Panic attacks are sudden surges of intense fear that typically peak within minutes. They are often described as among the most unpleasant experiences in existence. Symptoms can be intensely physical and include a rapid heart rate, sweating, shaking, shortness of breath or a choking sensation, chest pain, nausea, feeling dizzy or faint, chills or feeling overheated, numbness or tingling, a sense of being detached from oneself or reality, and a fear of going crazy or dying. These symptoms are related to the body launching into the fight, flight, or freeze response, even when no real danger is present. While panic attacks can feel catastrophic and like you are losing control, the truth is that they are uncomfortable, not dangerous, and are temporary, typically lasting from one to thirty minutes.
Help is available for managing panic attacks. While it may feel like you cannot control panic attacks, overcoming them is achievable with practice and persistence.
Seeking Professional Panic attack Help
Consulting an experienced professional is a direct route to getting help. Therapists spend their days helping people resolve emotional and mental distress and have experience in identifying causes and solutions, offering understanding and experience. If basic ideas do not seem to be working, professional help can be the best course.
It is often recommended to consult a medical professional first to rule out other ailments that can mimic panic attack symptoms, such as heart attacks, stroke, or hyperthyroidism. If medical doctors provide a clean bill of health, the focus should then shift to managing the anxiety or panic.
Therapeutic approaches can help. For instance, body-based therapies like Somatic Experiencing or sensorimotor psychotherapy can help address the physical aspects of the panic response. Emotion-focused therapy explores emotional functioning and treats emotions as aspects of motivation and intelligence. Professionals can also support and guide you through understanding the roots of your difficulties and healing.
Self-Help Strategies for Panic Attacks
There are many things you can do to help yourself manage and overcome panic attacks.
- Understanding Panic: Gaining credible knowledge about the panic and anxiety response is a crucial first step. Understanding that a panic attack is an exaggeration of a normal bodily reaction to stress and will not harm you is important. Recognising that symptoms are often related to the body’s preparation for an emergency can make them less troubling. Being aware of symptoms and their cycle allows you to approach treatment from knowledge rather than fear and helps gauge which attempts at reduction work. The maximum panic response duration is about ten minutes, and understanding this can counter the fear that attacks will last for days.
- Facing Your Fear and Not Avoiding: One of the most important strategies is resisting the urge to flee the situation when panicky. Escaping might feel better in the short term, but it reinforces the power of panic attacks, making them harder to overcome. Trying to avoid the experience of panic attacks is a high risk for developing panic disorder. The struggle to minimise or prevent anxiety and fear takes energy and time away from valued life activities. Learning to experience fear and uncertainty by doing the things you fear is necessary. This approach, sometimes called exposure, helps you learn that the situation is safe and that you can cope with the symptoms. During exposure, it is usually preferable to attempt facing the fear without using safety behaviours, which are actions or rules that reduce panic sensations but interfere with learning that the fear is unfounded. Facing feared symptoms or situations allows for experiential learning that your brain needs.
- Breathing Practices: Controlling your breath can help you calm down and reduce symptoms. Deep, comfortable breathing can relax your body. Breathing deeply can help calm the body and decrease activation in the amygdala. However, trying to breathe your way through or out of a panic attack may not help or could even increase symptoms, potentially leading to hyperventilation. Hyperventilation (breathing too quickly) can cause symptoms like dizziness, tingling, or fainting. Taking deep breaths by opening your mouth can increase panic symptoms and lead to hyperventilation. When hyperventilating during a panic attack, closing your mouth so you do not breathe through it is recommended. Some advise simply letting your body restore itself without intentional interference during a panic attack. Proper breathing techniques, like slow, deep breaths mostly with your belly, inhaling for 5 seconds, holding for 2, exhaling for 5, and holding for 2, can be effective. Practising proper breathing regularly when not in a panic will help make it the default state when you need it. Breathing techniques are tools to maintain a state of non-reaction, not shields to prevent or stop panic attacks.
