signs so you can prove to her that she is physically alive and well, but honestly if nothing has helped yet then we're leaving the realm of my expertise.
If she's anxious about losing you, hugs first. If she's anxious about trusting you, a blanket and some hot cocoa first. If she's anxious about something that doesn't involve you, it matters less. This can be hard to judge because at this point you still haven't asked her what's wrong. We're getting to that.
In any case, don't just leave and go get things for her. Communication is key. Don't ask her if she wants something; she'll probably say no. Let her know you're planning to go get it for her and give her enough time to stop you if she doesn't want it or would rather you stayed by her.
Edit to clarify previous paragraph. Think of it this way: if you ask if she wants something, the status quo is you not doing something but if she accepts the offer, she's given you a little extra burden. You don't mind or even think about it that way because you love her, but she can worry about that kind of thing when she has anxiety. If you just tell her what your plan is, the status quo is that you've already decided to do the thing, so she's less likely to stop you just because she feels like she doesn't deserve it.
Now, once she's begun to relax or volunteer the information, you can ask about what the initial problem was.
Behind the Scenes
Step one was something called "grounding". She's in hell inside her head, and you've got to get her to focus on something real and concrete. Show her the way out of her head to a place where she can talk.
Next, you made her take an objective look at the real problem. When you're having an anxiety attack, the real problem is the anxiety attack. Your panic response is in a feedback loop: you're panicking because you're panicking. The thing that initially caused you to panic, if it was ever real, is no longer part of the equation. She needs to go from "I'm dying" to "I feel short of breath because I'm scared about ____." That's why we avoided asking her what was wrong. She's wasn't sure at that point, and if you asked her then she might've started panicking even more.
Now that no new fuel is being added to the fire, you put it out and/or stay with her until it burns itself out.
Edit to add: If all else fails, there is one more thing you can try. Just talk to her. Let her know she's not necessarily expected to participate; just talk. Avoid topics that would make her more anxious, obviously, but really just having another person there can be really helpful.
Edit: It really made my day that this has helped so many people. I had no idea it would blow up like this. Thank you all for the comments and gold.
My experience: Literally everyone I've ever been close to except for one person deals with anxiety in some level. At the worst end, my sister had a suicide scare more than once and at the best end, my closest friend's anxiety is basically under control and I've never been with her during an attack. Also I deal with my own anxiety. I'm in academia, so I have some experience reading academic journals as a way of learning new information, but that's the only advantage I've got: I'm not in psychology and what I say should not be considered medical advice. If it's truly serious, talk to them about seeing a professional.
Grounding techniques: I went over two of them. These are the two that, to me, are the easiest to walk a person through conversationally. There are lots of grounding techniques, but many of them would be rather obviously clinical to try and walk someone through, and I can't tell you how well that would be received. If you have the chance to talk seriously about anxiety with your partner, it can be good to go over some grounding techniques with them and encourage them to find what works for them. There are a couple mentioned elsewhere in this thread, and they're all over the internet with varying levels of academic rigor behind them.
Notes about OP: I cannot emphasize enough how non-judgemental you have to be. It can be really hard for someone to make eye contact if they have anxiety. They might be genuinely not strong enough and if you try to make them, they might panic more. You'll have to learn a little from experience, but it might be better to switch steps one and two sometimes, or omit eye contact entirely. Maybe start a little bit of a conversation about the object they focus on instead of jumping straight into talking about their feelings. Get them to take in details of the world around them.
Hope this information helps people, here’s the link to the comment as promised: https://www.reddit.com/r/AskReddit/comments/5nmmcq/if_someone_were_to_take_over_your_body_in_this/dcd03qy/
