My mother and both my sons, including my son Charles, who died by suicide, struggled with depression but also anxiety and panic attacks, also known as panic disorder. Panic disorder is a type of anxiety disorder.
And YOU can treat this. I’m not saying that some people might not need medication, too. But most can manage this with a simple technique.
Panic attacks are recurring and unexpected sudden episodes of intense fear and anxiety accompanied by physical symptoms like a racing heart, sweaty palms, red face, shaking body parts, dry mouth, abject fear, overwhelm, and other sensations. It can generate a lot of heat in your body.
Sometimes you might think you are having a heart attack or dying, which can make you panic even more (called anxiety sensitivity), even though there is no real danger.
Early on, I took my oldest son to a therapist, and she taught me how to coach my kids through those anxiety episodes, transitions, and panic attacks.
It turned out, I needed the panic attack coaching more for Charles.
Relentlessness as an anxiety trait
When Charles got upset and really wanted something, he was relentless.
He’d blow up my phone with hundreds of text messages and calls.
If he was physically near, he would be on my heels, talking nonstop at the speed of light to make his case. His face would turn red, his limbs would flail about, his breathing would be fast and shallow, which would make him lightheaded… and panicked.
One time, a school administrator got so angry with Charles that he had a panic attack. She was upset because he was listening to music during detention—a strategy he used to manage his anxiety and something we had previously agreed upon. He started to lose it but was not aggressive or threatening. The administrator was just pissed off and that exacerbated his meltdown, which was him standing still, face hot, heart racing as he cried and his nose ran uncontrollably. Apparently, in her book, that was grounds for suspension, sending him even further into a spiral. He crumpled on the floor in fear that I’d be angry.
I called this the anxiety whirlpool vortex.
This is how you treat it, and it works
I nearly had a panic attack not long after my son’s death, and years before that, I had a panic attack when I had an asthma attack and didn’t know what was happening and ended up at the emergency room breathing in a paper bag (that works, too). I did need to be at the ER, it turns out, as my blood was not getting oxygenated. However, that was the result of my undiagnosed asthma attack, not my panic. I was only making it worse.
In the weeks after my son’s death, I recognized the symptoms right away after years of coaching my sons, so I pulled over and followed my protocol.
Here are the steps to managing panic with your breathing
- First PAUSE. Take one deep breath
- Then another. Followed by another. Slow and steady.
- When you do that, you engage your parasympathetic nervous system, your “chill” nerves. And yes you have chill nerves! How cool is that?
That PAUSE is your first step to slowing the anxiety symptoms
Some say diaphragmatic breathing is best, but I have found that just regular deep breaths work just fine. Take several deep breaths, even as long as 2-3 minutes, and then you will notice the symptoms subside.
This is better than marijuana, a drink, or pills because it’s immediate (faster than AI or Google), and it teaches you an important skill. The substances, however, are just numbing you, and these avoidance strategies rob you of the opportunity to build an important life skill.
Once your body calms, and it will, go through your inventory of fears one by one.
Ask yourself, “Can I live with that?”
Say to yourself, “I will figure this out. I have the tools.”
Do not chastise yourself. That won’t help. Talk to yourself as you would a friend. You deserve that.
My favorite is breathing in for a 6-8 beat count, and breathing out for 8-10 beat count.
Here are other favorites. If you want more instruction, here are more breathing tactics and a YouTube demo from my friend Karla Helbert.
Here are comments from others about managing anxiety
“I had a panic attack at work in 2007 and thought I was having a heart attack. I was taken to hospital, some checks and they said it was a panic attack. For the next 3 weeks I could not leave the house, everytime i tried, I had a panic attack. It was so debilitating. I was taught to close my eyes, take breaths, and pump my right hand whilst thinking of a fond memory (anchoring) to calm me.”
“Over a period, my panic attacks stopped and I haven’t had any since. I also learned about the 5-4-3-2-1 Grounding Technique a few years ago, encouraging anyone with anxiety to identify:
5 things you can see
4 things you can feel
3 things you can hear
2 things you can smell
1 thing you can taste
It helped my son regain calm before a medical procedure.”
“That PAUSE is so important. I personally then focus on the out breath rather than the in… naturally breathing in afterwards. I like the addition of the positive words of reflection too: will work out what phrase works for me. I push as much air out as I can… it feels like I’m releasing tension in the process: from the pit of my stomach. And then I become conscious of the process rather than the thought that was occupying my mind.”
