VSD and panic attack. What are the differences?

Even occasionally occurring panic attacks and VSD are connected by pathogenetic mechanisms. When there is an imbalance in the work of the sympathetic and parasympathetic parts of the nervous system, one of the manifestations of autonomic disorders can be sudden attacks of nervousness, fear and anxiety, which go away on their own, but cause irreparable harm to human health.

Causes of panic attacks during VSD

Vegetative-vascular dystonia is not included in the international classification of diseases. The etiology and pathogenesis of the disease are not known for certain. Sometimes, with frequent panic attacks, the term “VSD with a crisis course” is used in making a diagnosis. There are several factors that can provoke panic attacks during VSD:

• Genetic predisposition is the presence of similar conditions in close relatives.
• Disturbances in the hormonal regulation of the body - pregnancy, adolescence, menopause.
• Constant stress that depresses the nervous system.
• Cervical osteochondrosis, compressing capillaries and nerve roots in the spinal cord.
• Chronic diseases of the heart, blood vessels, thyroid and pancreas.
• Overexertion and lack of sleep, constant fatigue, weakness and headaches.
• Melancholic type of temperament.
• Childhood phobias and psychological trauma.
• Hangover syndrome.

If one of the identical twins is diagnosed with VSD and PA, then a similar diagnosis will be given to the other with a probability of 85-90%.

Types of attacks

This condition can overtake a person unexpectedly.
Panic attack is a general name for several conditions that differ in the reasons that caused them and clinical manifestations. Based on etiology, the following types are distinguished:

• Sudden, occurring in a calm state without reason.
• Situational - it is caused by some event or situation that has a negative impact on the psyche and state of a person.
• Conditional-situational, manifested by chemical or biological influence.

Depending on the number of symptoms, there are minor panic attacks, which include less than 4 criteria, and major ones, which include more than 4 manifestations. Symptoms of a panic attack during VSD are used as a differential sign. There are several types of the disease, based on the severity of the main manifestations:

• phobias and fears;
• vague, unpleasant sensations throughout the body;
• depression, despair and depression;
• hysterical disorders;
• increased breathing;
• disorders of the autonomic nervous system.

Symptoms of a panic attack

The ability to distinguish between a dangerous condition and the usual feeling of fear or anxiety before some event can help quickly relieve an attack and alleviate the condition, and sometimes save a person’s life. Signs and manifestations of a panic attack with vegetative-vascular dystonia include the following criteria:

In this condition, a person may experience hot flashes.

• regularly recurring severe fear and panic;
• feeling of imminent death;
• tachycardia and pain in the left side of the chest;
• lack of air;
• chills, trembling throughout the body;
• disruption of the gastrointestinal tract;
• disorder of self-perception and self-awareness;
• hot or cold flashes.

A panic attack usually lasts 10-30 minutes. The main symptoms appear sharply, with full force in the first 10 minutes and gradually subside. This condition develops during the day when a person is awake. In rare cases, panic attacks occur at night, which leads to insomnia. Once an attack occurs, it always repeats itself. On average, a person suffering from dystonia experiences 3-4 attacks per week. An individual’s fear that the condition will recur at any moment increases the risk of an attack.

VSD and panic attack. What are the differences?

Very often there is confusion between what a panic attack and vegetative-vascular dystonia (VSD) are.

In this article we will analyze these differences.

So, with vegetative-vascular dystonia, disorders occur that are accompanied by disorders of the autonomic nervous system, which is responsible for adaptation to the external environment.

The autonomic nervous system is located in the brain and spinal cord. This nervous system is regulated by the work of all internal organs. If there is a problem in the functioning of internal organs, then vegetative-vascular dystonia occurs. It can be divided into VSD of the brain, spinal cord, cardiovascular system and other organs. A part of the pathogenesis of VSD may be damage to the hypothalamic structures of the brain.

VSD can be observed in anxiety or panic disorders.

The causes of VSD can be:

1. Stress.
2. Hormonal changes in the body.
3. Severe fatigue.
4. Head or back injuries.
5. Predisposition.
6. Diseases
7. Various diseases.
8. Poor nutrition.
9. Lack of physical activity.
10. Unfavorable weather conditions, climate features.
11. Allergies.

