How to Manage Panic Attacks

If you’ve ever experienced the sudden, overwhelming terror of a panic attack, you know how frightening it can feel. One moment you’re going about your day (perhaps watching TV, driving to work, or even sleeping peacefully), and the next, your heart is racing, your chest feels tight, and you’re convinced something is terribly wrong.

Panic attacks can be managed with mindfulness practices, lifestyle adjustments, breathing techniques, medication, and therapy (such as CBT or exposure therapy). However, panic attacks are hard to manage on your own. Without treatment, they often get worse over time and severely affect your quality of life.

What Is a Panic Attack?

A panic attack is a sudden episode of intense fear that triggers severe physical reactions, usually when there is no real danger or apparent cause. These episodes often strike without warning and can leave you feeling completely out of control.

Many people describe the experience as feeling like they’re having a heart attack or losing their grip on reality. While intensely uncomfortable, panic attacks aren’t necessarily dangerous. However, they can be deeply disruptive to your daily life and relationships.

What Does a Panic Attack Feel Like? (Symptoms)

With a panic attack, you may feel a combination of emotional and physical sensations that come on suddenly and peak within minutes. You might notice:

• Rapid, pounding heart rate
• Sweating, trembling, or shaking
• Shortness of breath
• Tightness in your throat 
• Waves of chills or hot flashes washing over
• Nausea, abdominal cramping, or chest pain
• Sense of impending doom
• Dizziness, lightheadedness, or faintness
• Numbness or tingling in hands, feet, or face
• Strange feeling of unreality or detachment

These symptoms typically reach their peak within ten minutes and gradually subside. 

But if you or someone else is experiencing severe or radiating chest pain, sudden difficulty breathing, loss of consciousness, or thoughts of harming yourself (or themselves), call 911 or go to the nearest emergency room immediately. 

What to Do When You (or Someone Else) Gets a Panic Attack

If you’re experiencing a panic attack, there are several strategies that can help you get through the episode:

1. Try to remind yourself that what you’re feeling, while extremely uncomfortable, is not necessarily life-threatening. The symptoms will peak and then gradually fade.
2. Use grounding techniques to help shift your attention away from your internal symptoms and toward something outside your body. Focus on the sights and sounds around you, naming five things you can see, four things you can hear, three things you can touch, and so on.
3. Avoid the temptation to flee from wherever you are. If you can stay in place and allow the symptoms to pass on their own, you build confidence in your ability to handle these episodes.
4. Try to avoid self-talk that focuses on the symptoms. Telling yourself ‘stop panicking!’ or ‘ what’s wrong with me?’ tends to increase anxiety rather than reduce it. Instead, try compassionate, reassuring thoughts like ‘this is uncomfortable, but it will pass,’ or ‘my body is having a stress response, but I am safe.’

If you’re with someone else who is having a panic attack, the most important thing you can do is remain calm and reassuring. 

• Speak in a slow, steady voice and remind them that what they’re experiencing will pass.
• Avoid telling them to ‘just relax,’ or ‘calm down.’ While well-intentioned, these phases can actually increase feelings of frustration and helplessness.
• Encourage the person to focus on their breathing by taking slow, deep breaths with you.
• Help them focus on something outside their body, such as describing objects in the room.
• Stay with them until the symptoms begin to subside, and reassure them that you’re there to help. 

Again: if you or someone else has severe or radiating chest pain, sudden difficulty breathing, loss of consciousness, or thoughts of harming yourself (or themselves), call 911 or go to the nearest emergency room immediately. 

Why Do I Get Panic Attacks?

At the heart of panic attacks lies your body’s ‘fight or flight’ response (in addition to freeze and fawn responses). Your heart rate increases, your breathing quickens, and blood rushes to your muscles to prepare you to either fight the threat or run away from it.

Sometimes this alarm system gets triggered when there’s no actual danger present. This is what can cause panic attacks for no apparent reason (or at least no reason that’s immediately obvious to you). Your brain and body react as if you’re facing a life-threatening situation, even when you’re watching a movie, sitting at your desk, or lying in bed. 

