how do you deal with panic attack during a life to death situation where you are running for your life?

Stress inoculation. Train to do something difficult under stressful conditions. That's no guarantee that you won't freeze up, but it should help. Once you've trained to do difficult things under stressful conditions, actually doing those things should help even more.

Is Picard asking about addressing fear in general in a highly stressful situation, or is he asking about having a panic attack specifically?

From the Mayo clinic: "A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying." It is a medical condition that can be treated. <http://www.mayoclinic.com/health/panic-attacks/DS00338>

If we're just talking about handling stressful situations better, then, yes, train regularly in a stressful task. This will take commitment, because, whatever activity you're training in needs to be safe -- or safe enough, because it should have some real risks. To manage risks well, you need to start small, gain skill, and gradually tackle bigger and bigger problems. One way to do it is through a good martial arts place with a strong practical focus -- and that includes developing the "fighting spirit," which means the proper psychology to get you through a violent conflict. I'd think sports that involve an element of danger and a lot of skill will help, too -- rock climbing, for example.

Also, it helps to train for the situation you want to be prepare for. So when you find yourself in the situation, you can just follow a pre-programed flowchart. You have something to do, something to focus on, so you won't give play to the fear inside of you screaming to get out.

There has been some discussion on this sort of stuff. I think it was Night Hiker who said he found it helpful to focus on the immediate tasks rather than on the big picture, and that was how he got out of an up-side-down submerged helicopter. That seems like a good tip.

I am addressing fear in general. People freeze up during danger.

Come to think of it, what are the ways to train for stressful situations? I suggested two ways in my previous post, but would like to hear other's input.

D.R. has it written on the sheet inside his survival kit. In case you get get lost, STOP. STOP, THINK, OBSERVE, PLAN. Or, sit down and make a cup of tea. Whatever works for you. The point is to slow your though process down and get focused on a task so you don't fall into panic mode.

I'm sure there are methods for general panic attacks as well such as focusing on breathing, counting to 10, etc. You want to put your mind to work, not let it run wild.

IMO, the old fashioned drill sergeant's performed this function. You were subjected to various forms of stress while training to perform your military duty. It helped you learn to deal with stress (aka fear) and still do your job.

Just thinking out loud (so to speak)...Without a drill sergeant standing over your head stressing you out, ask yourself what stress is and how can you duplicate it. Exercise -- work-out to elevate your heart-rate and then do whatever it is you want to accomplish while under stress. If you are literally running for your life, then wind-sprints might be a good exercise. Run hard to elevate your heart-rate and tire your muscles and then a nice relaxing walk back to the starting point where you do it again (and again and again). Condition yourself to that physical stress but without a mental stress component.

There's a book titled, "Mental Mechanics of Shooting, How to Stay Calm at the Center" which is not a plug for the book (hard to find) but for one technique on how to calm the fear/panic. Just do whatever it is while calm and when you do it for real, the calm will return when you do it for real -- theoretically. In the book the idea is to only practice shooting while calm. Add an elevated heart-rate but no external threat (drill sergeant) so you are actually practicing under physical stress, but not necessarily mental stress. It seems that if the authors theory holds, the act of doing should bring back the calm. You are returning to something familiar and your body responds.

OTOH, if you are in a panic when you practice, the act of doing may bring back the panic -- theoretically.

FWIW, $.02

I've never been in such a situation. From what I've read, it often helps to have planned in advance. For example, if you routinely take note of all the exits from any indoor space you happen to be in. On an aeroplane, count the number of seats between your row and the nearest exit in front of you and behind you. Even if your advance plan turns out not to be usable, it at least forms a starting point and helps put you in a viable frame of mind.

Breathing. There are specific, ritualistic breathing exercises that can help restore calm. I have wondered if the Litany against Fear would help, but I have no evidence either way. Proper breathing has a deep physiological affect beyond the psychological.

Honestly, I have not had a panic attack that I can remember. When my life has flashed before my eyes, it's kind of like everything slowed down. Afterward, I reflect on how crazy it was, but during the brief moment I'm strangely more calm. This happened just last weekend actually. I was driving and hit a patch of slippery road near a cliff. I lost control of the car. My girlfriend went completely nuts. I went completely silent, calm, and focused on what I needed to do to avoid a crash. The moment only lasted for about 3 seconds, but it seemed like about 10 seconds.

This may sound goofy, but I think I'm conditioned for this reaction from playing organized sports from a young age. Playing games and being expected to do well, it puts stress on a little kid. The kid eventually hardens himself and learns to control his senses and emotions. That stressful feeling of being expected to score (which is THE WORLD to a kid) is the same feeling I get when suddenly faced with a life-or-death situation.

So, what can adults do? As others have stated above, there are ways to train. I don't think it's enough to self-train. You need to enroll in an organized race, or something like that, where you're competing against strangers. Make a commitment to achieve a personal record or even win the race. That may not seem like a big deal from an observer's standpoint, but the person actually doing it feels stress that is uncommon in everyday life.