- Challenging Your Thoughts: Identifying and questioning your thoughts and beliefs is crucial. Panic attacks are often caused by the thoughts and feelings associated with a situation, and the beliefs and assumptions you carry about yourself. Questioning thoughts involves asking what is causing the anxiety, if it’s a false alarm, or what is the worst that can happen. Identifying self-defeating and frightening thoughts and countering them can help. Tracking your thoughts, associating them with situations, and comparing the physical sensations they cause can help you understand unhelpful thought patterns. Recognising and disputing negative beliefs fuels panic. Changing the way you think and respond to situations can help you feel calmer and more in control. Instead of asking “why” there is a problem during a moment of anxiety, focus on “how” to create a solution. It is important to adjust your thinking; remind yourself panic is uncomfortable, not dangerous, and temporary.
- Shifting Your Focus: Focusing on what you choose to think about matters significantly. Training your attention on symptoms and how you feel will not help. When starting to panic, keep the focus outward. Describe your surroundings neutrally and focus on what you need or want to be doing, not evaluating how well those things are going. Being genuinely engaged in your life versus anxious thinking is a goal. Focusing all energy on panic is likely to make you feel worse. Try listing positive or neutral experiences you are having right now to feel better. Learning to focus productively is vital; when anxious, your mind may race with obsessive or irrational thoughts. When in a panic, catastrophic thoughts suggesting danger and the need to escape are common and can fuel panic. Observing rather than reacting to anxiety and just noticing what is going on inside without trying to change the experience can be helpful.
- Acceptance and Self-Compassion: A posture of acceptance and non-avoidance is a key preventative mechanism. The fight to control one’s own experiences is a battle that paradoxically cannot be won. Instead of fighting or running from fear, try to be fully present with it. Being told to “accept” anxiety can be frustrating without explanation of why or how. Mindfulness concepts like awareness, acceptance, and self-compassion can be a lifeline during a panic attack. Acceptance involves being present and living fully, even when anxiety and panic appear. Self-compassion helps quiet racing thoughts. It involves letting go of embarrassment and shame, which can worsen symptoms, by reminding yourself that you are simply experiencing a panic attack, which is a normal response of the fight-or-flight system going haywire, not a sign of weakness. Validating your feelings by acknowledging them and understanding why you feel as you do is important.
- Lifestyle and Relaxation: Avoiding stimulants such as caffeine, alcohol, smoking, energy drinks, and certain medications can help, as they can increase risks if you are sensitive to panic attacks. Regular relaxation practices help the body exercise calming responses. These can include meditation, yoga, and muscle relaxation. Practising relaxation exercises regularly helps reduce overall stress. Ensuring you are getting enough sleep can help reduce emotional arousal levels. Exercise is also mentioned as a way to calm down during a panic attack. Taking care of yourself physically involves eating well and not being sedentary.
- Tracking and Reflection: Keeping track of your panic attacks using tools like worksheets can help you identify triggers, observe sensations and emotional reactions, and understand your thought patterns. Reflecting on your experience after an attack can help increase awareness of bodily sensations and the connection between physical responses and thoughts. Tracking coping strategies can help you distinguish helpful ones from those that are not. After an attack, focus on anything you felt you did okay or well, training yourself to focus on positive steps rather than disappointment.
Remember that panic attacks are temporary. The discomfort will pass without your interference. Even without any help from us, the maximum panic response duration is about ten minutes. You are not in danger, and the panic is not actually causing you any harm.
Summary: Help for panic attacks involves understanding their nature as temporary, non-dangerous physical reactions. Professional guidance can be beneficial, especially after ruling out physical causes. Self-help strategies include facing feared situations or symptoms directly without avoidance, employing specific breathing techniques for calm (though not as a way to stop an attack), actively challenging unhelpful thoughts and beliefs, shifting focus away from internal sensations and catastrophic thinking, cultivating acceptance and self-compassion, adopting healthy lifestyle habits like avoiding stimulants and practising relaxation, and using tools like journaling or worksheets to track experiences and identify patterns. The core is often learning not to react with fear or avoidance to the sensations and thoughts associated with panic.