This is the same system that would protect you if you encountered a danger, like a car speeding toward you or facing a threatening animal. When your brain perceives danger, it signals your autonomic nervous system to flood your body with adrenaline (or similar hormones).

What Causes Panic Attacks During Sleep?

The same factors that trigger daytime panic attacks can cause them while you’re sleeping. Your body might not simply shut off its stress response when you go to bed. So if you’re dealing with chronic stress, unresolved anxiety, or an overactive nervous system, the fight-or-flight response can activate even during sleep.

Changes in your breathing patterns or dreams that trigger emotional responses can also cause panic attacks during sleep. Some people find that consuming caffeine or alcohol close to bedtime increases their likelihood of experiencing a nocturnal panic attack.

Anxiety Attacks vs Panic Attacks

Both experiences involve intense emotional distress and uncomfortable physical sensations that can leave you feeling overwhelmed and frightened.

Anxiety attacks are typically tied to specific stressors or worries in your life, with the anxiety building gradually as you think about or anticipate these stressors. Panic attacks often arrive without warning and with startling intensity, with symptoms escalating rapidly.

It’s important to note that chronic anxiety can make you more vulnerable to panic attacks. Experiencing them can increase your overall anxiety level as you worry about when the next attack might come.

What Is Panic Disorder?

When panic attacks become frequent, and you develop a persistent fear of having more attacks, you may be dealing with a condition called panic disorder. While anyone can experience an occasional panic attack, panic disorder involves repeated episodes along with significant changes in behavior.

You may start avoiding places or situations where you’ve had panic attacks before, or where you worry you might have one. This avoidance can gradually shrink your world, making it harder to work, socialize, or enjoy activities you once loved.

The good news is that panic disorder is treatable. With the right combination of therapeutic approaches, many people experience significant improvements in their symptoms and quality of life.

What to Do to Avoid Panic Attacks

While you may not be able to eliminate panic attacks entirely, there are steps you can take to reduce their frequency and intensity:

1. Regular practice of relaxation techniques and mindfulness can help keep your baseline anxiety level lower. Even just ten or fifteen minutes of daily practice can make a meaningful difference over time.
2. Addressing sources of chronic stress in your life (through setting boundaries, making changes, etc.) can also reduce your vulnerability to panic attacks.
3. Avoiding substances that can trigger panic attacks is also helpful. Caffeine is one of the most common culprits, so consider reducing (or eliminating) coffee, energy drinks, and other caffeinated beverages. Alcohol and recreational drugs can also trigger panic attacks in susceptible individuals.
4. Getting enough quality sleep supports your nervous system’s ability to regulate emotions and respond appropriately to stress. If you’re struggling with sleep, addressing this issue can have positive effects on your panic symptoms.
5. Staying engaged with treatment, even when you’re feeling better, helps prevent relapse. Panic disorder specifically requires ongoing attention and maintenance to keep symptoms under control.

When to Seek Professional Help

If you’re experiencing recurrent panic attacks, have developed a fear of having more attacks, or have started avoiding places or situations because of panic, it’s time to reach out for professional psychiatric support.

However, it’s also important to note that panic attacks can resemble symptoms of other serious health conditions, including heart attacks. Conditions like diabetes, asthma, inner ear problems, hyperthyroidism, and other cardiac issues can all cause symptoms that feel similar to panic attacks. A thorough medical evaluation from a healthcare provider can possibly rule these conditions out, or get you the right diagnosis and treatment.

Compassionate Care for Your Journey

At Strong Mind Psychiatry, we recognize that panic attacks can affect every aspect of your life: your work, relationships, and ability to enjoy the things that matter most to you. We also know that seeking help takes courage, and we honor that courage by providing empathetic, thorough care that meets you where you are.

You’ve already taken an important step by seeking information and exploring your options. The road ahead may present challenges, but our holistic approach to mental wellness can help guide you toward relief and recovery.

Contact our team today to schedule your initial consultation. We welcome new patients for in-person sessions at our Vancouver WA location, and extend telehealth appointments to individuals throughout Washington state.

Effective treatment for panic attacks is available, and many people experience significant improvement with the right support and care. Together, we can work toward a more confident future for you.

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