Handling a fear of passing out

Okay so just a quick side note for anyone that is worried about riding out a panic attack with a fear of passing out / fainting / becoming unconscious.  First of all, it is extremely extremely unlikely that someone would lose consciousness during a panic attack.  Why?  As you are now aware, a panic attack is your body going into fight-or-flight mode and this involves, among everything else that is explained below, an increase in your blood pressure to deliver oxygen to your muscles so you are ready to fight or run.  Fainting, or passing out, involves low blood pressure - your brain doesn't have enough oxygen and since it is all the way up there at the top of your head, the easiest thing for it to do is cause you to lose consciousness, thus ending up on the ground where your blood doesn't have to fight against all of that gravity to deliver oxygen to your brain (again, a defense mechanism, this isn't going to harm your body at all).  So anyway with your high blood pressure during the attack it is HIGHLY unlikely that you will ever pass out.  I know it feels like you might, trust me!!!  But it just won't happen.  You might feel lightheaded, yes, and that is probably due to you hyperventilating without realizing it which is why the breathing exercises are so important.  And you don't have to breathe in super super deep - just a natural, slow pace like in....1....2....3....out...1...2...3.  Focus on filling your lungs with oxygen and then emptying them completely.  It is also easier while sitting or lying down because that way you will breathe with your diaphragm (lower chest) instead of your upper chest, which helps even more.  

The one thing I have noticed with my panic attacks is that since you feel like you aren't getting enough air (sometimes called "air hunger"), you tend to do a lot of inhaling but then sort of forget about the exhaling, or don't exhale completely.  The exhale is really important and I can get into all of the details about blood oxygenation levels if necessary but just trust me that you want to inhale completely and also exhale completely - focus on your exhale during the attack if you realize that it is a problem for you as well.  You don't want to be taking huge breathes and then not exhaling because this might lead you to feel more lightheaded or dizzy (which isn't dangerous so don't worry but it is just unnecessarily uncomfortable).  Okay good luck!!!!  Email me if you need help or advice!