Also, it’s difficult to force more air into a tight chest. Allow the in breath to happen naturally and the amount will increase as relaxing happens. Focusing on the out breath allows the out breath to slow.”
“Milind Joshi, Child, adolescent, and adult psychiatrist
…Indeed , the panic disorder treatable, and considering how debilitating and painful it is, I feel medications along with therapy improves outcome. Non addictive options such as clonidine, propranolol and hydroxyzine can help in acute panic attacks, and to permanently rewire the panic circuits, antidepressants (in non bipolar patients) are the best options. I have treated hundreds of patients successfully.”
Your story also speaks for the fact that panic disorders have strong biological tendencies and people often can not ‘just think positive’ to make them go away, of course they can use coping skills to reduce their burden to an extend.
I have seen patients are able to comply with therapy better when they can take medications.
Additionally, at least in USA, therapy is something that not everyone can afford as it requires multiple sessions and insurance companies may not always approve. Medicaid patients have very tough time finding therapist that accepts their insurance.”
Breathing exercises also work great in conjunction with medication if you need it. So much of the healing journey is packing your toolbox with the tools that work best for you. The pause…so undervalued yet the most powerful practice in settling our thoughts, feelings and central nervous system. It helps me feel regulated and grounded. Thank you for sharing
I also suffered panic attacks a decade ago and through persistent investigation I found out the root of them: Perimenopause—> hypertension —> ventricular regurgitation (with symptoms such as arrhythmia). It took me a decade to finalize a diagnosis but I never stopped my zen practices including Breathwork. I just want to also add that pangs of attacks (panic or anxiety) do not have to develop into disorder. While I was debilitated lecturing and teaching group exercise temporarily, I found all avenues to help eliminate the triggers and symptoms, and therefore not developing a disorder.
“Therapy alone doesn’t work for everyone and no one should be made to feel shame in taking medication. I have GAD and panic attacks. I see a therapist and I also take medication.”
“Panic attacks are definitely not fun. I had 3 during Covid. The second was the worst and most terrifying. Turned out I have anxiety, which is easily kept in check with a very low dose medication. I also started swimming 3 years ago and love going in a cold plunge and sitting in there. That has helped enormously whenever I have felt overwhelmed.”–Dave
AnneMoss Rogers is a leading wellness and suicide education expert and one of the top mental health speakers and suicide prevention speakers. Known for her powerful, motivational keynotes, AnneMoss combines her personal story of loss with proven strategies to help organizations build a wellness culture that drives results and saves lives. She speaks at conferences, workplaces, K-12 schools, and universities, delivering impactful presentations that inspire change and promote mental health awareness.
AnneMoss does this work in memory of her son, Charles, who struggled with anxiety, depression, and addiction, and died by suicide at age 20 in 2015.
OMG I think my 35 y/o son Alex who died by suicide must have had panic attacks too — but he several debilitating illnesses, such as bipolar depression, OCD, huge anxiety, and Pervasive Developmental Disorder. We often saw him freaking out during an argument (or FIGHT) and stripping off his shirt, turning red, sweating. I never (for some stupid reason) thought of it as a panic attack, just “freaking out”. Now I’m upset that I didn’t recognize this or teach him a breathing technique. I did email his psychiatrist a couple of times over the years that he would have “meltdowns” fairly often, but he didn’t ask more details and never mentioned panic attacks :(
My older son’s panic attacks were more like the textbook kind.
But Charles’s were not. And it took me a long time to recognize that. I will say once they are in the emotional vortex, it’s almost impossible to reach them at that point no matter how great the technique. When it’s classic textbook, they feel more desperate to listen. But with some of Charles’s and the ones you describe you have to recognize the pre-signs and intervene early and that is very hard to learn and do. I didn’t recognize it, for instance, when he had a panic attack after he was suspended. It was only months later that I thought, “I handled that poorly. How can I do better?”
Panic can also happen in psychosis, which is also very difficult to address and again, you just have to wait until it peters out in that case if you don’t catch it early. Knowing the warning signs is the key there.
What you describe here is probably a panic attack. But it’s hardly textbook. Give yourself some grace because seeing those early signs would have been challenging. And even then, he would have to have complied.