Ways to manage panic attacks when running

Ways to manage panic attacks when running

Do you suffer with panic attacks when running? Here are some ways of managing this…

Panic attacks can come out of nowhere and feel unpredictable. Once we have had one in a situation, we can associate that situation with panicking; therefore we get even more anxious the next time we are going into that situation that we will panic again: which ironically makes it more likely that we will because we are going into that situation primed to feel unsafe.

What is Panic?

In order to manage panic attacks, we need to understand what they actually are. Our nervous system has a massive responsibility for enabling all the parts of our body to communicate with each other whilst taking into account both internal and external influences. It needs to work in harmony and promote balance for us to be healthy and adaptive to our environments. Two branches of the system which regulate us are sympathetic and parasympathetic systems.

Our sympathetic system is often linked to ‘fight/flight’ – getting us ready for action, whilst our parasympathetic system is known as ‘rest & digest’; the system which is about energy conservation. The parasympathetic system also branches off again and as is evident when we are resting, feel safe, calm and connected to others. However, another role is to conserve energy by shutting down our system. This can include feeling cut off, numb and dissociated.

Although panic is a manifestation of our sympathetic state and hyperarousal, it is also on the brink of the parasympathetic state and shut down, with early signs of dissociation (e.g. tunnel vision or things looking different, feeling detached from ourselves, hearing ringing in our ears). Panic is often associated with feeling trapped and helpless, unable to fight or take flight, which is precisely why our nervous system shifts from protecting us by getting us ready for action, to protecting us by shutting down. Hence panic is veering to the space where both parts of our system are working in dual motion. It’s confusing, disorientating and distressing.

We have a skill called ‘neuroception’ which is the way that we assess an environment and its safety. This is done unconsciously and automatically. It means that our bodies might respond to something without us understanding why, but what follows is our brains making sense of it by placing its own interpretation on the sensations. A simplistic example is we have a felt sense that there is something in the trees and might have an interpretation of “there’s some birds nesting in there” or we could appraise it as “something feels threatening”.

Panic can therefore be triggered by sensations and cues from our body bought about by neuroception (and we can be more sensitive in our neuroception if we have experienced trauma) and other changes in the body, which obviously also happen when we run! These changes are interpreted by the brain and this impacts our reaction. Hormonal changes can also be a part of this and can affect brain functioning.

It also works the other way where we feel under a lot of stress and we are overthinking. This leads us to feel overwhelmed and unsafe. Overthinking and feeling trapped can lead the body to react with panic mode. We might be very stressed about something, but the panic can happen at any time and might not be easy to associate it with the thing we are stressed about.

Regardless of the cause, we experience physical symptoms including racing heart, fast breathing, fluctuations in body temperature which is all part of getting us ready for action but at the same time also symptoms of feeling unsafe, trapped and helpless indicating to our system that we need to shut down.

So how can we manage this?

“Name it, to Tame it”

Professor of Psychiatry, Dan Siegal, coined the term “name it to tame it”. This refers to us being able to activate the ‘thinking’ part of the brain in order to support the ‘emotional’ part which is being highly triggered during a panic attack. If we can do this then soothing neurotransmitters are sent to the emotional brain, signalling that it is ok, and we are safe. It can be difficult to do this when we are highly stressed, which is why connection with a supportive friend can be so important.

Even if you are not sure about the trigger of a panic attack, you can still do this by talking yourself through what the panic attack actually is: “This is my body’s’ way of responding to some kind of threat which has been identified and it is trying to be protective. I am ok in this moment; I can focus on slowing my breathing down as this will help my nervous system to regain balance and help me to focus”

Slowing down your breathing

During a panic attack we are often breathing much faster and shallower breaths. This perpetuates the brain not getting enough oxygen which is when we start to shut down to conserve energy. It is important to try and slow down the breath to regain some balance in your system.


Obviously physical sensations of running are very similar to those in a panic attack! Sometimes slowing down and regulating your physical state can help but distraction can also be helpful to redirect your attention.

For example, focusing on reaching certain landmarks, taking in your surroundings and talking to yourself about what you are noticing around you, counting (anything you can see, distances or just counting to yourself), thinking about something nice you have planned to do later or what you will do when you get home.

Be compassionate!

Once you know what is happening and have talked yourself through the function of what you are experiencing, try to remember to take a stance of self-compassion rather than criticism (although the inner critic may well kick in!). Show yourself understanding and kindness and remember that we don’t always know why something happens, but it does not mean it is our fault; more the way our brains have evolved to protect us. Think about how you would be talking to a friend who was running with you having this experience and try to adopt this for yourself.

I hope these tips have been helpful. Please do share anything else which you use or have found helpful to manage and overcome panic attacks.

This article was written by Dr Joanna Astill, Principal Clinical Psychologist, Owner of Breakthrough Psychology Services and Co-owner of Stressed Out to Feeling Fabulous

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