What To Do When Panic Attacks Happen In Public

Medically reviewed by Majesty Purvis
Updated March 18, 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 also see our Get Help Now page for more immediate resources.

Around six million Americans have panic disorder, an anxiety disorder characterized by panic attacks. Panic attacks are sudden fear and extreme nervousness for ten minutes or more at a time. They are often strong feelings of being terrified at seemingly random times or after a triggering event. Panic attacks can occur at unexpected times,  regardless of where you are. There are some useful coping mechanisms and ways to make managing panic attacks in public easier.

What is panic disorder?

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Chronic or frequent panic attacks can point to a panic disorder. The main symptom of panic disorder is having frequent, uncontrollable panic attacks. 

Other symptoms could include:

  • Feelings of impending danger
  • Fear of not having control over a situation
  • An incredibly fast heart rate
  • Shaking
  • Difficulty breathing
  • Dizziness
  • Headaches
  • Chest pain

It is important to note that it is possible to experience a panic attack and not have the disorder.

Anxiety and panic attacks: What’s the difference?

The terms “panic attacks” and “anxiety attacks” are often used interchangeably. However, they are very different. While they have certain symptoms, panic attacks have more intense symptoms and are completely sudden. Whereas with anxiety disorder, anxiety levels can fluctuate in intensity, and symptoms can gradually worsen over time. Panic attacks can occur without a trigger, while anxiety is a response to a perceived stressor or threat. 

Panic disorder, according to the Anxiety and Depression Association of America, “is diagnosed in people who experience spontaneous seemingly out-of-the-blue panic attacks and are very preoccupied with the fear of a recurring attack.”

If you have panic disorder, you may sometimes feel like panic attacks are out of your control. The fear of panic attacks can make you feel like you need to be intentional about what situations you put yourself in to avoid triggering a panic attack. This fear can impact a person’s decision to go out in public to work, socialize, run errands, or participate in beloved activities.

What causes panic disorder?

The cause of panic attacks is unknown. Major stressors can play a key role in developing a panic disorder and subsequent panic attacks. Various events can put you at greater risk for panic disorder. These could be traumatic events or built-up trauma. Also, a family history related to panic attacks can increase the likelihood of developing a panic disorder. 

We do know that more women than men experience panic disorder, though it can occur in everyone. Additionally, people who have panic disorder are more likely to experience depression, misuse drugs or alcohol, and attempt to die by suicide.*

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Panic disorder should not be taken lightly. If you or a loved one has been diagnosed with panic disorder, getting help from an expert can be critical to maintaining a good quality of life. If left untreated, a person living with panic disorder may experience significant physical and mental health challenges.

*If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The 988 Suicide & Crisis Lifeline can be reached at 1-800-273-8255 and is available to assist 24/7.

What to do when panic attacks happen in public

Panic attacks often happen suddenly. They can happen without a trigger or in response to a small trigger. This means that panic attacks can happen in public places frequently. Someone with panic disorder could experience a panic attack during work meetings, in class, on dates, and even when spending time with family. Learning to cope with panic attacks can be crucial. 

Get comfortable with your surroundings

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When you feel yourself starting to have a panic attack in public, the first thing you should do is make sure you are in a safe space where you can stop for a minute and wait things out. You could try to learn to be comfortable letting people see you in a vulnerable way. If you’re scared about how people will look at you, it could just make your panic attack worse. For many people, the added fear of panicking in public can only add to the symptoms and length of a panic attack.

When you feel a panic attack coming on in public, try to take a moment to yourself to feel vulnerable and recognize that some people will probably see you during the attack. You can try to allow yourself to be okay with that vulnerability. If you get used to this, you could start to feel comfortable enough for other people to see you panic, and the fear of having a panic attack in public can dissipate. 

Taking a moment to familiarize yourself with the surroundings and allow yourself to be vulnerable could help the attack run its course more quickly. It is important to go through this without worrying about other people. Remember that people will see much worse in their lives than you experiencing a panic attack. 

Recognize when a panic attack may be coming on

It can be difficult to recognize the early signs of a panic attack. When you feel your heart racing, it can be hard to discern if it is a panic attack or if it is simply walking up the stairs. You may be observing yourself and evaluating your body all day to see if you need to prepare yourself for a panic attack. 

To try to recognize the early signs of your panic attacks. It can even be beneficial to take notes of the signs or symptoms that lead up to your past panic attacks. Journaling your heart rate, if you are sweating, your breathing rate and more can help you recognize your common symptoms. Learning to look for a pattern can give you a warning when you are about to have a panic attack in public. 

Additionally, in the middle of a panic attack, it might help to refer back to previous reflections or records to assure yourself that you endured the previous panic attack and will find your way back to a controlled nervous system. 

Remove yourself from the crowd

Sometimes, being in a crowd when you feel a panic attack coming on can make it significantly worse. You might feel like people will judge you or misunderstand what is happening. Try to find a secluded space or a tucked-away area. Crowds can be overwhelming and scary even when you are not having a panic attack. If you work at an office or go to school, it is a good idea to find your own place. Knowing exactly where to go when you feel a panic attack coming on can give you a moment of peace that will make your panic slightly less derailing.

Focus on your breathing

A common symptom of having a panic attack is labored or restricted breathing. Many people who live with panic attacks or panic disorder describe it as feeling like they are having a heart attack. They can’t breathe, and they can’t think about anything else. 

Focusing on deep breathing can help minimize the effects of a panic attack. Focusing on breathing can help to keep your mind occupied during this difficult time and can help restore your breathing to a normal pattern. Breathing and other relaxation techniques can help calm the mind during this scary time.

Let someone you trust know when you are having a panic attack

Panic attacks can happen at the most inconvenient times. Letting someone know can help remove some of the pressure. They can cover for you when at work or take notes for you in class. If you are with someone and you can feel a panic attack starting, tell them. One of the best ways to work through a panic attack before it overwhelms you is to let the person you are with know what is about to happen. 

It could be helpful to have them talk you through something else to get your mind off things. This could include asking questions about your favorite show or activity. Distraction does not cure panic attacks but can help lessen the blow and keep you somewhat composed.

Know yourself

One of the most important things when having panic attacks in public is to know yourself. Know that it’s okay to not be okay, and if other people disagree, that is okay, too. Know your triggers and how your body feels leading up to a panic attack. Recognize the signs of your feelings and feel them through completely. 

Once everything has passed, don’t try to block out what happened. When you feel comfortable enough, revisit what happened so you can learn about yourself and how to get through things better than the last time. Even though it doesn’t feel okay at the moment, the moment will pass.

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Seek help from a counselor

Getting help from a professional can help you figure out the best ways to manage your panic attacks. A counselor can explain why you have panic attacks and what the root of them may be. If seeking traditional therapy isn’t available to you, you might consider online therapy. Online therapy through platforms like BetterHelp allows you to meet with a therapist where you’re comfortable. For people with panic disorder, online therapy means that they can manage a panic disorder wherever they have internet, versus a new or unfamiliar setting in an in-person therapist’s office.

Online therapy has proven effective in treating panic disorder and its symptoms. A literature review of 14 relevant studies discovered that online cognitive behavioral therapy (CBT) resulted in a 50% improvement in symptoms of panic disorder, social anxiety disorder, depression, compulsive gambling disorder, generalized anxiety disorder, and obsessive-compulsive disorder (OCD).

Takeaway

The fear of having a panic attack in public doesn’t have to keep you from living a happy, functional, and fulfilling life. Talking to an online therapist can provide you with the tools you need to prepare yourself for a panic attack, stay calm in the moment, and maintain your dignity when your panic attack requires additional vulnerability.
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