A Practical Guide For Getting Through Panic Attacks

Medically reviewed by Majesty Purvis, LCMHC
Updated June 5, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.

Panic attacks are brief episodes of severe anxiety accompanied by physical symptoms like sweating, shakiness, chest pain, shortness of breath, or tingling sensations. These attacks can occur independently for no apparent cause, due to an inciting event, or as a symptom of a mental health condition like panic disorder

If you're experiencing panic attacks or want to know what to do if you ever have one, there are a few ways you can manage anxiety, control your nervous system, and regain control of your body. 

This article explores what panic disorder is, how you can stop a panic attack, and mental health tips to manage anxiety disorders. You're not alone, and it can be possible to find relief from these attacks, including while they occur.

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Address panic attacks in a safe and non-judgmental environment

Panic disorder: Physical symptoms of a panic attack

Panic attack symptoms are generally categorized under panic disorder, a type of anxiety disorder. While the physical and emotional symptoms can vary for each person, panic attacks tend to present similar sensations for many people. 

Below are common symptoms of anxiety and panic attacks: 

  • Rapid breathing 

  • Dry mouth

  • Sweating

  • Agitation or irritability

  • Chills or hot flashes

  • Feeling dizzy, lightheaded, or tight in the head

  • Shaking or trembling

  • Heart palpitations (skipping a beat) 

  • Increased heart rate or pounding in the chest 

  • Tightness, pain, or discomfort in the chest that may be mistaken for a heart attack

  • Feeling short of breath

  • A lump in the throat or a choking sensation

  • Nausea (or vomiting)

  • Numbness or tingling

  • Feeling frozen or unable to talk

  • Racing thoughts

  • Difficulty concentrating

  • Depersonalization or derealization (feelings of unreality and detachment)

  • Fear of losing control 

  • Fear of dying

  • Fear of other people seeing your panic attack in public 

Many people report that their panic attacks don't seem to have a cause or specific trigger. Others, however, can identify their anxiety symptoms or potential triggers ahead of time (e.g., negative thought patterns about fears of interacting with certain people). 

Regardless of whether there is an identifiable cause, many people report that panic attacks feel like they’re on the verge of having a medical emergency like a heart attack. Others may attach a spiritual meaning to the experience. 

When someone experiences a panic attack in a particular place, like a train station or grocery store, they may avoid going there again to prevent more panic attacks. The repeated decision to avoid places where one has had a panic attack may develop into agoraphobia

What causes panic attacks? 

The source of a panic attack can vary. In some cases, they may occur due to a traumatic event, chronic stress, or panic disorder. However, there might not be a source for every person. 

A systematic review from 2019 indicated that individuals who experience strong responses to stress may be at a higher risk of having panic attacks.

When stress occurs in the body, it can activate the "fight or flight" response of the sympathetic nervous system. The body releases stress-related chemicals that can cause an increased heart rate, increased blood pressure, flushed skin, a blunted pain response, dilated pupils, and loss of bowel and bladder control. The parasympathetic nervous system returns the body to its original state. If it does not respond appropriately, the aroused "fight or flight" feeling lasts, potentially extending a panic attack.

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How to get through a panic attack alone

Through years of research, mental health professionals have learned how to treat panic attacks. Panic attacks are highly treatable and not life-threatening. 

By understanding this fact, you may be able to reduce feelings of panic when you feel them arising. 

However, in the short term, you can use a few strategies designed to reduce stress to begin to calm yourself. After identifying which coping strategies and treatments work for you, you can learn how to potentially prevent these episodes from occurring.

Recognize you are having a panic attack 

To control a panic attack, it may be beneficial to acknowledge that you are having one. Notice the sensations you feel and recognize that they are signs of a panic attack. If you have had a panic attack before, you can remind yourself of previous times you had a panic attack and thought it might be something else.

If you're having trouble breathing or feeling unreal, tell yourself internally or externally that you're experiencing a panic attack and that it will pass. You might try some breathing exercises and breathe slowly to calm your sympathetic nervous system and help it recognize that you’re not in any real danger. This may be enough to begin to reduce tension and anxiety symptoms so your panic attack is more manageable. 

Remember that a panic attack is not life-threatening on its own. Panic attacks often pass quickly, and your nervous system may return to baseline. Repeat these facts as affirmations to de-escalate the intensity of your panic.

Drink water

Once you recognize you're having a panic attack, have a few sips of water. Drinking water relieves dry mouth and can help support your body's return to homeostasis by stimulating your parasympathetic nervous system. Additionally, putting cool or chilly foods or drinks in your mouth may ground you in the present moment.

