My Panic Attacks Are Getting Worse. What Should I Do?

A reader asks:

About three months ago, I started having panic attacks. Out of the blue, I just start feeling scared, my heart starts racing, my palms get sweaty, sometimes I feel lightheaded or dizzy, a pit in my stomach, and I get tingling sensations in my fingertips, etc. I’ve seen my doctor about this and she assures me there’s nothing wrong with my heart or anything else that she can see. I saw a couple different therapists but we just talked and nothing seemed to change. Any advice?

When I worked as a therapist, I specialized in panic, which was a really rewarding specialty because of two seemingly opposed facts:

  • Panic is one of the most acutely painful forms of emotional suffering there is. And if left unchecked, it can completely ruin your life.
  • Panic is also one of the simplest issues to get rid of. Not easy, necessarily, but remarkably straightforward to cure (yes, you can cure panic).

Over the years, I helped dozens and dozens of people to completely eliminate panic attacks—often after having suffered with them for decades.

The trick is to understand—and accept—that 99% of the advice out there for dealing with panic is wrong and will make your panic worse in the long-run.

To be a little more specific, most approaches to panic are based on a coping mindset, which says that when you’re experiencing panic, you need to do something to calm yourself down… Deep breathing, mindfulness, positive self-talk, drugs, etc.

(Part of the reason this mistake persists even among professionals is that many therapists and counselors themselves are scared of their clients having panic.)

While these approaches may be more or less effective at alleviating your panic in the moment, all of them make panic worse in the long run because—by avoiding your panic—they teach your brain to fear it, which makes you more susceptible to it in the future.

The alternative to this coping mindset is the confidence mindset, which says that the key to getting rid of panic is to be 100% willing to have it without any attempts to make it go away because you’re confident that you can have panic and nothing bad will happen.

See, while panic feels awful, it’s not dangerous. Nothing is wrong with your body even at the height of a panic attack. (Next time you’re having a panic attack, measure your pulse, then compare that number to your pulse when you’re doing some strenuous exercise—it’ll be about the same).

Panic is simply your body going into fight or flight mode (extreme sympathetic nervous system arousal) when it doesn’t need to. All those symptoms that feel terrible—racing heart, elevated respiratory rate, knots in your stomach, tingling in your fingertips, etc.—those are all simply manifestations of a lot of adrenaline surging through your body getting you ready to either fight or flee some imminent danger.

Where people understandably get into trouble with panic is that they get anxious about their panic. And this leads them to try and get rid of or avoid their panic, which as we’ve talked about, only leads to more panic attacks later. The more you do this, the more your brain learns to panic about feeling anxious, which is why you tend to have more and more panic attacks over time.

Every time you try to avoid panic, you make future panic more likely.

The only way to break this vicious cycle is to show your brain that you’re not afraid of panic. And the most powerful way to do this is to be 100% willing to have panic and not try to lessen or avoid it at all. In other words, because you’re willing to have panic, you demonstrate confidence to your brain, which makes it less sensitive to panic in the long run.

I’m explaining all this background information because if you want to stop having panic attacks, you need to stop trying to get rid of them. But you’ll only be willing to stop trying to get rid of them if you actually understand what’s going on with panic and how it really works.

If you want a slightly more in-depth explanation of panic, this article of mine on How to Stop a Panic Attack might be helpful.

Of course, you can always work with a professional therapist who specializes in panic to guide you through this process—just make sure they have real expertise and training treating panic specifically—most don’t. I have some tips on finding a good therapist here.

But anyone can start to foster a healthier confidence mindset toward their panic with a few simple steps:

  1. Acknowledge the Feelings. As soon as you notice feeling anxious, acknowledge your anxiety and label it directly. E.g.: I feel afraid right now and I’m worrying that I’ll have a panic attack. The earlier you catch panic the easier it is to move through it.
  2. Dissolve the Danger. Remind yourself that just because panic feels bad doesn’t mean it is bad. Panic is just your fight or flight system misfiring.
  3. Accept the Discomfort. Instead of trying to avoid or reduce your panicky feelings, be 100% willing to have them. What you resist persists and what you allow exits. You can have panic and get on with your life anyway.
  4. Refocus your Attention. Don’t dwell on your panic—either the thoughts, emotions, or physical feelings. Once you’ve gone through the previous steps, give yourself permission to refocus your attention on something else that’s meaningful or productive (but still being willing to have the panic).

Okay, hope that helps.

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