Symptoms of VSD:

1. feeling of weakness in the body,
2. headache,
3. sleep disorders,
4. dizziness,
5. coldness of hands and feet,
6. hand trembling,
7. respiratory disorders,
8. rapid heartbeat, heart failure,
9. fear about heart function,
10. internal trembling
11. joint pain,
12. feeling of heat in the face,
13. changes in body temperature,
14. fainting,
15. high blood pressure,
16. sweating,
17. nausea, abdominal pain,
18. frequent urination,
19. lump in the throat,
20. redness of the skin.

Symptoms can be completely different and vary. Not all symptoms are listed here. There are more than 150 of them, but those that occur frequently are indicated. Symptoms may persist for a long time.

A panic attack is a type of anxiety disorder that is associated with stress. Accompanied by intense anxiety that comes suddenly, lasts no more than 20 minutes and suddenly goes away. At the same time, people feel very strong fear and anxiety.

A panic attack develops as follows: adrenaline and other substances are released into the blood following stress, blood vessels narrow, the heart rate increases, the breathing rate increases, the level of carbon dioxide in the blood decreases, and a feeling of lack of air occurs.

Causes of panic attacks can be:

1. stress,
2. operations,
3. mental pathologies (depression, phobias, fears),
4. taking medications or drugs,
5. weakened body
6. bad habits,
7. childbirth, pregnancy, onset of sexual activity, onset of the menstrual cycle, puberty,
8. lack of physical activity,
9. unresolved conflicts,
10. lack (deprivation) of sleep.

Symptoms of a panic attack:

1. hot or cold flashes
2. frequent urination,
3. shortness of breath and chest pain,
4. palpitations, feeling that “the heart is about to jump out”,
5. sweating,
6. weakness,
7. dizziness, numbness,
8. increased breathing, shortness of breath,
9. increased blood pressure,
10. a feeling of impending trouble and surrounding danger,
11. fear of dying or just pointless fear,
12. timidity and stiffness or, conversely, motor restlessness,
13. lump in the throat,
14. feeling of unreality of what is happening,
15. waking up during sleep.

Symptoms arise suddenly, like “a bolt from the blue,” “suddenly something happened.”

Thus,

• VSD can last quite a long time (months, years with periodic weakening and the appearance of symptoms), panic attacks pass quickly, up to 20 minutes.
• Various physiological mechanisms of the formation of VSD and panic attacks.
• With panic attacks, there is a greater mental component: severe fear, anxiety, insomnia, confusion of thoughts.
• VSD is a disorder of the autonomic nervous system. A panic attack is a type of anxiety disorder.
• VSD is the “ground” for the formation of panic attacks.

Treatment of panic attacks

A person who has experienced this condition at least once knows that it is not fatal and will soon end. But strong fear is always present. To cope with an attack, you must follow the following rules:

To make the attack go away faster, you need to try to relax.

• Lie down on the sofa and relax.
• Normalize your breathing on your own, trying to inhale and exhale slowly.
• Imagine or remember some good moment in life, smile.
• Drink warm tea in slow sips.
• Repeat a text, poem or song by heart.

These methods help fight the attack, but without the help of medications and consultations with a psychotherapist, it is impossible to cure VSD forever. Neurological disorders are usually treated by a neurologist, but before drawing up a course of drug therapy, it is recommended to visit a cardiologist and psychotherapist. Prescribed drugs for VSD and panic attacks are divided into the following groups:

• Antidepressants are medications that affect the level of neurotransmitter hormones and quickly relieve a panic attack. Suitable for long-term treatment. You cannot take them on your own, without a doctor’s prescription, because the body gets used to them and only a doctor can draw up the correct regimen for taking them. The most widely used are Anafranil, Cipralex and derivatives.
• Beta blockers - stop the release of stress hormones into the blood and are used only for short-term treatment or relief of attacks. A well-known representative is “Anaprilin”.
• Tranquilizers that have a sedative, relaxing and hypnotic effect. The main disadvantage is side effects in the form of sleep disturbances, excessive weakness in the body and aggressiveness. These include Phenazepam, Relanium and their analogues.

Treatment of VSD and panic attacks includes maintaining a proper lifestyle, normalizing sleep and nutrition. It is advisable to avoid drinking alcohol and smoking. A strict ban on bad habits is imposed when undergoing a course of drug therapy. Regular light physical activity without overexertion is beneficial. During the day, black tea is replaced with decoctions of soothing herbs: mint, chamomile, calendula and rose hips.

