Dealing with Panic Attacks When You Have OCD

Living with obsessive-compulsive disorder (OCD) can be challenging in itself. However, if you also experience panic attacks, it can feel overwhelming, and sometimes hard to tell if what you’re experiencing is panic or OCD. Both OCD and panic attacks are rooted in anxiety, but how they manifest is different:  

• OCD is characterized by obsessions (intrusive thoughts) and compulsions (repetitive behaviors). These obsessions and compulsions can cause significant anxiety. 
• Panic attacks, on the other hand, are sudden episodes of intense fear that trigger severe physical reactions when there is no real danger or apparent cause. 

OCD and panic can exacerbate each other, creating a cycle of anxiety that is tough to break, and adding to feelings of distress and frustration. The good news is, there are ways to manage panic attacks even when you also have OCD. You don’t have to choose one or the other. In fact, the strategies to manage them are similar. 

Understanding how these conditions interact and adopting practical strategies can help you create a plan for dealing with the panic while also managing your OCD in healthy ways. 

Understanding the Connection Between OCD and Panic Attacks

To manage panic attacks when you have OCD, it's essential to understand how they may interact. 

Anxiety commonly occurs with OCD. People with OCD are prone to worry, overthink, and experience high levels of stress. For some, the obsessive nature of OCD can lead to overwhelming fears or catastrophic thinking, triggering panic attacks.

For example, someone with OCD might have a sudden fear that they’ve forgotten to lock their door. This distress caused by intrusive thought could escalate, leading to physical symptoms of panic, such as a racing heart, shortness of breath, and sweating. In other cases, panic attacks may arise from the intense anxiety associated with resisting compulsions. Over time, if left unmanaged, the combination of OCD and panic attacks can create a loop of anxiety, with each condition feeding into the other.

It should be noted that having panic attacks is not the same thing as having a panic disorder. Panic attacks are a symptom of panic disorder. Panic disorder is a specific type of anxiety disorder characterized by multiple unexpected panic attacks. A main feature of panic disorder is that the attacks usually happen without warning and aren’t due to another mental health or physical condition. There’s often no specific trigger for them.

Not everyone who experiences a panic attack develops panic disorder.

Recognizing the Signs of a Panic Attack

Knowing the signs of a panic attack can help you recognize when anxiety is escalating so you can take action. While everyone experiences panic in different ways, common symptoms of a panic attack include:

• Sense of impending doom or danger
• Fear of loss of control or death
• Rapid, pounding heart rate
• Sweating
• Trembling or shaking
• Shortness of breath or tightness in your throat
• Chills
• Hot flashes
• Nausea
• Chest pain
• Headache
• Dizziness, lightheadedness or faintness
• Numbness or tingling sensation
• Feeling of unreality or detachment

Symptoms usually come on suddenly, without warning. Symptoms typically peak within about 10 minutes and then subside soon after. You can feel quite fatigued following the attack. One of the most troubling things about panic attacks is the intense fear of having another one. That fear can be so intense that you may avoid situations that you think may trigger an attack. 

It’s important to remember that experiencing panic doesn’t mean that you’re in danger. A panic attack is your body sounding a false alarm. You’re not in harm’s way. You’re not going to pass out or lose control. You’re not dying. It just feels like it in that moment.

Knowing your triggers and symptoms can help you be prepared should a panic attack strike. Here are some strategies that you can keep at the ready should you need them.

Strategies for Handling A Panic Attack

Panic attacks can occur at any time or any place. When you’re in the middle of a panic attack, it’s not the time to try to figure out what to do. Having a “panic attack toolbox” can help you feel less anxious and more prepared in the event an attack occurs. 

Try out a few strategies. Some may feel more doable than others. Some may feel right for some settings and not others. See what feels best for you. Add them to your toolbox.

Grounding Techniques

When a panic attack strikes, your mind may be racing a mile a minute. Grounding techniques can help anchor you in the present moment. Grounding is especially effective for people with OCD who are caught in spirals of intrusive thoughts.

5-4-3-2-1 Technique

This is a very popular strategy for managing anxiety and panic. It is simple to use, and you can use it almost anywhere. When you find your anxiety or panic escalating, try to focus on these things around you: 

• Name five things you can see
• Name four things you can touch
• Name three things you can hear
• Name two things you can smell
• Name one thing you can taste

This method helps to focus your mind away from your intrusive thoughts and onto your surroundings.

