How to deal with panic attacks

Updated: Sep 6

Having a panic attack is a nightmare. The terror feels real, overwhelming and like it might never go away. Once you've had a panic attack, a new fear arises: that of having another panic attack. This can create a spiral with no hope of escape.



Man having a panic attack
Panic attacks are hell

How to cope with a panic attack


One of the most important steps to short-circuiting a panic attack is to reduce fear. The fear feeds on itself, perpetuating the panic attack. The best method I have discovered for reducing this fear is called "The School of Fish."


The School of Fish

Imagine you are a huge powerful shark in the ocean. Little to nothing scares you. But one day you are swimming around and see an even bigger shark swimming in the distance. It looks so much bigger than you that you panic and swim away as fast as you can. But, it turns out, it wasn't a shark after all. It was a school of fish. You had way more power than you believed.


Panic attacks are like a school of fish. These tiny fish appear to be a powerful shark that could eat you whole. When we experience panic attacks, we experience it as if it were a giant monster that is killing us. However, if we look at what is really there, we can see that it's really a bunch of little fish.


The three types of fish

There are three types of fish that make up the school of fish: thoughts, emotions, and bodily sensations.


Thoughts

Thoughts that someone might be having during a panic attack are:


  • I'm dying.

  • This is never going to end.

  • This is terrible.

  • I have to make it stop.

  • I'm going crazy.

All of these are just thoughts. None of these thoughts can hurt you. It's only the belief that they indicate the presence of a scary shark that's eating you whole do they become something to fear. Each one of these thoughts is just a little fish. As quickly as a thought comes, it can swim away. It's only when a multitude of little fish swim against us at once, do we get confused and believe it's a massive ocean monster that wants to kill us.


Emotions

The dominant emotion during a panic attack is fear. True, there are variations and grades of fear, but that fear is just a feeling. Those feelings can't hurt us. They are just little fish. Like thoughts, this type of little fish also can't hurt us. It's only because there are a lot of little fish swimming around us at once that we panic.


Bodily sensations

Finally, there's bodily sensations. Some common examples of this type of fish are:


  • Sweaty palms

  • Racing heart

  • Shallow breathing

  • Dilated pupils

  • Tense muscles

None of these "fish" can hurt us, but like the other fish, when we are experiencing all of these fish swimming around us at once, we can become terrified.


How to deal with a school of fish

First, don't treat it like it's a giant ocean monster trying to kill you. If you are swimming in the ocean and big school of fish swims by, it might be uncomfortable, but it's not life-threatening or even dangerous. If we just let the fish be there, we can actually open up to the experience and be curious about it, even if it's really uncomfortable! Eventually, the fish will slowly disperse. We'll notice that fewer fish are present until they have all swam away.


We can take the same approach with a panic attack. The symptoms will start swimming near us. We'll notice what's happening. Rather than becoming terrified, we can acknowledge what is happening, that the school of fish has swam by. We can start noticing individual fish rather than being overwhelmed by the presence of the entire school. We can notice each thought, feeling and sensation. We can be curious about them. We can try to open up to each individual symptom as we experience it. Eventually, we will notice that the symptoms have started swimming away. Eventually, they will all have departed.


If we want the school of fish to move, the last thing we want to do is to feed them. Fear feeds the school of fish we call a panic attack. By being curious about each little symptom, we minimize how much we feed the panic attack. By being curious, we express our confidence that this episode of panic can't hurt us and that we know it's something we can handle. This approach doesn't mean that panic attacks will never arise again, but in my experience, once using this method, most people I've worked with have had panic attacks stop completely or arise much less frequently than before.

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