Imagine this: It’s a new day and you’ve decided to go for a stroll. You lace up your running shoes and grab a jacket, ready to smell the crisp morning air. You pass by familiar buildings and people - the post office, your favorite coffee shop on the corner, and a sea of schoolchildren shepherded by sleep-deprived parents. You extend a half-smile to the passersby and all seems well-until your racing heartbeat and shaking legs catch you off guard. Confused, you stop in your tracks, wondering what has prompted this rapid change in your body, but now your thoughts are going a mile a minute and it feels like you are out of control. You double over, placing your hands on your knees to catch your breath, and despite your best effort, it feels like you're gasping for air. You’re convinced you're dying at this moment. Sound the alarm, you’ve just had a panic attack. 

Roughly one in ten adults will have at least one panic, or ‘anxiety’ attack every year. 

While the clinical picture of panic attacks can vary, they are characterized by the following symptoms: increased heart rate, sweating, trembling, shortness of breath, choking, nausea, stomach pain, dizziness, lightheadedness, tingling in the arms or legs, feeling hot or cold, derealization (feeling that things around you aren’t real) or depersonalization (feeling like you are outside of your body), and fear of dying or losing control. Despite only lasting minutes, panic attacks can be very debilitating and can develop into panic disorder. 

Fortunately, panic attacks aren’t random. In fact, panic attacks are very predictable because they are triggered by internal or external cues of perceived threats. When you come in contact with these cues (i.e. a large group of people headed toward you during your morning walk), it signals to your mind that you are in danger and need to avoid, escape, or surrender to something to survive that moment. In essence, panic attacks are your body's emotional fire alarm system.  

When physical threats were a daily occurrence in human evolution (i.e. avoiding becoming a large animal's lunch), our ability to detect them and react appropriately was advantageous. What an effective fire alarm system! Fast forward a couple thousand years and becoming lunch isn’t a common concern anymore and our fire alarm system has evolved to detect psychological threats too. Reminders of deep fears, difficult, or traumatic events (i.e. a swarm of people subtly reminds you of the time you were caught in a stampede), or really uncomfortable thoughts about yourself (i.e. the thought “I am not good enough”) are perceived as ‘dangerous.’ This is just enough to sound off our body’s fire alarm. For individuals with recurrent panic attacks or with panic disorder, the fire alarm becomes too sensitive and will detect a wider variety of triggers that don't seem threatening at all. At this stage, panic attacks are like the alarms that sound the second you turn on the stove - you’re receiving all the signs that the house is on fire when in reality, the alarm is reacting to one controlled flame.

Panic attacks are treatable. Through therapy, you can learn the underlying meaning of your anxiety, become aware of your triggers, and begin to form a new relationship with distressing thoughts and feelings that arouse panic symptoms. In the meantime, understanding the neuroscience of panic attacks gives us ways to ‘hack’ our nervous system and override our emotional fire alarm at the sign of the first symptom to decrease the intensity and duration of panic episodes. 

Activating the Parasympathetic Nervous System: During a panic attack episode, our sympathetic nervous system - the fight, flight, and freeze system - is activated. However, we can override our panic symptoms by activating our parasympathetic nervous system - the rest and digest system - through paced breathing or changing our bodies temperature when we notice early symptoms of panic. 

• Paced Breathing: Exhaling through the mouth twice as long as we inhale through the nose is a proven way to activate the parasympathetic nervous system. Practice inhaling for 4 counts and exhaling 8. 

• Temperature: Taking a cold shower or placing a cold compress on your face or the nape of your neck while holding your breath can activate the mammalian diving reflex. This reflex slows your heart rate and activates the parasympathetic nervous system.

Releasing Endorphins: Another ‘hack’ to mitigating panic symptoms is to fight fire with fire, literally! Eating spicy foods releases endorphins in our brains which aid in reducing pain, releasing stress, and improving mood. Additionally, for heat-averse individuals, eating spicy foods at the earliest sign of panic is such an overwhelming experience that the brain shifts our attention away from thoughts and feelings related to panic (i.e. “oh no, everyone will see me panic now”) to focus on relieving the burning sensation (i.e. “my mouth is on fire, I need water”). Carrying spicy candies or gums such as RedHots or Big Red gum can be helpful for individuals on the go. For spice-lovers, eating spicy candy or gum may not have the same overwhelming effect, therefore eating sour foods or candies like lemons or sour candy is advised. 

Although these hacks are helpful and effective, they are temporary. These skills can disrupt a current panic attack episode from progressing if caught early enough, but will not prevent future episodes from occurring. Forming a relationship with a trusted therapist to address your panic attacks is the only way to reprogram your emotional fire alarm and prevent future episodes.