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Outdoor First Aid

When Panic Attacks

Stay calm, have a bite to eat, and remember there's nothing to fear but fear itself.

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Walk, run, swim. Exercise, any form of it, is a stress reducer.

Expose yourself to fear. Dr. Gallo recommends what psychologists call in vivo (real-life) exposure in order to desensitize yourself. Create a hierarchy of fear situations, ranking them from relatively harmless to the most awful thing you can imagine. If you’re like Brevik and heights make you break out in a body-soaking sweat, list climbing a stepladder first and taking a mountaineering class last. Rate your scenarios on a 1 to 100 scale, with 1 being the easiest. Then expose yourself to those real-life situations, understanding your body’s response and acclimating to it. Take your time. You don’t need to jump into the deep end of fear right away.

Avoid comparisons. Don’t worry about what anyone else thinks. Your friends may be able to hike a trail or scale a wall that makes you cringe, but for all you know, they could be terrified of the dark.

What if you’re three days into a five-day hike and are suddenly confronted with a panic-inducing scenario? In addition to applying the nutritional and relaxation advice outlined above, try these strategies recommended by

Dr. Gallo:

Check your head and stomach. Hungry? Tired? Suffering altitude sickness? “A hiker pushing too hard can misconstrue these responses as panic or anxiety,” he says. Maybe it’s time for a lunch break. If you’re cold and tired, backtrack to a spot where you can set up the tent and take a quick nap, then attack the tricky spot when you’re rested and well-fed.

Talk yourself out of it. “Fear often turns our thoughts to the catastrophic, and we must turn them back,”

Dr. Gallo says. Repeat positive phrases to yourself as the attack peaks, plateaus, and dissipates. It’s called cognitive restructuring, and it helps replace irrational fear with a rational, composed frame of mind.

Stay put until you’re calm. Moving forward could amplify the fear; immediately running away from the situation won’t prove the fear is unfounded. Once the initial panic attack has passed, you can decide-rationally and calmly-whether to go forward or change your plans.

Let your partner help. Tell him up front about your situation, so he’ll be ready to help talk you through it, encourage you, get you used to your surroundings, whatever you need. Partners can also help recognize when you’re ready to move on after the attack passes. A good partner is one who’s not pushy, won’t make fun of you, and is sympathetic even though he can’t relate to irrational panic.

“I felt stupid,” Brevik says of panicking in front of her hiking partner. “I asked if she had any fears because I wanted her to understand mine.”

Her partner, Backpacker Senior Editor Michele Morris, says she quickly learned what it means to confront intense panic, and gained newfound respect for those who suffer from attacks. “Randi thinks people who don’t think twice about tackling risky trails are brave. But Randi, and others like her, know they could face a panic-inducing situation around any corner, yet they still get out there and do things. They’re the ones with real courage, because they refuse to let fear get the best of them.”

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