关键点
恐慌是由肾上腺素激增引起的，肾上腺素通常会在 3 到 5 分钟内代谢完毕。
不要强行克服恐慌，而是顺应焦虑的浪潮。
直面恐慌、顺势而为、自我安慰、让时间流逝，可以减少恐慌的影响。
我反复看到，接受咨询的客户抵制恐慌症状往往会加剧恐慌症状，使情况变得更糟。这是心理健康专业人士和医生的普遍观察结果，他们注意到焦虑药物处方数量令人担忧地增加。虽然药物对许多人来说是必不可少的，可以挽救生命，但行为干预在解决普遍的焦虑问题方面也至关重要，而且往往没有得到充分利用。
重要的是不要紧张或试图抑制恐慌症状。虽然采取行动是必要的，但对抗恐慌本身可能会适得其反。以下是应对恐慌的四个步骤，以及增强应对工具包的其他策略：
1. 面对现实，不要逃避
试图逃避恐慌或说服自己无法应对这种情况往往会加剧问题。例如，如果乔迪在会议期间感到恐慌发作，她可能会本能地想离开。然而，通过留下来并告诉自己，“我感到焦虑，但我以前处理过这种情况，可以再次做到”，她采取了一种正念方法。承认自己的焦虑而不试图逃避可以帮助减轻症状的强度。
2. 顺势而为
不要强行克服惊恐发作，而是顺应焦虑的浪潮。焦虑治疗领域的先驱克莱尔·威克斯 (Claire Weekes) 区分了“第一次恐惧”（最初的生理反应）和“第二次恐惧”（对症状本身的恐惧）。例如，当约翰开始感到心跳加速时，他可能会想，“我受不了了”，这加剧了他的焦虑。相反，通过说“这只是我的身体反应，它会过去的”，他可以顺应症状而不是与之抗争。
3. 做出令人安心的陈述
用平静的肯定句来安慰自己。当艾米莉感到恐慌发作时，她会告诉自己：“这也会过去的”，或者“我以前处理过这个问题，现在我可以处理了。”这些话帮助她专注于焦虑的暂时性，并减少对症状的恐惧。
4. 留出时间
恐慌是由肾上腺素激增引起的，肾上腺素通常在三到五分钟内代谢。如果你允许这种反应发生而不增加二次恐惧，你很快就会开始感觉好些。例如，当迈克感到恐慌发作时，他提醒自己，强烈的感觉会很快达到顶峰并消退。通过不产生额外的恐惧反应，他可以让肾上腺素自然代谢，这有助于恐慌更快地过去。
应对恐慌的其他策略
练习深呼吸：在研究我的书《青少年焦虑、抑郁和愤怒工具箱》时，我更广泛地了解到深而慢的呼吸如何帮助平静你的神经系统——适用于所有年龄段。例如，简使用 4-7-8 呼吸法：吸气四秒，屏住呼吸七秒，呼气八秒。这有助于她降低心率，并在恐慌发作时感觉更能控制自己。
接地技术：接地技术可以帮助您与当下时刻保持联系。马克使用 5-4-3-2-1 方法：他确定了五件他能看到的东西、四件他能触摸的东西、三件他能听到的东西、两件他能闻到的东西和一件他能尝到的东西。这种方法将他的注意力从恐慌症状转移到周围环境。
渐进式肌肉放松：渐进式肌肉放松包括收紧然后慢慢放松不同的肌肉群。Lisa 发现这很有帮助，因为它将她的注意力从恐慌转移到肌肉的感觉上，促进放松。
保持身体活跃：定期进行身体活动有助于降低焦虑水平。汤姆将每天散步纳入日常生活，这不仅有助于他保持健康，还能减轻他的整体压力和焦虑。
寻求支持：与值得信赖的朋友、家人或治疗师交谈可以给她安慰和指导。Rachel 发现与治疗师讨论她的感受有助于她感到被理解和支持，从而更容易控制她的焦虑。
结论
总而言之，恐慌发作虽然强烈，但也有时间限制。通过面对恐慌、驾驭恐慌、做出安慰性的陈述并让时间流逝，你可以管理和减少恐慌发作的影响。
深呼吸、接地技术、渐进式肌肉放松、身体活动和寻求支持等其他策略可以进一步增强您应对焦虑的能力。这些行为干预是可以补充药物并有效缓解焦虑的宝贵工具。
要寻找您附近的治疗师，请访问《今日心理学治疗目录》。
参考
Rabasco, A.、McKay, D.、Smits, J.、Powers, M、Meuret, A. McGrath, P (2022)。
恐慌症的心理社会治疗：系统评价和荟萃分析的总体评价，
ISSN 0887-6185，https://doi.org/10.1016/j.janxdis.2022.102528。（https://www.sciencedirect.com/science/article/pii/S0887618522000019）
Ziffra, M. (2021) 恐慌症：治疗方案回顾，临床精神病学年鉴；33(1):e22-e31 doi: 10.127788/acp.0014
9 Steps to Panic-Proof Your Life and Conquer Anxiety
Instead of forcing your way through a panic attack, ride the wave of anxiety.
