Panic attacks can feel scary. When people experience panic attacks, they may feel they are experiencing a medical emergency or that their lives are in danger. A panic attack can cause distressing physical sensations like shakiness, hyperventilation, ringing in the ears, numbing or tingling in the arms and legs, and chest pain, among other symptoms.
What Is A Panic Attack?
It can be helpful for a person who experiences panic attacks to understand what they are and why they can occur. Panic attacks can be a stress response to feeling under pressure, overwhelmed, or afraid. A traumatic event, loss, or perceived threat might also trigger them. Often, during a panic attack, the fight-flight-freeze response can be activated, causing an individual to feel the need to run, fight, or freeze.
Those experiencing panic attacks may also live with one of several anxiety disorders, including generalized anxiety disorder, social anxiety disorder, and panic disorder. Panic disorder in particular is characterized by frequent or chronic panic attacks.
Common symptoms of a panic attack include:
- An intense feeling of dread, fear, or anxiety
- Trembling or shaking
- Chest pain
- Shortness of breath or difficulty breathing
- Chills or hot flushes
- A feeling of choking or a “lump” in the throat
- Muscle tension
- Gastrointestinal issues, such as diarrhea
- An urge to run, fight, or stay frozen
- Feeling “out of your body” or dissociated
Panic attacks can feel like a real threat and may be terrifying for those experiencing them. It's also possible to mistake them for other health conditions, like a heart attack. Understanding how to reduce fear can be beneficial in knowing the difference between a panic attack and a medical emergency.
How To Cope With Panic Attacks
Panic attacks can feel challenging to live with. It is possible to experience stress just by thinking about future panic attacks. You might not always know what triggers your attacks or feel out of control when they occur. At times, panic may be triggered by daily life events, relationships, or situations.
When you have a panic attack, your body and mind may feel overwhelmed, and it could cause you to have difficulty interacting with or noticing your immediate environment. When the fear and stress response of a panic attack takes over, it can be difficult to regain control over your mind and body. However, there are exercises that you can learn to help you minimize and even stop a panic attack in some cases. These exercises include the following:
Reset Your Nervous System
Recent studies on panic attacks and the nervous system found that immediate exposure to cold water or temperatures can stop panic attacks. One study found that swimming in cold water stopped panic symptoms in specific individuals. A dialectical behavior therapy (DBT) skill called the TIP skill also addresses this fact. The DBT workbook expresses that putting your face in a bowl of cold water or holding an ice pack against your face (safely) can help you calm down from emotional dysregulation. To practice the TIP skill for emotional distress regulation, consider the following steps:
- T: Change your body’s temperature
- I: Practice intense exercise
- P: Practice paced breathing and paired muscle relaxation techniques
Consider talking to a licensed counselor if you need support practicing the TIP skill. Many counselors are trained in DBT skills.
Focus On Your Breathing
Hyperventilation can be an unpleasant and unsettling symptom of panic attacks. When you are experiencing a panic attack, your breathing may become shallow. This shallow breathing could deprive your body of oxygen, which may make your other symptoms worse.
People might tell those who are panicking just to take a deep breath. However, it could be challenging and overwhelming to focus on deep breathing when you are hyperventilating, at least without assistance. Instead, it may be beneficial to use an app that provides guided deep breathing exercises. Breathing apps often have calming screens and soothing music; once downloaded, they can show you how to practice breathing exercises, including when to breathe in and out. These apps have the capability to help you manage panic attacks, though you may have to try a few before finding the right one for you.
You can also try a box breathing exercise by trying the following steps:
- Breathe in for five seconds.
- Hold your breath for four seconds.
- Breathe out for five seconds.
- Hold your breath for four seconds.
As you start to feel calmer, you may switch to normal breathing. Breathe through your nose and out through your mouth and focus on the sensation.
Consider The Facts
Panic attacks can feel like medical emergencies to many. When having a panic attack, focus on the facts of the situation to determine the risk. Symptoms of a cardiac event may last longer than 30 minutes, while panic attacks may last for less. If you’re unsure, there may be a 24-hour nurse response line in your area that you can talk to. They may take a list of your symptoms and advise you whether to visit your emergency room or not.
