How can I prevent panic attacks?

I have been experiencing panic attacks when I think about upcoming scans. How should I address these panic attacks and prevent them from occurring in the future?

Fay Hlubocky, licensed clinical health psychologist at University of Chicago Medicine

Panic attacks are abrupt, intense episodes of fear and anxiety that cause physical, cognitive and emotional symptoms. Panic is an extreme form of the body’s “fight-or-flight” response that alerts you to a threatening situation. This reaction helps us in realistically dangerous circumstances. Yet, for many people, this response also occurs in psychologically overwhelming situations, such as when there’s an upcoming scan.

Any person with a history of cancer, especially individuals with a personal or family history of anxiety, may experience panic attacks at any point during their cancer journey, from diagnosis through long-term survivorship. A panic attack can be an uncomfortable, frightening experience. While panic attacks are not dangerous or life-threatening, living with the constant fear of future attacks can become overwhelming and debilitating.

Several strategies can help you regain control by directly addressing the underlying fears and intense anxiety associated with panic attacks. Your oncology team may offer several options, including medication, cognitive behavioral therapy, mindfulness-based stress reduction, and individual or group therapy. Cognitive behavioral therapy helps you first identify the cause of your anxiety and then manage the underlying distress and fear you are experiencing by reframing anxiety-specific automatic thoughts. Other helpful tools you can use to tackle the anxiety associated with panic attacks include relaxation training, breathing retraining, visualization, affirmations and writing in a panic diary.

If you experience panic attacks, talk to your oncology team and ask for a referral for psychosocial oncology care experts. They can help you identify your triggers and guide you in applying tools to address panic and prevent future attacks. If your hospital or cancer center does not offer psychosocial support services, several advocacy organizations offer both free online connections to therapists or support groups and in-person therapy with mental health professionals.

In the meantime, practice staying in the present moment and using self-talk methods to promote a calm, accepting attitude toward yourself and your current experience. To help you cope with a panic attack in the moment, remind yourself, “My symptoms are caused by anxiety.”

Take deep breaths to bring the panic attack under control. Close your eyes, breathe in slowly and deeply through your nose, and breathe out slowly from the mouth, concentrating on every breath. Repeat at your own pace. If these breathing exercises are uncomfortable, you may also distract yourself from your anxiety by focusing on pleasurable activities or places you enjoy. Partnering with a psychosocial oncology clinician can help you to master these techniques.

With the needed support and guidance, you can learn to manage the intensity of panic attacks and your own experience of them. You can take back control, confront your fears and nurture yourself with kindness. You are going through a great deal now, and many people in similar situations experience these moments of panic. Know that you are not alone.

PANIC ATTACKS // Cleveland Clinic offers tips to help prevent panic attacks by identifying and avoiding triggers. // Mayo Clinic details the difference between having a panic attack and having panic disorder.

The expert’s response was edited for clarity and based on an interview with Kendall K. Morgan.