Picard isn't asking about panic attacks specifically, just fear in general.

The title of this thread is, "How do you deal with a panic attack?"

Normal fear is NOT a bad thing. Fear keeps me alive. However, panic is a debilitating type of fear. According to Dictionary.com, panic means "a sudden overwhelming fear, with or without cause, that produces hysterical or irrational behavior..." If fear becomes panic and I can't operate effectively, that's a bad thing.

All due respect to military training, but I think the military is interested in different objectives than someone who is merely trying to survive. The military often goes on missions where "mission accomplished" is more important than keeping everybody alive. In many military missions, it is known that you will probably die. Consider, for example, the storming of the beaches of Normandy. If a person's objective was to stay alive, then the correct thing to do would be not to get off the boat, not to go on the mission, or not to be in the military at all.

It would be advantageous for the military to ELIMINATE fear entirely from a soldier if they could. So, they train to do so as best as they can. In contrast, for a survival situation, where the objective is to stay alive, eliminating fear entirely would be a bad thing. It's an important distinction.

regular people don't have millitary to manage panic attacks.

I'll let you know if I ever get there!

At work, my job can be very stressful since I tend to get the worst crap thrown at me and often all at once. So it is a matter of learning to dance, box and swim at the same time. The last 3 weeks of work just before my current vacation was just that. Although there was no outright panic attack the stress was extremely weary. Each day would knock me down so by 6:00 I headed home to relax. However, one afternoon it came to a head and I just had to bail. (The final trigger was something so minor and unexpected - I dumped my food in my lap!) I told people I needed some space and took off for the rest of the afternoon before I blew up at someone.

Later my supervisor recognized that I did the right thing in that moment and encouraged me to take it easy during my well deserved time off.

There are few times when someone is going to come face to face with a life crisis like a vehicle accident or natural disaster or whatever. You will handle it they way will handle it. Although some mental preparation and training is helpful, when you are out of your element you will just have to adapt and deal with things OR you will panic.

That said, I think the idea of panic is overblown especially in the movies and the media. Studies have shown that in fires, etc that people tend to just react fairly calmly and even rationally. What is the first thing most people think of in a crisis? -- Where are my loved ones? How can I get to them and protect them? So in spite of sirens and commands from others most people will seek out those they are separated from. Its instinctive. During my Wilderness FA training, the instructor related several stories of people had instant recall of their training after a moment or two of hesitation and were able to perform first aid with clarity.

A couple of months ago I posted a link on the forums about some kids who stayed calm and took control of their school bus when their driver suffered from a heart attack while driving. Students too young to really have much training evidently were calm enough to control the situation. http://forums.equipped.org/ubbthreads.php?ubb=showflat&Main=17454&Number=244761#Post244761

You don't need military training, you just need training. Often that just involves going through the motions and getting your head around whatever the problem might be. Much fear and panic is based on the unknown -- "I've never been there before, what do I do now?". Get comfortable with the emergency procedures; go through the motions, find the emergency exits and if they aren't alarmed, walk through and take the stairs.

A lot of military boot camp is focused on physical conditioning, you don't need military boot camp to work out and get in shape -- find a gym. Your mind and your body are connected. Mental stress can be mitigated with physical stress; working out is a stress release.

When I took my last (hopefully it will be my last) water survival qualification swim the instructors were testing survival techniques -- pass/fail. It was a one hour work-out that started with simple swimming and swimming underwater, then progressed to putting on the gear and swimming while fully suited. At the end of the hour I felt like I'd had a pretty good work-out. You don't get to that point if you aren't in shape to begin with. That's just a qual and a re-familiarization with survival gear.

In the real world where you aren't in a heated pool but in a cold ocean, the stress (mental and physical) is much higher. The only way to deal with that real world threat is to be physically fit and mentally prepared. Otherwise you become a statistic.

But you aren't in the ocean, you're in a office building. The same principle applies. Get in shape now so the physical stress of the emergency is not a factor and then train with whatever procedures you feel appropriate to get around the mental stress component NOW, before it's real. Train yourself with your evacuation plan now and you won't have to figure it out in real-time when you don't have time to ponder.

$.02

It has been my experience that training is one of the most effective mechanisms to overcome panic. Both muscle memory and removing “what do I do” from the equation helps to focus one in on performing a function or task at hand. When training for rescues, many people do not know how they will react since they have not been in the situation before or even if they have; the “wave of panic” can hit anyone. Understanding that this is a normal reaction to being in a stressful situation will often allow one to stop, slow one’s breathing down, take a moment to access the situation, formulate a mental plan of action and put it into action. For many First Responders, this could be during their first blindfolded run through the fire maze on air, the first time in the burn building, in an narrow tunnel during confined space training, first time repel or their first call. Your training kicks in and you learn to focus (hopefully not with tunnel vision) on the task at hand. It is after, when you have time to reflect on the experience, you sometimes react almost panic like to the event.

Pete

"People don't rise to the occasion. They default to their training."
This quote has been attributed to Rick Rescorla, the soldier-turned-security officer who saved the lives of all but six of the 2,700 Morgan Stanley employees in the World Trade Center on Sept. 11, 2001. Other firms that hadn't conducted the disaster drills Morgan Stanley had, lost scores of employees in the terrorist attacks.

A real "panic attack" is an organic form of an anxiety disorder recognized by the professional mental health associates. Under normal circumstances, the brain and body work together to identify a perceived or real threat. Hormones stimulate the adrenal gland to produce adrenalin. With an anxiety disorder, the body produces the hormones that stimulate the production of adrenaline without any real or perceived threat, but the body's "fight or flight" instincts/reflexes are instantly kicked into gear. There is really no way to control the panic attack after it has begun, other than to just sit still, bear it and wait it out. The oversupply of adrenaline essentially overcomes the body's fine motor and critical thinking skills. This is the "flight" part of the disorder. The flip side of the coin is the "fight". This is essentially a rage of a magnitude that most people never experience in a lifetime of getting angry and those who have experienced rage of this order usually experience it only once or twice in a lifetime. For a person with this version of the anxiety disorder, such rage is experienced much more often - as often as weekly. These people are capable of as much destruction of physical objects, including other people, as any adrenalized individual. Treatment of both manifestations of this anxiety disorder is permanent maintenance of daily doses of tranquilizers. As with the "flight" or panic attack malaise, it can be controlled, once started, only by an extreme exertion of will power. In either case, the exertion of will power is only sufficient to essentially self-immobilize the individual. The feeling of panic or rage eventually dissipates as the adrenaline if burned up by the body.

My training helps. As does shutting down all emotions and doing what needs to be done.

The military does not try to eliminate fear but rather attempts to train you to work through the fear. Fear causes normal and predictable reactions in all of us. Knowing what these reactions are combined with constant muscle memory drills allows a person to cope with the fear rather than be crippled by it.

If you are really interested, check out a book called "on killing" written by an American colonel (grossman) If I recal correctly. Extensive research was done on the subject. I didnt read the book myself, but I had to attend his seminar on a few occasions.