It’s All in Your Head; Noticing and Managing a Panic Attack

Adam Bertram
5 min readJul 1, 2019


I’ve struggled with the occasional panic attack for many years now. Four glorious years had went by until I had my last one at the MVP Summit a couple of weeks ago. Since then, I’ve had two; that’s just the way these things go.

It was during a normal conference morning a few weeks ago. I had a few too many beers the night before, was a little hungover but no big deal really. I managed to get down to breakfast in time, had my bacon, eggs and too-fancy conference with a couple of cups of coffee while I chatted with a few friends. I wasn’t feeling great but didn’t feel terrible either…until the bus ride.

Imagine a typical hotel → conference bus; packed with people just chatting away about the conference experience so far; normally a good vibe until you feel it coming. Once on the bus, the “feeling” emanates from the chest as it normally does as my hearts starts to race and spreads down to my extremities making them all tingly. Once the tingly sensation spreads the cold sweats start to creep up. Before you know it, you’re freezing but sweating like it’s 110 degrees. This is when you know you’ve been gripped with a full-on panic attack. I hadn’t felt one of these for many years but if you’ve ever had one you will never forget.

Once at this point, the first priority is removing all noise and getting into an open space. Panic attacks generally are the onset of claustrophobia for me as well. Now, imagine the scene; on a jam-packed bus with people I don’t know too well, in a city that I don’t know very well with everyone talking at the same time. It’s a recipe for disaster and I was in it. If that wasn’t enough, the bus was stuck in traffic but only makes things 10x worse. “Just get me OFF of this damn bus NOW!”

I began to consider stopping the bus driver and telling him I needed to get out on the freeway but a little bit of common sense still remained. I was plotting my escape from various angles. Can I escape through the window? If I walked up to the bus driver, would he be understanding and just stop ASAP? I don’t know. At this point, it was a battle to fight back every urge I had to get off of this bus ASAP and to remain calm and just ride it out until I got to the conference.

My conversation with my neighbor turned silent many minutes ago as I politely told him what was happening. “Stay calm. Breathe in through the nose and out of the mouth.”, I kept saying to myself over and over again. This helps a little but once at this stage, I’m simply managing it; not reducing its strength.

Luckily, I didn’t jump from the bus like a crazy person and made it to the conference. However, once the panic attack starts and subsides a little the damage is done. You are now well aware that your brain is capable of producing such a monstrous event you are scared shitless of it happening again. This lasted throughout the rest of the day where I was walking on pins and needles cautiously pretending like it never happened but it was always with me.

This, my friends, is a typical panic attack. It’s a traumatic, dreadful experience that you will do anything to make it stop. Simply writing this blog post brings forth those initial feelings of one coming on. However, at this point, I’m able to control the urges to just go insane to some point.

If you’ve ever had an experience like this or — heaven help you — you have a future time like this here’s a few things I’ve found that trigger panic attacks.


This is the second time I’ve had a panic attack after I’ve been hungover. They always seem to come when I feel terrible. Perhaps my brain is at its weakest. Who knows.


During a panic attack, your heart starts racing like crazy. If it’s already racing by caffeine thinks aren’t going to go down too well.

Unfamiliar surroundings

I work from home. I’m always at home. Home is my safe haven. This time I was in Seattle with people I consider friends but not people who I’ve known for years and years. If I don’t feel like I have a grasp on what’s going on 100%, it always makes things so much worse.

No control

I was on a bus. I had no control over where it went and when. Panic attacks are about losing control. If you’re in a situation where you don’t have control to do whatever you need to do it’s bad. You could be on a freeway driving with an exit only miles ahead, away from a bathroom where you’ve gotta go or in a space that you can’t get out NOW for some reason.

Confined spaces

I have moderate claustrophobia and the feeling is similar to that. If you’re in a confined space, a panic attack is much more likely to happen.

Previous panic attacks

I had gone 4 years without a panic attack. I don’t know why my brain just decided to freak itself out that day but I’ve felt “panicky” on numerous occasions since then. Once you have one you never want to have another. However, the experience is so traumatic that you can’t help to think about them. This ends up rolling around in your head and makes me more prone to have them. Once more time subsides and you don’t experience one the inclinations slowly fade.

Once you’re in the throes of a panic attack here are a few tips to manage it.

  1. Xanax. I know. It’s a pill and there are ways to manage panic attacks without pills but Xanax is by far and away from the best method for managing a panic attack. They help so much.
  2. Having a Xanax available. It sounds stupid but just the mere thought of knowing that Xanax will get rid of a panic attack and that I have one available greatly prevents them.
  3. Deep breaths; breathe through your diaphragm, completely fill up your lungs, hesitate for a few seconds when your lungs are full then slowly exhale through your mouth. Repeat.
  4. Go to your happy place. It may sound cheesy but I try to experience myself in a comfortable situation. It helps if I can focus on that thought.
  5. Attempt to distract your brain. Sometimes I try to have conversations with people that take my mind off of it, for example. Sometimes it works. Sometimes it doesn’t. I also physically hurt myself through pinching my arm or leg to make the physical pain override the mental pain I’m in. Physical pain is better than any day!
  6. Get mad. A panic attack is all about losing control. Your mind is taking over making up situations that are not dangerous but aren’t. It’s ridiculous. Notice that ludicrous nature of what you’re going through and get pissed. Get mad at yourself for going through this. This doesn’t help your social standing to those around you but it really does help me get through it.



Adam Bertram

A 20-year veteran of IT, crypto geek, content creator, consultant and overall problem solver.