Panic attacks are not all in your head—they have a biological basis and you can use that to help you avoid them
Panic attacks are, hands down, one of the most terrifying things anyone can experience. They often get dismissed as "just" a mental glitch or are even used as a punchline. But the real deal? One can make even the strongest woman weep on the floor like a baby, convinced she is dying. (This Woman Bravely Shows What a Panic Attack Really Looks Like.) I know, because I used to have them on a frequent basis, and it got so bad that simply fearing having a panic attack could start one. It was a nightmare.
One of the worst parts of having a panic attack was being told by doctor after doctor that since it was "all in my head" there was nothing they could do to help me. But it's not just all in our heads; there is a biological basis for it. And there is something you can do about it.
It all starts with carbon dioxide. As humans, we all inhale oxygen and exhale CO2. But one of the first things we do when something triggers our fight-or-flight reflex (AKA our panic button) is hyperventilate. This is why people will tell you to "just breathe" or instruct you to "take deep breaths" during a panic attack. Unfortunately, this advice is exactly the opposite of what your body needs.
When you hyperventilate, your body is trying to get more oxygen to the brain. But all that inhaling means you're ODing on the oxygen while your CO2 levels fall dangerously low, according to Alicia Meuret, Ph.D., a psychologist and panic disorder expert at Southern Methodist University in Dallas. And when your CO2 is too low, it causes symptoms like heart palpitations, dizziness, nausea and (my personal favorite) that feeling that you're dying—all class signs of a panic attack. The low CO2 makes you panic and the more you panic the lower your CO2 gets. (Make sure you know the Panic Attack Warning Signs—and How to Deal.)
In short: You don't need more oxygen, you need less CO2. So the key to stopping the panic attack in its tracks is to normalize your CO2 levels, says Meuret, who developed a breathing technique called Capnometry-Assisted Respiratory Training, or CART, to solve this problem.
"We found that with CART it's the therapeutic change in carbon dioxide that changes the panic symptoms and not vice versa," Meuret explains. "Most panic-disorder patients report they are terrified of physical symptoms such as shortness of breath or dizziness, and [the breathing technique] was proved an effective and powerful treatment that reduces the panic by means of normalizing respiratory physiology."
In other words, your brain is screaming at you that you're suffocating and you're going to die, so all you need to do is, well, stop suffocating yourself.
Meuret's method uses a capnometer device to help people regulate their breathing, but if you don't have access to one, don't panic (ha!). You can use a simple technique, called power breathing, to achieve the same effect.
Power breathing is simply exhaling for twice as long as you inhale, as explained in a video below by Jane McGonigal, Ph.D., a senior researcher for Institute For the Future. Not only does it help bring your oxygen and CO2 levels back in balance, but it also helps calm your freaked-out nervous system.
"The reason why this works so effectively is that it triggers a switch in your body's nervous system from sympathetic nervous system state to parasympathetic. And parasympathetic is a nervous system state that's associated with what they call 'rest-and-digest.' [instead of] 'fight-or-flight,'" McGonigal says in the video.
Inhale for one count. Exhale for two counts. It sounds too simple to be true, but I can personally attest to its effectiveness.
When I was in college, I accidentally stumbled on "power breathing" during a yoga class (except they called it "dragon breathing") and was amazed at how quickly it took my panic attacks down from ordeals that had me vomiting in the ER twice a month to almost a non-event. It's been over ten years and while I have had a few panic attacks (anxious people are anxious), I've always been able to calm myself with breathing—no meds or ER trips required! (Not panicked? You can also try these 3 Breathing Techniques for Dealing with Anxiety, Stress, and Low Energy.)