VSD and panic attacks. Everyone should know about this!

If you come across this article, do not rush to part with it. The idea that she is not for you is inherently wrong. Everyone needs to know about this. Not only overstaying housewives and frail students came to see me with panic attacks, but also seemingly strong people - military personnel, police officers and the Ministry of Emergency Situations. This “unidentified object” called panic attacks (PA) and vegetative-vascular dystonia (VSD) can suddenly arrive to any inhabitant of the planet.

Which of us has not felt ill at least once in our lives for reasons of our own physiology? For example, I felt dizzy. Or maybe you have ever felt sick or had a fever. Or was there something else, for example, numbness in the limbs, local pain in some part of the body, weakness, pressure surge, tachycardia, tremors, weak knees, etc. If you understood why this was happening to you, for example, you didn’t eat enough fresh food, and now you feel sick, then you understand what to do in such a situation, how to help yourself, and this will not cause you great fear. But if the cause of such symptoms is not known, then you may become frightened, experience severe fear and panic.

At such a moment, people have thoughts that they may lose control of themselves, fall, lose consciousness and never rise again.

The thought that something is wrong with my health and that something bad might happen to me has probably happened at least once in every person’s life. But for some people, having happened once, such manifestations begin to occur regularly, acquire a stable, recurring character, and are accompanied by attacks of acute fear and panic.

This phenomenon is becoming more and more widespread. And it threatens to take on the character of an epidemic. Already, at least 6% of the population suffers from it. VSD and PA are getting younger. Once, a young man at the age of 20, who began having attacks of PA at the age of 7, came to see me.

The fact that VSD and PA can happen to any person and at the most inappropriate age remains a reality. But if this happens, it will make a significant difference whether you are familiar with this “unidentified object” or are completely unaware of it. Recognizing this, correctly assessing what is happening and acting correctly is the main goal of this article. Forewarned is forearmed - this is more appropriate than ever.

So, what do you need to know about VSD and PA in order to meet them in all weapons.

The main thing is not to be scared! It can be scary. But it depends on you how you react to what is happening to you, and what conclusions you will draw about what is happening. The body is a complex system; failures can occur in it for reasons unknown to us. A person experiences these disruptions as painful or unpleasant bodily sensations. But this may simply be a failure that the body successfully copes with on its own. In addition, we ourselves give reasons for our body to “go astray.” Do you have any diseases? Wonderful. Do you lead a 100% healthy lifestyle? Yes? - Amazing. But if the answer to at least one of these questions is no, then disruptions in the body will inevitably happen to you. This is exactly how they should be perceived. Like failures that have reasons. You may think that now I feel bad because of my illness. Or I felt bad because I didn’t get enough sleep, yesterday I was on a binge, I don’t spend enough time in the fresh air, I don’t eat right, etc., etc. And these will be the right thoughts.

By the way, people who experience panic attacks often begin to lead a healthy lifestyle and completely give up drinking alcohol and tobacco.

Leading a healthy lifestyle is the responsibility of each of us. Everything is important for human health: maintaining a sleep and rest schedule, proper nutrition, regular exercise and sports, hardening the body, spending enough time in nature, reducing the use of stimulants (coffee, tea, large doses of B vitamins, energy drinks, alcohol, quitting smoking), developing the skill of emotional stability.

But, if you have had panic attacks or VSD, switching to a healthy lifestyle does not lead to relief from panic attacks and VSD, although the person’s well-being improves, and for this reason the frequency and severity of panic attacks decreases. Panic attacks have another cause, which remained unknown for a long time.

“This happened to me when I was at home alone. There was not a single event that could have caused such a reaction in me. For no reason at all, my heart began to beat at an incredibly high pace, hit my temples, my body began to tremble, I felt feverish, and I began to choke. I was very scared, I thought that I was going to die, after which I felt even worse, my heart pounded even stronger, I began to breathe even faster, my head began to spin, I began to pass out... I don’t know how much time passed, but gradually I began to come to myself. It's gone, I thought. I was lying on the sofa, there was a feeling of weakness, as if after hard physical work. The next day I went to the hospital. After undergoing the appropriate examination, the doctors did not reveal any diseases in me. I forgot about this incident, never understanding what happened to me. A few weeks later I was traveling to the countryside for work. And this happened to me for the second time. And again it seemed to me that I was dying. But the attack again did not end in anything. After this attack, I became afraid of leaving my city. Since my work involved constant travel on orders to other localities, I was forced to stay at home. I spent a lot of time sitting and doing nothing. Bad thoughts became my constant companions. I became afraid of many things that I was not afraid of before. Before the attacks began, I worked as an industrial climber. Now I began to be afraid even of heights. Attacks began to occur to me regularly. I was only 25 years old, I decided that I was hopelessly ill and would not be able to lead a full life, work normally, start a family, and fell into depression.”