Posted May 19, 2024 | Reviewed by Tyler Woods
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Key points
Panic is driven by a surge of adrenaline, which usually metabolizes within 3 to 5 minutes.
Instead of forcing your way through a panic attack, ride the wave of anxiety.
Facing panic, riding the wave, self-reassurance, and allowing time to pass reduces the impact of panic.
I have repeatedly seen with my counseling clients that resisting panic symptoms can often exacerbate them, making the situation worse. This is a common observation among mental health professionals and physicians, who have noted a concerning rise in the prescription of anxiety medications. While medication can be essential and life-saving for many, behavioral interventions are also crucial and often underutilized in addressing widespread anxiety.
It's important not to tense up or attempt to suppress panic symptoms. Although taking action is necessary, fighting the panic itself can be counterproductive. Here are four steps for coping with panic, along with additional strategies to enhance your coping toolkit:
1. Face It, Don't Run
Attempting to run away from panic or convincing yourself that you can't handle a situation often amplifies the problem. For example, if Jodi feels a panic attack coming on during a meeting, she might instinctively want to leave. However, by staying and telling herself, "I’m feeling anxious, but I’ve handled this before and can do it again," she takes a mindful approach. Acknowledging her anxiety without trying to escape can help reduce the intensity of her symptoms.
2. Ride the Wave
Instead of forcing your way through a panic attack, ride the wave of anxiety. Claire Weekes, a pioneer in treating anxiety, distinguished between "first fear" (the initial physiological reaction) and "second fear" (the fear of the symptoms themselves). For instance, when John starts to feel his heart race, he might think, "I can't handle this," which adds to his anxiety. Instead, by saying, "This is just my body reacting, and it will pass," he can flow with the symptoms rather than fight them.
3. Make Reassuring Statements
Reassure yourself with calming affirmations. When Emily feels a panic attack starting, she tells herself, "This too shall pass," or "I've handled this before and I can handle it now." These statements help her focus on the temporary nature of her anxiety and reduce the fear of her symptoms.
4. Allow Time to Pass
Panic is driven by a surge of adrenaline, which usually metabolizes within three to five minutes. If you allow this reaction to occur without adding secondary fear, you will start to feel better soon. For example, when Mike feels a panic attack beginning, he reminds himself that the intense feelings will peak and subside shortly. By not reacting with additional fear, he can let the adrenaline metabolize naturally, which helps the panic pass more quickly.
Additional Strategies for Managing Panic
Practice Deep Breathing: When researching my book, The Anxiety, Depression, & Anger Toolbox for Teens, I learned more extensively how deep, slow breathing can help calm your nervous system—for all ages. For instance, Jane uses the 4-7-8 breathing technique: inhale for four seconds, hold for seven seconds, and exhale for eight seconds. This helps her reduce her heart rate and feel more in control during a panic attack.
Grounding Techniques: Grounding techniques can help you stay connected to the present moment. Mark uses the 5-4-3-2-1 method: he identifies five things he can see, four things he can touch, three things he can hear, two things he can smell, and one thing he can taste. This method shifts his focus away from panic symptoms and back to his surroundings.
Progressive Muscle Relaxation: Progressive muscle relaxation involves tensing and then slowly releasing different muscle groups. Lisa finds this helpful, as it shifts her focus from the panic to the sensations in her muscles, promoting relaxation.
Stay Physically Active: Regular physical activity can help reduce anxiety levels. Tom incorporates a daily walk into his routine, which not only helps him stay fit but also reduces his overall stress and anxiety.
Seek Support: Talking to a trusted friend, family member, or therapist can provide comfort and perspective. Rachel finds that discussing her feelings with her therapist helps her feel understood and supported, making it easier to manage her anxiety.
Conclusion
In summary, while panic attacks are intense, they are also time-limited. By facing them, riding the wave, making reassuring statements, and allowing time to pass, you can manage and reduce their impact.
Additional strategies such as deep breathing, grounding techniques, progressive muscle relaxation, physical activity, and seeking support can further enhance your ability to cope with anxiety. Behavioral interventions like these are valuable tools that can complement medication and provide effective relief from anxiety.
To find a therapist near you, visit the Psychology Today Therapy Directory.
References
Rabasco, A., McKay, D., Smits, J., Powers, M, Meuret, A. McGrath, P (2022).
Psychosocial treatment for panic disorder: An umbrella review of systematic reviews and meta-analyses,
ISSN 0887-6185, https://doi.org/10.1016/j.janxdis.2022.102528. (https://www.sciencedirect.com/science/article/pii/S0887618522000019)
Ziffra, M. (2021) Panic disorder: A review of treatment options, Annals of Clinical Psychiatry ;33(1):e22-e31 doi: 10.127788/acp.0014
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