Take deep, slow breaths

Many guides that explain how to treat a panic attack include a section on deep breathing. While deep breathing can help some people immediately, it can increase anxiety for others. If you are well-practiced in deep breathing, using that skill may remedy panic attacks. However, it may not be the immediate solution for you if you do not have much experience with breathing exercises before experiencing your panic attack. Without guidance, you may hyperventilate.

Many tools can help you with deep breathing. If you're a visual learner, you could watch visual deep breathing guides. If you prefer to be guided by someone auditorily, many guided breathing exercises are available for free through music apps, video streaming sites, and other online locations. 

Get moving

Moving your body may also help you reduce panic, as panic attacks sometimes cause people to "freeze" in place. Try some light exercise and throw your sneakers on for a few laps around your kitchen, doing jumping jacks, or dancing to your favorite music. Aerobic exercise can be beneficial to building resilience in the long term, but it has short-term benefits, too. Exercise can release pent-up physical energy, as it works alongside the adrenaline rush your body experiences during a panic attack.

Ground yourself

When experiencing a panic attack, you might experience dissociation (feeling unreal or detached from your body). Even if you are not experiencing depersonalization or derealization, grounding exercises may help you feel present and in control of your thoughts and bodily sensations. Below are a few potential grounding techniques: 

  • Drinking cold water

  • Deep breathing exercises

  • Exercise

  • Walking outside barefoot

  • Smelling a strong scent like vanilla extract, or an essential oil

  • Receiving physical touch like a hug or back rub

  • Observing and stating out loud the names of five different items in your environment

  • Picking a color and naming every item of that color in the room

  • Holding an ice cube

  • Putting your face in cold water to "reset" your nervous system 

  • Swimming or taking a shower in cold water

  • Listening to a guided progressive muscle relaxation technique video to relax your whole body

  • Practicing cognitive behavioral therapy techniques alone, with a therapist, or between therapy sessions

Many of these techniques can be practiced quickly from anywhere. For example, when you’ve learned progressive muscle relaxation techniques, you can run yourself through them in less than a minute if you feel you need them. 

Return to your routine 

After grounding yourself, try to return to whatever task you were doing before the panic attack occurred. If you can't focus on your routine, focus on another task. Refocusing your thoughts on an external activity may prevent you from ruminating on the discomfort you have experienced. However, if you are exhausted after the attack, you might also try taking a nap to replenish your energy. 

Connect with others after the fact

It might also be helpful to talk to a trusted friend or loved one to let them know what happened if they were not present for the attack. Connecting with other people could help you feel present after a panic attack. They may also offer validation and support to help you return to regular activities. 

Eat a snack

Try to have a snack during or after your panic attack. You can replenish your energy with a tasty and nutritious treat. In addition, experiencing the sensation of taste could be a form of mindfulness or grounding. If you struggle to gain the energy to cook, go for a walk, shop, clean, or order food (if you can afford to).

Can medications help with panic attacks?

Some healthcare professionals may prescribe medications to reduce anxiety symptoms. For example, you may be prescribed benzodiazepines for short-term management. 

Always discuss the potential side effects of a medication your doctor prescribes. The benzodiazepine drug class carries a boxed warning because of the risk of addiction* and withdrawal when you stop using them. 

*If you believe you or a loved one is experiencing or at risk of addiction or substance use disorder, reach out for help immediately. The SAMHSA National Helpline can be reached at 1-800-662-4357 and is available 24/7.

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Address panic attacks in a safe and non-judgmental environment

Counseling and professional support for long-term panic attack prevention 

Seeking professional help may offer you the tools to cope with panic attacks and prevent future episodes. Through therapeutic methods, you may build coping skills and resilience. Your therapist can teach you how to decrease catastrophizing thoughts and help you determine whether you are holding onto thoughts based on specific fears or phobias. As you work through these symptoms, you may also learn to restructure your thought patterns and sit through the discomfort of anxiety until it passes.

In addition, if you're living with a mental health condition like panic disorder or post-traumatic stress disorder (PTSD), these conditions may contribute to panic attacks. You can work through a treatment plan for symptoms with your therapist. If you're living with panic disorder, online therapy through a platform like BetterHelp may make it easier to get help without leaving home. With online therapy, you meet with your therapist from the comfort of your home, or anywhere you have an internet connection. 

Research shows that online treatment can be effective in treating panic disorder. One review reported that internet-based modalities were as effective at relieving symptoms as in-person therapy, and another review showed they could reduce symptoms by as much as 50%. When you sign up for an online platform, you can take a questionnaire about your symptoms and get matched with someone specializing in your condition or therapeutic goals. 

Takeaway

Panic attacks are more than situational fear. They can negatively affect a person’s life by impeding their daily routine or prevent them from trying new experiences. If you experience panic attacks and want to learn how to cope with them or lessen their frequency, consider contacting a therapist for personalized guidance and support.
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