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Family Medicine

Don't Panic! But You're Having a Panic Attack

Fear not, for there is no danger with panic attacks — if you know the symptoms and steps to stop them.

woman looking overwhelmed with people around her

It strikes without warning. A sudden sense of terror. You feel like you’ve totally lost control. Something terrible is happening, and you’re going to die.

It’s a panic attack, and it’s terrifying. Literally. A feeling of terror is one of the most common symptoms, along with a sense of impending doom or death.

It doesn’t matter where or when it happens. The fear is real. You could be sound asleep or enjoying a nice walk outside. The terror takes over, paralyzing you and causing a scary set of mental and physical symptoms.

Yikes. What is happening in a panic attack?

For starters, you’re not dying. And you’re not going crazy.

Nothing is as bad as it seems. And it can seem, and feel, pretty bad. Panic attacks are often confused with heart attacks or strokes. They share many of the same symptoms:

  • Racing heart
  • Chest pains or tightness
  • Trouble breathing
  • Tingling or numbness in your hands and fingers
  • Dizziness or lightheadedness
  • Heavy sweating
  • Getting the chills

That’s a scary list. Who can blame you for fearing the worst? But the fear and terror you feel are misplaced. Your feelings don’t reflect what’s actually happening around you and are actually causing your brain and body to react in those ways.

What’s actually happening to you is unclear. It could be purely genetic. Or the result of major stress triggering your fight-or-flight response. You could just be more sensitive to stress and negative emotions. Your first panic attack can occur without a trigger, but it can also create one. The places, things, feelings or people you associate with your panic attack can trigger future episodes.

I think I’m having a panic attack! What should I do?

Go to the emergency room.

There’s no time to second-guess yourself. If you’ve never had a panic attack before and you experience the symptoms, get medical help right away. It could very well be a heart attack, stroke or other health issue that can do lasting damage. The emergency medical professionals can rule out more serious problems and let you know if it’s “just” a panic attack. They’ll calm you down and maybe give you medication to help relax.

But if you’ve had one panic attack, you’re more likely to have another. At that point, you know what it feels like. Despite the feelings of doom, you should recognize the panic attack when it hits and take steps to stop it.

How to Stop a Panic Attack

Panic attacks are overwhelming and paralyzing. It can be hard to overcome that and actively take measures to stop the attack. But if you’ve been through it before, you should be prepared for the next one. Try these techniques if you feel a panic attack coming on:

  1. Remind yourself what’s happening. You’ve been through this before. It’s scary, but it’s temporary. There’s no real danger. By recognizing what’s going on, you can take away the symptom that fuels it all: terror.
  2. Breathe. Hyperventilating and difficulty breathing adds to the fear you’re already experiencing. Breathe deeply and slowly. Fill your lungs with air, hold your breath for a few seconds, then exhale. Keep it going until your breathing returns to normal.
  3. Go to your happy place. Something in your environment may have triggered the panic attack. Close your eyes and practice mindfulness to remove yourself from the situation. Think about somewhere or something that brings you joy and focus on that. This helps you block out any potential triggers and concentrate on your breathing.
  4. Act normal. It’s easier said than done. But the quicker you convince your brain that there’s no danger, the quicker the fear and other symptoms fade. Get back to doing whatever it was you were doing when the panic attack started.

It’s over...what happens now?

Relax. Then get help.

Panic attacks are short — typically 10 minutes or less. But they can last much longer. Coming down from the attack can take hours.

A few minutes or a few hours, panic attacks are draining. Your body was just in overdrive responding to this false fight-or-flight situation. It can take a while for your heart rate to slow down. You may experience fatigue, confusion or issues concentrating. Try some relaxation techniques to calm down or light exercise to improve your mood with a flood of endorphins.

Fear is the fuel of panic attacks. And it can affect you long after the attack is over. The whole experience can make you worry about another panic attack or make you avoid things you think may have caused it in the first place. You end up living in a constant state of fear of future attacks.

Regular exercise can help keep these anxieties in check. But you should inform your healthcare provider of your panic attack and your lingering fears. They can help you overcome these fears — through therapy, medication or other treatments — to keep panic attacks from getting worse or more frequent.