Deep Breathing Exercises

Anxiety and panic are a response to the body’s “fight or flight” signal. Slow, deep breathing helps to activate the body’s parasympathetic nervous system, signaling the anxious part of your brain that you’re safe and not in danger. Deep breathing helps to send more oxygen to the brain too so you can think more clearly as you control that stress response. 

Breathing exercises have been found to be particularly helpful in calming anxiety and panic. Of all the types of breathing exercises (and there are many), controlled breathing, slow breathing, and diaphragmatic breathing seem to be the most helpful. 

Visualization

Imagine a place where you feel calm and safe. Picture every detail, from the sounds and smells to the colors and textures. This visualization can help distract you from distressing thoughts and physical sensations. 

Touch or Hold an Object

Holding an object, like a smooth stone or piece of fabric, can provide a sensory distraction, which may break the loop of anxiety associated with your OCD and panic symptoms.

Reframe Catastrophic Thinking

Catastrophic thinking, or assuming the worst possible outcome, is common in OCD and can trigger panic attacks. Learning to reframe your thoughts can help manage the anxiety that fuels panic attacks.

Challenging Negative Thoughts

1. Identify the negative thought.
2. Challenge the thought. Ask yourself, “Is this thought based in fact, or is it an assumption?” Often, catastrophic thinking doesn’t align with reality. Remind yourself that thoughts are not facts, and that OCD tends to exaggerate fears.
3. Examine the evidence. Gather evidence for and against the intrusive thought.
4. Reframe the thought into a more balanced perspective. Limit the “what ifs”. Try to replace the “what ifs” with positive statements like, “I am safe right now” or “I can handle whatever happens.”

Build a Panic Attack Toolbox

Being prepared can be your best response if a panic attack strikes. Having strategies at the ready can help you feel confident that you can manage whatever comes. Customize your toolbox with items that fit your lifestyle and help you stay grounded or calm during a panic attack. Here are some ideas:

Calming Music or Podcasts 

Have some playlists or podcasts that soothes you. Listening to calming music or a soothing voice can offer comfort and distract you from your panic.

Journaling

Keep a journal and pen with you. Writing down thoughts and feelings can help to diminish some of their power. 

Distractions 

Keep small items like a stress ball or a fidget or other sensory object handy. Touch can sometimes help to break that anxiety loop and can even be soothing for some. 

Practice Self-Compassion

Dealing with OCD and panic attacks together can be exhausting. It’s easy to feel overwhelmed and frustrated. Self-compassion, the ability to acknowledge one’s shortcomings or failures without criticism or judgment, but rather with kindness and understanding. Self-compassion is a powerful deterrent to self-judgement and negativity and enhances resiliency and emotional well-being. 

Acknowledge Your Efforts

Living with OCD and panic attacks requires tremendous resilience. Recognize the hard work you’re doing to manage your symptoms. 

Give Yourself Grace

Progress is never linear or all-or-nothing. If you have a rough day, remind yourself that it’s part of the journey and does not diminish the progress you’ve made. 

Seek Professional Support

While self-help strategies are an essential part of the process, professional support can make all the difference in managing OCD and panic attacks.

Therapy

Exposure and Response Prevention (ERP), a specialized type of cognitive behavioral therapy, is the gold standard for the treatment of OCD. ERP involves gradually exposing the person to their obsessive fears without allowing them to engage in compulsions. Over time, this helps reduce the anxiety associated with the obsessions. ERP has also been found to be effective in reducing anxiety and panic. 

Medication

For some people, medication can be an effective tool for managing both panic attacks and OCD symptoms. 

Medications such as selective serotonin reuptake inhibitors (SSRIs) are often prescribed for OCD. They help balance serotonin levels, alleviating symptoms of anxiety and obsessive thoughts. SSRIs may help with anxiety and panic symptoms too. Some medications commonly used to treat acute panic can sometimes worsen OCD symptoms so doctors may recommend alternative medications or lower doses. 

Whether or not to include medication as part of your treatment is an important conversation to have with your healthcare provider to explore options that may be right for you. 

Support Groups

Support is key to successfully managing your symptoms. Connecting with others who experience OCD and panic attacks can provide comfort and validation. Whether you choose online or in-person support groups, sharing experiences can make you feel less isolated, and you can learn from others who have faced similar challenges.

Final Thoughts

Living with both OCD and panic attacks can feel like a constant battle, but it’s important to remember that there are tools and techniques to help you manage. Having strategies and a plan in place, you can gain control over your symptoms, build confidence and resilience, and improve your quality of life. There is help and there is always hope. 

References

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