One can cite a large number of similar cases when, due to panic attacks, people are even forced to leave work, cannot move independently within their hometown, are forced to sit at home, and constantly need someone to be nearby. They fall into severe depression due to their inability to change anything in this situation.

The problem of panic attacks has become widespread. It makes me feel sorry for people suffering from this disorder who turn to doctors for help and receive a diagnosis from them that they are healthy. At the same time, the algorithm for correct actions in the event of PA is unknown to the vast majority of people and gives rise to numerous worries.

It should be understood that physical symptoms with PA can be exactly the same as with various types of diseases. In this case, appropriate treatment is required. Therefore, when PA appears, the first thing to do is see a doctor and undergo the necessary examination to identify hidden diseases.

Many people make the mistake of not believing the doctors’ diagnosis - “You are healthy” - and continue the examination, spending a lot of effort, time and money on these procedures.

In most cases, the cause of bodily symptoms such as tachycardia, inspiratory spasm, tremor, dizziness are purely psychological reasons, and not somatic diseases. Therefore, if doctors have not found something that really requires treatment, you should immediately seek help from an appropriate specialist - a psychologist-psychotherapist.

Second. During panic attacks, a person has thoughts that “not everything is okay” and he may die or go crazy. The good news is that PA attacks themselves cannot cause death or cause a person to go crazy . As they say, no one has ever died from attacks of PA or gone crazy! Attacks of PA last from 1.5–2 minutes, sometimes up to 15–30 minutes, and stop. A longer attack will no longer have the same intensity and will stop sooner or later. Even if you don’t do anything about it, the panic attack will stop on its own. Switching your attention to something other than your feelings allows you to cope with it faster.

Third. There are many myths and misconceptions about PA. For example: “A panic attack is an attack of panic anxiety, accompanied by various somatic and psychological symptoms that cause changes in thoughts and behavior.”

This definition confuses cause and effect. Anxiety, panic behavior and bodily symptoms are all the essence of a person's response to activating events. And the cause of these reactions is precisely thoughts.

For example, a person found himself in a confined space (stuck in an elevator or in a traffic jam), as a result of which a panic attack occurred. As reactions we have: at the level of emotions - fear, at the level of the body - bodily symptoms - tachycardia, pressure surge, tremor, inhalation spasm, at the level of actions - panic behavior. These reactions are interconnected.

During a panic attack, bodily symptoms necessarily occur against the background of fear. It doesn’t matter what comes first - fear or symptoms. If bodily symptoms appear first, their appearance is preceded by the appearance of fear that is not conscious to the person.

Human reactions are a single process that is formed in the neural network of the brain, and the whole question is how strong the excitation of the corresponding parts of the brain is. If the arousal is not strong, then it covers only the limbic system of the brain, which is responsible for the manifestation of emotions. There will just be anxiety or fear. If the excitation is strong, then it also covers the relic part of the brain, which is responsible for the reactions of the body and the functioning of the autonomic nervous system.

Why is that? This is the nature of fear - it is an emotion that is associated with the basic, innate instinct of self-preservation. No other emotion achieves such a high level of excitation of brain neurons as the emotion of fear. Here, as they say, life itself is “at stake.” Therefore, excitation reaches the relic part of the brain, which controls the body and causes vegetative reactions.

Without going into details of these mechanisms, suffice it to say that fear is accompanied by the release of the hormone adrenaline, which stimulates the heart muscle, after which a rapid heartbeat (tachycardia) and a jump in blood pressure appear.

Can, for example, a person get stuck in an elevator, get scared, and not have an attack of PA? Yes maybe. Then it's called claustrophobia. Whether there will be vivid somatic manifestations (tachycardia, inhalation spasm, lump in the throat, tremors and numbness of body parts - this is all the essence of the body’s reaction) depends on the intensity of the fear experienced (how much a person is afraid) and the biology of the person, first of all, on the characteristics of his and nervous and endocrine systems, constitutional and other characteristics of the body.

