Man experiencing intense anxietyAnxiety attacks are hardly ever fatal, but when you’re in the midst of one of these episodes, you may be overwhelmed by the fear that you’re going to die. In fact, many of the physical symptoms resemble the signs of an impending heart attack or stroke: 

  • Sweating
  • Numbness or tingling in the extremities
  • Tightness or pain in the chest
  • Choking sensations
  • Difficulty breathing
  • Dizziness
  • Nausea
  • Tremors 

For many people who experience anxiety attacks, the experience is so terrifying that they begin to avoid situations that might trigger an episode. This avoidance can cause debilitating social impairment, leading to isolation, depression, occupational problems, and substance abuse.

Learning to manage an anxiety attack, also known as a panic attack, isn’t just about stopping the attack while it’s happening, but about acquiring a set of tools that you can use to promote relaxation and reduce stress. Successful long-term management requires a combination of education, therapy, and stress reduction training. Many people who suffer from crippling panic attacks have also seen improvement in their symptoms by taking anti-anxiety medications.

What causes anxiety attacks?

Anxiety attacks are more common than you may realize. According to Psychology Today, as many as 1 million people in the US suffer from the symptoms of severe anxiety — including anxiety attacks — each month. One out of every 75 Americans will meet the criteria for panic disorder, a debilitating psychological condition characterized by repeated anxiety attacks.

The exact cause of anxiety attacks is unknown, but there are several important factors that may trigger these episodes:

  • Genetic predisposition. Having a family history of mental illness can increase your risk of having anxiety symptoms.
  • Neurological factors. Anxiety has been linked to an imbalance in certain brain chemicals. Research from the University of Chicago indicates that serotonin and gamma-aminobutyric acid (GABA), two neurotransmitters that regulate your moods and your response to stress, are often deficient in people suffering from anxiety disorders.
  • Past trauma. A personal history of traumatic events, abuse, or violence can leave you psychologically vulnerable, making you more prone to anxiety attacks.
  • Drug or alcohol abuse. Although alcohol, tranquilizers, marijuana, and other sedatives are often used to manage anxiety attacks, these substances can actually make the episodes more intense and more frequent.
  • Previous anxiety attacks. According to the American Psychological Association, most panic attacks are not caused by a fear of a threatening event or object, but by a fear of having another attack. If you have already had a panic attack in public, you may have been so terrified by the experience that you start to isolate yourself in order to avoid having another episode in front of other people.

Learning about the causes of anxiety attacks won’t stop these episodes from occurring. However, it may help you relax during an attack if you know that the symptoms aren’t caused by a life-threatening illness, but by psychological distress or by chemical abnormalities in the brain.

Learning how to manage severe anxiety isn’t an overnight process. Many of the of the most effective techniques — calm breathing, self-soothing, reassuring self-talk — must be practiced for weeks or even months before you can come to rely on them. If you’re struggling with severe anxiety, a mental health professional can help you in the following ways:
  • Talk therapy. Through face-to-face discussions, a therapist can help you explore the roots of your anxiety and learn how to prevent or manage panic attacks. For many people living with anxiety, talking about past and present fears with an objective professional can be a healing experience.
  • Behavioral modification. Cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT) have been used successfully to help people with severe anxiety disorders manage their symptoms. These therapies address the negative thought patterns, catastrophic fears, and self-defeating ideas that can lead to an anxiety attack.
  • Exposure therapy. If your anxiety attacks are triggered by a specific situation, object, animal, or event, your therapist might use exposure therapy to help you overcome your fear. In this approach, the patient is gradually desensitized to the object of fear through repeated exposure in controlled circumstances. For instance, if your attacks are triggered by public speaking, your therapist might encourage you to gradually take more challenging opportunities to address a group or an audience.
  • Anti-anxiety medication. A class of antidepressant medications called SSRIs (selective serotonin reuptake inhibitors) is often prescribed to treat anxiety disorders. These medications help correct the neurochemical imbalances associated with panic attacks. For people with severe anxiety attacks, a doctor may prescribe sedatives or tranquilizers on a short-term basis; however, many of these medications can become addictive, so their use must be carefully monitored.
  • Substance abuse treatment. If your anxiety attacks are related to alcohol or drug abuse, a therapist may refer you to a rehab program that specializes in the treatment of co-occurring disorders — or the coexistence of a psychiatric disorder with substance abuse. In order to recover from both an anxiety disorder and a substance abuse problem, both issues must be addressed at the same time.
When you feel an anxiety attack coming on, the last thing your body and mind want to do is to relax. However, if you can learn how to identify the early signs of an episode, you may be able to guide yourself through the crisis. Eventually, you might even be able to reduce or eliminate the number of attacks you experience and the duration of each event. Here are a few steps to manage anxiety attacks in the short term:
  • Understand what’s really going on. When your personal safety is threatened, your body reacts with a series of responses that are intended to protect you from harm. Your heart rate speeds up, your pulse races, your breathing quickens, and you feel the urge to escape at all costs. In an anxiety attack, your body reacts as if you were in danger, even though there are no immediate threats to your safety. To manage these episodes, it’s important to understand that an anxiety attack is rarely caused by real danger to you or to someone you care about.
  • Learn how to slow down your breathing. Rapid breathing, choking sensations, and tightness in the chest can make it difficult or impossible to breathe calmly during an anxiety attack. But if you can learn how to breathe calmly when you start to feel the first signs of anxiety, you may be able to slow down your body’s “fight or flight” response. At times when you’re feeling relaxed, practice breathing slowly through your nose and exhaling slowly through your mouth at an even, regular pace. Practice yoga, guided meditation, tai chi, or other stress reduction techniques that focus on slowing and controlling the breath.
  • Talk yourself through it. During an anxiety attack, you may sincerely believe that you won’t survive the episode. You may feel that you’re completely crazy or out of control. But the fact is, most anxiety attacks don’t last more than five to 10 minutes, and very few cause any physical harm. If you’ve had at least one anxiety attack, you already know that you can survive another one. During a calm period, make a list of reassuring phrases to repeat to yourself when you’re having an attack, such as: “I’ve been through this before,” “This isn’t going to kill me,” “I’m safe and strong,” and “I can survive this.”
  • Teach your body to relax. Severe anxiety makes the muscles go rigid and tense. You may find yourself clenching your fists, grinding your teeth, or hunching your shoulders in a defensive posture. Learning how to consciously relax your muscle groups may help you de-escalate your fears. The American Medical Student Association recommends a technique called “progressive muscle relaxation” for managing the physical symptoms of stress.
  • Practice self-soothing techniques. There are many ways to calm yourself down during an anxiety attack; the trick is to learn which methods work for you. Make a list of activities, objects, or sensations that you find soothing, and use this list to build an “anxiety toolbox.” Some people find that the scent of essential oils like lavender or orange help them relax more quickly. Others like to carry a portable music player with soothing nature sounds or meditation music. Holding a smooth stone or rhythmically squeezing a rubber ball may also be helpful.
  • Reward yourself for each victory. Surviving an anxiety attack isn’t easy. Do something special to reward yourself each time you successfully survive an episode or stop an attack in its tracks. Take a long walk, rent a movie, soak in a hot bath, or set aside an hour to read a good book. You’ve earned the relaxation!

Anxiety disorders are extremely common among individuals with drug or alcohol addiction. The Recovery Village offers a full spectrum of recovery services for men and women who are suffering from anxiety and substance abuse. To learn more about our treatment programs, and to take that first important step toward recovery, call our intake specialists today.

How to Manage an Anxiety Attack
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