4 Steps to Manage Panic Attacks as a Highly Sensitive Person

A highly sensitive person experiencing a panic attack

Panic attacks hit some people harder than others — and they can seem impossible to tame. Here’s how to down-regulate your nervous system and stop the panic response. 

Being at the dentist is enough to make anyone want to run screaming from the room, especially when you hear the word extraction. But when you are a highly sensitive person (HSP), or even moderately sensitive, the experience is even more magnified. Because, as sensitive souls, it usually doesn’t take much stimulation for our central nervous system to go from 0 to 100. 

I have been particularly aware of my high sensitivity since my teenage years. It was around that same time I started to experience panic attacks, and it was a very, very long time before I realized what they actually were. (I was well into my married life with children before I was able to manage them.) 

According to the Mayo Clinic, panic attacks are characterized by suddenly being overcome with an intense fear. They feel real since many physical reactions occur, from sweaty palms to a rapid heartbeat to chest pain. But, in actuality, you are not in danger — but the anxiety and fear trick you into thinking you are.

A few weeks ago, when I took my youngest daughter to the dentist, I was surprised when panic decided to rear its ugly head after many years of laying dormant. It amazed me just how quickly I felt that familiar need to run like hell. 

So I decided to use my experience as an opportunity to document each step I took to calm the beast. And calm it I did. So although these steps may not seem long, they have a very long history behind them. I have tried many and varied things to control “it,” the panic. For those who experience panic attacks, sensitive or not, it’s not easy. “It” controls us and we never know when “it” will come. 

Here are some things that help me manage my panic attacks as a sensitive person.

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4 Steps to Manage Panic Attacks as a Highly Sensitive Person

1. Allow the panic to come on and exist. Acknowledge it and name it. (And remember that no one has ever died from a panic attack.)

Sitting in the dentist’s room with my daughter, I started feeling a little queasy as she climbed into the chair. I was anticipating that the dentist would say she had to have her tooth out. I noticed her worried little face. Automatically, I felt her nerves. I felt her uneasiness. I felt her anxiety. As a sensitive person, I can’t help absorbing others’ emotions, especially my child’s. 

So once it was decided that the tooth had to come out today, the dentist and I chatted away to distract my daughter from the physical feeling of someone pushing and pulling in her mouth. I held her leg and talked about the ice cream we would have for lunch. In about 12 seconds, the tooth was done. Gauzed up, we left feeling proud at what we both had endured.

However, as we began to drive home, I could still feel the nervous energy and queasiness in my stomach. She was leaning her head on the back of the seat with a strange look on her face. My mind switched up a gear. Was she having a reaction to the aesthetic? What would I do if something happened to her while I was driving? Alas, I had entered a very familiar territory: “It” — the panic. 

What had gone from mild concern and edginess quickly increased in intensity. Back in the day, I would have instantly felt overwhelmed — which is common for HSPs, too — and done anything to get the hell out of there. “It” would have controlled me. My poor body would have been frazzled and my mind would be telling me the world was unsafe, I was unsafe, and to avoid, avoid, avoid whatever was going on… 

However, today was different. Out of nowhere, something unusual happened — my mind didn’t go into a full-blown primal threat response. My conscious brain stayed online and a word came into my head: Caring. So I kept repeating it. Saying this word to myself seemed to stop the overriding need to flee. Caring. I am caring. What the heck? 

Usually by now I’d be an illogical mess! Caring. Okay. I’ll go with that. Caring. I am caring. I kept repeating it. Over and over again…

Me saying this word seemed to hold off that crazy surge of energy that makes you want to run. I am caring. I am actually highly caring (similar to how I am highly, or moderately, sensitive).

Caring. 

Caring. 

Caring. 

Not spiraling into a full-blown threat response was amazing. In fact, it was so amazing that I when I got home, I started writing it down. (Notably, any type of journaling can help you make sense of your emotions and be an effective coping mechanism for us HSPs.)

So why “caring” — and what did I do next? I had listened to a podcast on highly sensitive people a few weeks prior and the host described us as being “naturally highly caring.” Being sensitive to anything had always felt like such a weakness… but then it struck me: How could it possibly be something positive? 

I think this word popped into my head because, as I looked at my daughter, I really cared deeply about something happening to her, a trademark of us sensitive folks. Somehow, I knew it helped me ward off the almighty beast of full-blown panic. So, in that moment, I somehow concluded that I was a caring person and not “crazy.” 

I then did something that I practice all the time: I allowed the intense feeling to be there. 

I had often applied this to other emotions, such as anger, but had never thought to apply it to panic. I allowed the feeling of panic, uneasiness, and general fear to be there. I let “it” come. I let “it” in. Hello, Panic. Welcome. 