To resist attacks of PA, the main thing is to understand and find the cause of fear.

There are two options for the development of a panic attack. In the first option, fear appears due to the appearance of bodily symptoms (which, in fact, is an internal event). These symptoms - pressure surge, tachycardia, inspiratory spasm, lump in the throat, tremors and numbness of body parts - can cause a person to fear death. A person perceives what happens to a person as follows: further development of the process can lead to me getting even worse, I can lose consciousness, fall, or I can have a heart attack or stroke. In this case, a panic attack is guaranteed. Who wouldn't be afraid of the real threat of death? But the good news is that in reality there is no such threat. If the threat of death is real, then there is no problem, you won’t have to suffer for long. No person, no problem, as they said in the bad old days (a little humor).

Many people during a panic attack are afraid of losing control of themselves, losing consciousness, or falling. Another good news is that during a panic attack, the likelihood of losing consciousness is close to zero. This happens due to the release of adrenaline. Remember how in that song about the New Year: “I’m rushing, I’m rushing...”. The person is excited and cannot lose consciousness.

But if a person is able to realize that there is no real threat to his health and life, and is not afraid, then the bodily symptoms quickly fade away. This basically happens to many people. Having experienced attacks of vegetative symptoms once, twice, three times, etc., a person understands that nothing bad is happening to him and stops reacting so sharply. Subsequently, the process develops according to the VSD scheme. Physical symptoms appear, but the person no longer has acute attacks of fear and panic.

In the second option, a person is first afraid of external influences, and then of what happens to him. For example, a person suffering from claustrophobia finds himself in a confined space, or a person suffering from social phobia finds himself in a large crowd of people. This causes a strong attack of fear and panic. And the fear intensifies due to the appearance of bodily symptoms.

In this variant, if the person is not frightened by the external activating event, there will be no attack of PA.

But in both the first version of conscious fear and the second version of subconscious fear, it is necessary to look for the reasons for its appearance.

Of course, getting stuck in an elevator is not a very pleasant experience. But many people calmly experience this and wait for the problem to be resolved.

A surge in pressure, tachycardia, an inspiratory spasm is also not a very pleasant event, but many people pull themselves together and calm down.

Why is that? Why do some people fail, while others succeed? After all, the same events affect people.

The answer lies in how people perceive these events.

Those. It is not the activating event itself, but how people perceive it that determines their responses. And whether there will be fear or not ultimately depends on the person’s perception.

The process of perception is closely related to the process of thinking. In other words, whether inappropriate, exaggerated fear will appear depends on what the person thinks and says in response to the activating event. If a person stuck in an elevator says to himself, “There’s not enough air here, I might feel so bad that I can’t stand it (I can’t stand it, in the sense that I’ll die or go crazy), then he will have a strong attack of fear.

If a person stuck in an elevator says to himself, well, he’s stuck and stuck! Every day hundreds of people around the world get stuck in elevators, and none of them died or went crazy from it. It is possible that I will now have to endure some discomfort, but it is not fatal.

This is just some inconvenience, it will be difficult and unpleasant for me for some time I can get through it, and soon I will feel good again. Help will arrive and I will leave this elevator. In the meantime, I have time to think through a plan for the upcoming weekend or other event, or remember again the pleasant moments of my last year’s vacation, or think about something else good.

If a person thinks this way, then there will be no fear.

Thus, the cause of PA is a distortion in the perception of events, manifested in an erroneous judgment or assessment of the event. In this example, it is a belief in the form of a low tolerance for frustration that exaggerates possible negative consequences.

You can say this - the “lever” that presses the “button” of fear, in this example, is a thought containing an exaggerated threat of experiencing discomfort, inconvenience that does not correspond to reality, which appears in a person stuck in an elevator. Moreover, the reliability of this idea is beyond doubt.

The problem is that if a thought containing an exaggerated threat that does not correspond to reality appears, then it begins to exert its negative influence and initiate the appearance of fear and a panic attack. Therefore, as a rule, it is difficult for a person to cope with this problem. A specialist psychologist-psychotherapist (these are those specialists who work without the use of pharmacology) can help you identify the sources that give rise to such thoughts and stop their action. It is the psychologist-psychotherapist who works with a person’s psychological problems, those psychological problems that are the cause of panic attacks and VSD manifest themselves at the level of a person’s thinking, ideas, beliefs, emotions and bodily manifestations.

