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What to Do When You Have a Panic Attack on Vacation

By Cassie Shortsleeve

01.06.20

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Travel can be rewarding and freeing but it can also provoke anxiety. Here, experts offer coping and calming strategies to take with you on the road.

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A few years ago, on a sunny Saturday morning in August at a little breakfast spot around the corner from Wrigley Field, my sister started having a panic attack. It seemed to be out of the blue. We were enjoying a weekend getaway the month before my wedding. Outside, the crowds for the day’s Cubs game were starting to fill the street. Inside, my sister’s face went white; she said it felt like her throat was starting to close up.

Panic attacks are the abrupt onset of intense fear paired with a slew of uncomfortable symptoms, including shortness of breath or a fast heart rate. These attacks can be a characteristic of panic disorder, which is an anxiety disorder defined by unexpected, repeated waves of intense fear accompanied by physical symptoms. They may be triggered, but they can also be random. Anxiety disorders are the most common travel-induced mental health problems, according to research published in the Journal of Travel Medicine

“Anxiety thrives when we don’t have control and when there is a lot of uncertainty,” says Julia Martin Burch, Ph.D., a staff psychologist at the McLean Anxiety Mastery Program. When you’re in a new place, stuck in a middle seat, or even dining in a crowded restaurant, there’s a great deal of unpredictability. “[Panic is] particularly uncomfortable when you’re traveling because you don’t have the routines and comforts of home,” she says.

Some people only deal with panic once or twice. But for others, it’s a battle they face for life. So if you find yourself panicking on vacation, it’s important to consider both long-term strategies and short-term coping techniques for handling the situation. Here’s what you need to know.

Check your instincts

Our first impulse at the restaurant that day in Chicago was to leave. And we did. We paid the bill and walked a few miles back to our hotel along the lakefront trail and through the zoo. It seemed a logical choice given the circumstances.

But experts say other strategies are more effective in the long run.

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“Your goal is to not change your behavior on the basis of the attacks,” explains Lily Brown, Ph.D., an assistant professor of psychology at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania’s Perelman School of Medicine. Whether in daily life or while traveling, sitting through panic—and recognizing your panic for what it is—can help you learn and practice coping techniques (more on these below) and reduce the likelihood of future attacks.

Another understandable instinct might be to alert someone else when upsetting symptoms appear—a flight attendant or your partner, for example. But while inviting other people into the experience can offer relief in the moment, Brown points out that not doing so gives you another chance to practice coping: “In the long run, we try to help people find opportunities for learning about their ability to tolerate distress because it will go away.”

Of course, different people experience panic differently. And what works for one panic-prone person might not work for another. If you’re suffering from panic, a doctor or mental health professional can tailor a treatment plan to your individual needs, but if you get caught off guard on the go, these five coping strategies can help.

Your breathing can become disordered during a panic attack, so consciously slowing down and focusing on your exhale can be a good way of dealing with it.

Use coping techniques

Talk to yourself.

Try repeating reassuring statements such as this will pass, anxiety can’t last forever, anxiety comes and goes like a wave, or I am going to get through this. Acknowledging anxiety like this allows you to confront (rather than avoid) it, which helps prevent your emotions from snowballing, experts say.

Remember, panic attacks are temporary. 

Although terrifying, panic attacks reach their peaks within 10 minutes, according to Brown. “It’s not biologically adaptive to stay in a high-intensity state for that long,” she says. “Eventually the body will take care of itself and will bring you back down.” Realizing a panic attack is happening and even repeating to yourself that it’s temporary could help you through those difficult moments.

Associate physical symptoms of panic with other parts of life.

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If you fixate on low-grade symptoms of panic, including minor sweating or shortness of breath, you may begin to interpret them as dangerous, which may make them worse. But consider this: “Physical symptoms of panic come up commonly in other situations, too, such as during exercise, before riding a roller coaster, or when we’re doing something exciting,” says Brown. Reframing your symptoms as not threatening, but rather familiar parts of the human experience can be helpful, she says.

Slow down your breathing and focus on the exhale.

One of the most common symptoms of panic attacks is unregulated, hyperventilation-style breathing, notes Brown; this often looks like big gulps of air in with very short exhales. A short-term fix can be to reverse that style of breathing, slowing your breath down and focusing on long exhales, she says. This activates your parasympathetic nervous system, the “rest and digest” mode, naturally calming you down.

Make sure your physical needs are met.

Hunger, lack of sleep, thirst, and stress can all feed into panic and anxiety, notes Martin Burch. On a trip, make sure that you’re taking time to eat, drink, and relax accordingly. In a moment of panic, make sure you’re not dehydrated or starving, for example. Says Martin Burch: “Physical vulnerabilities can make us more vulnerable to anxiety.”

Look for long-term solutions

One of the terrible side effects of panic attacks, especially recurrent panic attacks, can be agoraphobia, an anxiety disorder in which you start to avoid activities or places because you’re worried they could induce panic. This exacerbates panic’s symptoms and shrinks your world. If you’ve started to avoid certain aspects of travel (going out to a crowded restaurant or flying) because you’re scared you might experience a panic attack, talk to a mental health specialist or doctor to create an individual treatment plan.

But there are steps you can take on your own as well, experts say. For example, if you’re worried that crowded restaurants will trigger panic attacks on vacation, consider dining in a quieter restaurant before you leave, working your way up to busier ones. While that might seem downright terrifying, exposing yourself to smaller moments of what you’re avoiding can be beneficial. “Practicing coping with anxiety and potential panic attacks in more comfortable settings can help you realize you can handle it,” says Martin Burch. Eventually, with that confidence, you’ll be able see that panic is something you can tackle no matter where you are. 

>>Next: How a Hike Can Make Your Vacation More Relaxing

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