Even though I had some previous experience in this practice — of acknowledging and allowing — can I just say how utterly impossible it initially felt to allow something as terrifying as panic “in”? But something told me to try it, so I did. And guess what? I survived! (And so can, will, you!) 

I then went on to name how I felt: “Okay, I’m feeling fear; okay, I’m feeling panic.” This is also something I’d do regularly. I get in touch with what the heck is going on and I find a way to describe it. (There is so much research out there on how just naming your emotions can pacify and calm the body, but I’ll leave that for another post). The aim is that you allow the discomfort to be discomfort without trying to change it (just yet). Let it in. Acknowledge the feeling for what it is and label it as best you can.

2. Do something physical to allow the stress response to complete itself, which will change how you feel.

So after allowing your fear and panic in and giving it a name, I found where this emotion and tension was in my body. (They are linked, as much research shows.) Why? So I could release it. 

This, too, takes practice. But this part of acknowledging where “it” is is huge. Panic can often be felt as a constriction in the throat, burning of the ears or cheeks, sweating palms, tension in the hands, clenched jaw, serge of energy felt through the whole body, or heaviness in the chest (to name a few). There is lots of information out there on “where” parts of your body feel this fearful emotion — and you can certainly use this as a guide — but my advice would be to try and explore this for yourself. Namely, because emotions don’t always show up in the same place. 

Today, for example, I felt the panic in my hands, gripping the steering wheel. So I started shaking my hands (one at a time) and made fists — squeeze and release, squeeze and release. Repeat, repeat, repeat. 

I also shrugged my shoulders so hard up toward my ears (all while driving safely) — shrug and drop, shrug and drop. Repeat, repeat, repeat. I just kept doing this over and over again. 

So I allowed the energy of this emotion to wash through me and out of me, physically letting the stress response finish and releasing the surge of energy from my body. (This brings to mind the saying by English Psychiatrist Henry Maudsley, “The sorrow which has no vent in tears may make other organs weep.” In other words: GET. IT. OUT.) 

I kept shaking and shrugging and squeezing and shaking and shrugging and squeezing over and over and over again… the intensity began to subside. I kept saying to myself, “I am letting ‘it’ go, I am letting ‘it’ go, I am letting ‘it’ go…”

So even if you are feeling overwhelmed and overstimulated as a highly sensitive person, without a panic attack, try this as a grounding exercise. It really does work wonders.

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3. Down-regulate your nervous system.

Now it was time to really bring my body back to a place of safety. Easiest way to do this? Deep breathing from your belly. 

Think of it as cooling down a cup of tea. Inhale through your nose and exhale out through your mouth, pursing your lips, pretending to cool down a hot cup of tea. Taking deep breaths brings us into parasympathetic domination, which reduces stress. This is a place of safety. It signals to the body that “all is well, you have safe passage.” 

I continued to breathe deeply until I had reached home. 

I’d like to make a note here that, for many years, I would jump straight to this step. I was so desperate to feel calm, I just started breathing deeply. And while yes, this does work, it would be many, many years of trial and error to know (and understand) that we have to first let it be there before it can truly subside. Otherwise, we will be experiencing the feelings of panic at the same time as trying to get rid of it. Confusing? Yes. It’s the trying to get rid of it perspective that I’ve learned isn’t helpful. When you try and get rid of something, then there really is a threat. But when it comes to panic attacks, the threat is not real. Our real fear is how we will feel when the panic comes, not the threat itself. 

So our goal is not to rid ourselves of the panic, but to allow space for it: “I have space for this.” We welcome it in, temporarily, accepting it’s visiting — and then gently send it on its way. Being able to “sit with it” also helps our self-esteem. We prove to ourselves we do have the capacity to handle it. 

As HSPs, we’re already used to managing big emotions — so you’ve got this, too!

4. Give yourself some praise. 

This step can feel really cheesy when you first start out — it feels so unfamiliar to praise yourself. But here’s the thing. It works. 

“I’ve got this!” It is perfectly okay to feel this way. It’s because I care deeply. Not because there is something “wrong” with me or I have some kind of disorder as an emotional, sensitive person. Fear is a normal human emotion and common to everyone. 

So tell yourself something like:

I have phenomenal coping skills!

I can handle this! 

I am brave! 

I am amazing! 

I’ve got this!

Or any variation you’d like…

Dr. Rick Hanson, a neuropsychologist, refers to this as getting in touch with your “inner caring committee.” At the end of the day, it’s a self-compassion practice. So whatever you would like to call it, honestly, it is worth a try. Remember the old adage: Action comes before belief? Of course, you may not believe it when you first start out, but over time, your beliefs start to change.

As sensitive people, we have a tendency to become overstimulated easily. But we can manage our emotions more so, panic attack or not.

Do you ever suffer panic attacks as a sensitive person? I’d love to hear about your experiences with them in the comments below!

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