When one has panic attacks...

I've only had one panicky attack (driving, narrow cliff road, no barrier there, curves so you couldn't see if a car was coming) and had to stop the car, which was as dangerous as going forward. I remembered reading that the thing to do is breathe slowly and that helped, that plus the logic of continuing going forward versus staying there. Probably not as good as the paper bag thing but it steadied me at the time.

Ah, we cross posted. So my comment is off-advice.

Give the square breathing described by djjd a try. It's pretty handy in regulating your breathing regardless of whether you're over- or under-breathing.

edit: it's also pretty unobtrusive. Most people aren't watching anyone else's breathing patterns.

One should go see one's doctor.

If not properly dealt with panic disorder tends to escalate, not simply go away, and eventually all sorts of the most innocuous stimuli will trigger a panic attack. Before long you could find yourself not wanting to leave your house.

Relaxation techniques are effective...once you have the disorder under some kind of control and that is best accomplished through drugs.

Klonopin is very effective but it makes most people very drowsy. Trazadone works with much less of the Klonopin side effect.

You needn't be on any of these drugs for a long period of time, let alone a lifetime, but you will be one rare sufferer if you can lick the problem with will power and breathing exercises alone.

Once you have the problem under some measure of control, relaxation techniques can be very effective.

The key is to not only recognize early on when you reach a state of arousal (nothing sexual implied here) but to have developed relaxtion as an autonomic response. Easier said than done of course and the assistance of a trained professional is recommended.

Whether you take medication or not, it is very very difficult to deal with panic disorder on your own.

Good luck.

I have to agree with Finn here.

Been reading through all the advice re breathing, exercise, other techniques.

However, and I'm speaking from experience, one cannot wish/will/breathe these episodes away.

Now, if one is talking about what everyone has gone through, a bout of extreme nervousness about a situation, a fear over a certain event, sure, taking a deep breath, thinking something like "this too will pass" can be helpful.

But a panic attack involves chemistry interactions within the brain that we just can't control by saying "stop that"

My belief is a sertonin reuptake inhibitor, an SRRI, can be helpful.

tsar, if this is an occasional, and by that I mean once every couple of years event, fine, breath deep, go for a walk.
If it's something that occurs, or is starting to occur more frequently, bigger guns may be needed.

Going on Zoloft at one point literally, and I mean literally saved my life, which had become a living hell with panic attacks.
After a certain amount of time, I weaned off the dosage/frequency, so it's not a forever thing.
My body had to retrain itself to not blow it's wad of serotonin every time it saw a ceiling fan rotating, my heart rate accelerated for normal exercise, throwing me into the abyss.

That took time.

They CAN be useful....but research is extremely clear that it is the cognitive component that is the most effective intervention.

If you can avoid being panicked BY the beginning symptoms you can ride the thing out and most people can pretty much stop having them.

In fact, in terms of desensitising to the initial panic feelings, drugs can actually get in the way, so if panic disorder is a problem for someone it is important to be careful about drugs.

Of course, some people prefer to manage them on drugs alone....and many prescribers have no knowledge of how clear the research is about the optimum treatment. The drugs will help but won't teach anyone how to manage the problem.

It's not true that there is a runaway and unstoppable chemical reaction.

The panic attack really gets going when we are made afraid by the initial flash of anxiety, and react with a fight or flight response, the results of which make us more anxious and the vicious cycle begins. We CAN, in general, learn to desensitise to that initial flash of fear and not go on to have an attack.

That being said, if I had really persistent attacks I'd likely use drugs, as recent research suggests that very frequent panic attacks can be physically damaging.

It's a damn good idea to have a medical assessment, though, just in case there is an adrenal lesion or some other physical cause.

I'm not saying drugs don't have a place....but the cognitive/behavioural interventions are what really help to stop people from experiencing the morbidity associated with the damn things. That and looking at life stressors, learning to calm the body etc.

I started having the buggers when I entered menopause....not that uncommon....and I was able to get to the point where I could have the beginnings of one actually in a session with a family, and either ride it out with nobody being able to notice a thing, or just stop the thing in its tracks.

I appreciate what you're saying dlowan.

In my case, I could not learn to calm myself cognitively because the attacks were coming so often (daily or more than once a day at its worst) that I was a physical wreck.

Taking the Zoloft allowed my body to calm enough so that I could concentrate on the methods of maintaining it. I think a multifaceted approach is good, for me, best.

I didn't want to walk around "drugged" which for a long time was what my perception of "taking something" meant. I felt so completely out of control of anything in my life, that the idea of taking something made me think it would completely send me over the edge. It took more than a year of gentle persuation by a therapist to agree to try medication. During that time, all sorts of calming exercises were tried, but it was like closing the barn door when the horse had been running around the field for decades.

As far as side effects, any that I had I truly didn't care about, and amounted to nothing in the long run anyway. I remember 2 distinct times that I would have called feeling high, and found such relief, like "omg, this is soooooo nice." However, looking back, what I was feeling at those moments were simply Normal.....it had been so long since I'd felt just plain old normal, it actually felt euphoric.

Side note, I've been told that there is a genetic component in this, and when I was finally able to see the forest through the trees, I realize that my mother, and her mother must have been experiencing the same. Too bad, especially for my maternal grandmother. She never did find relief I think. You know, it was so many years ago.....all she would do was pace, say the rosary.....for all the good it did.

I felt very fortunate to have found help.

The cognitive component may indeed be the most effective long term intervention, but it takes a while to get this right and people with panic disorders don't have the luxury of time.

Drugs can produce an immediate palliative effect that paves the way for a cognitive reset.

When you are regularly finding yourself in a place where you are convinced you are dying, spending time with a cognitive therapist is not the best answer.

True dat.

They (we if you have had panic disorder) also don't have the luxury of having a life.