Ask yourself the following questions:
- Have I experienced these symptoms before?
- If I have experienced these symptoms before, were they due to a panic attack?
- Do I have a fever or a low oxygen level?
- Were there any triggers that may have caused me to feel this way?
- Do I have someone I can reach out to?
If you have a friend or family you trust, tell them what you’re experiencing. They may stay with you until the panic subsides and offer comfort. If you’re not having an attack but feel like you might, they can be there with you to provide a calming presence. This may be able to help prevent panic attacks from developing further (though not in all cases.)
While panicking, although you could feel you are dying, panic attacks do not often cause death. However, if you are unsure about your physical health after evaluating your situation, doctors recommend going to an urgent care or emergency room for evaluation. As panic attacks can have similar symptoms to a cardiac event or emergency, getting a doctor’s opinion may be beneficial.
During a panic attack, you may experience tunnel vision and difficulty focusing on anything outside of the sensations or emotions you’re feeling. In addition to the above-listed suggestions, grounding can be a highly effective tool for panic. Grounding can mean focusing on the present, feeling “inside” your body, and reducing dissociation, which is commonly reported with panic attacks.
When you feel panicked, remind yourself to focus inward. First, ask yourself:
- What do I hear?
- What do I see in front of me?
- How does the surface I’m sitting, standing, or lying on feel?
- Are there any non-distressing smells?
You can use a skill like self-soothing from DBT to activate your five senses after reaching a point where you can move your body. To do so, find an activity you can do for each of your senses. For example, for touch, you might wear comfortable pajamas and snuggle with a pet. For sight, you might watch a movie. For taste, you might eat a small snack.
If you struggle to practice grounding in the moment of a panic attack, consider having a reminder on your wall that you can easily see or ask someone you care about to help you get started. If you have a therapist, you may be able to reach out to them for advice.
Seek Help Through Therapy
If you have frequent panic attacks, consider seeking mental health care. Panic attacks can be the result of stress, trauma, and anxiety. With counseling, you may work with your therapist to understand the core issues and triggers for panic attacks. You may also learn new ways to strengthen your coping strategies to help you calm down sooner and more effectively from a panic attack.
If you have difficulty finding a therapist in your area or struggle to manage anxiety in public, you might also benefit from online therapy. With this treatment, you can reach out to your therapist through phone, video chat, or live chat sessions. You may also find that online counseling is more cost-effective than in-person modalities. Studies have shown that online cognitive-behavioral therapy effectively treats the emotional and physical symptoms of panic and anxiety. Other studies on depression treatment found that online therapy can also be more effective than in-person therapy.
If you’re interested in communicating with a counselor online to receive support for panic attacks or treat anxiety, consider a platform like BetterHelp, which offers a match-based system and availability to over 30,000 therapists.
Panic attacks can be scary and uncomfortable. They can make you feel powerless. However, with support and research-backed coping mechanisms, you may find methods of managing your physical and emotional symptoms.
With the assistance of a counselor, you can learn more about what causes your panic attacks and find ways to reduce anxiety. If you hope to receive medical advice, reach out to your primary care physician or psychiatrist. Medications in the benzodiazepine drug class and antidepressants like selective serotonin reuptake inhibitors (SSRIs) are also sometimes available for panic attacks.If you are in crisis, do not use this site. If you are experiencing thoughts or urges of suicide, call the 988 Suicide & Crisis Lifeline at 988. They are available 24/7 to offer support.
Frequently Asked Questions
For examples of questions that might be beneficial to explore in therapy, please see below.
How long does a panic attack last?
What triggers panic attacks?
What are things to do for panic attacks?
What are types of panic attacks?
Do panic attacks happen for no reason?
How do I know if I have a panic attack?
What are panic vs anxiety attacks?
Do you cry with panic attacks?
How do I stop panic attacks?
Can you pass out from a panic attack?
What happens during a panic attack?
What works fast for panic attacks?
What is a good home remedy for panic attacks?
Is it normal to have panic attacks every day?
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