People with attacks of PA and VSD often end up with the wrong specialists who can actually help them. I mean psychiatrists and neurologists who “treat” PA and VSD medication - with tranquilizers, relaxants, antidepressants.

Such treatment does not eliminate the causes of PA and VSD - with medications it is impossible to teach a person to experience negative life events, change his attitude towards them, learn to perceive life events without distortion and think correctly, one can only “gloss over the symptoms”, postpone the solution of psychological problems for an indefinite period, which over time will lead to much more severe consequences for humans.

In addition, the use of psychotropic drugs produces a number of side effects, due to which people often refuse to take them themselves. Remember, PA and VSD are symptoms of psychological problems that “ring bells” - solve your psychological problems! They are not lethal. But, if you don’t do this, over a fairly large period of your life they will lead you to greater problems than panic attacks - deep disappointment, the realization that life has been spent in suffering, as a meaningless existence.

Most often, people with PA and VSD come to a psychologist-psychotherapist who have already visited a neurologist and/or psychiatrist and have been prescribed appropriate courses of drug treatment.

When starting a course of non-drug psychotherapy, people ask what should I do with the pills - should I continue to drink or not drink?

My answer in this case is always the same - I did not assign them to you, and it is not for me to cancel them. Decide for yourself - it's your responsibility.

Often people act wisely in this case and stop drinking them, reserving the right to take them situationally during an attack of PA or VSD, in the initial stage of the course of psychotherapy.

That is why, during attacks of PA, if, as a result of the examination, doctors do not find what can be treated, it is necessary to contact a psychologist-psychotherapist.

By contacting a psychologist-psychotherapist, you can detect and eliminate distortions in the perception of activating events and adequately respond to imaginary threats. After which inappropriate fears and attacks of PA disappear. A course of cognitive behavioral therapy gives good results for getting rid of fears and panic attacks, because aims to work with human perception and thinking.

So, let’s summarize all of the above in the form of an algorithm (exact prescription) of a person’s actions if he has attacks of PA and VSD:

Algorithm of actions to get rid of VSD and PA

1. If you have attacks of PA or VSD, see specialized doctors - a therapist, cardiologist, endocrinologist, neurologist.
2. If, as a result of the diagnostic procedures performed, you receive a diagnosis of any disease, treat your disease. If your diagnosis is healthy, move on to the next step.
3. Find a psychologist-psychotherapist who has proven himself as a specialist in working with panic attacks and VSD. It is your responsibility to choose a specialist who can help you.
4. Take an appropriate course of psychotherapy for PA or VSD.
5. Enjoy life!

Additional recommendations

“What to do during the attack of PA, if it happened for the first time or if they are still ongoing?”

1. Make an active shift of attention from your internal sensations to external events. By an effort of will, shift attention from sensations in the body to any details of what is happening around - the faces of nearby people, facades of buildings, shop windows. Focus on what you see.
2. Realize that the panic attack will end anyway. The attack will stop sooner or later anyway. But you shouldn’t tell yourself: “The attack should pass in 5, 10, 20 minutes.” If your expectation is not confirmed, this can provoke anxiety and the release of a new portion of adrenaline. Just tell yourself that the panic will pass anyway.
3. Experiencing a panic attack. You should understand that a panic attack is not your problem itself. This is just a symptom of your other problem. Psychological problem. This is exactly what you need to solve. You have enough time for this. And a panic attack is given to you so that you realize this problem and solve it. Psychological problems are not fatal. But if psychological problems are not addressed for a long time, then you may end up in a very losing situation. For example, at a certain age you may realize that your life was unhappy and all wasted. If you tell yourself this - a panic attack is an unpleasant but safe state, and I can survive it and still be happy , you stop anxiously waiting for a new attack. And gradually the attacks disappear. Those who have already experienced panic attacks know that they are not dangerous. That the next attack that has begun will end sooner or later, and that they can be survived.
4. Look for those actions that are available to you during a panic attack and lead to a decrease in the intensity of your experience personally. For example, the following helps people:

• Slow your breathing to 6–10 breaths per minute.
• Put a rubber band on your wrist in advance and snap it when panic symptoms arise - a slight pain will help you return to reality.
• Count in your head. Some people manage to calm down by concentrating on counting, for example, consistently subtracting seven from a three-digit number.

I wish you success!