10 Strategies To Help Manage a Panic Attack

Many individuals experience anxiety-induced panic attacks. Panic attacks are sudden, unexpected episodes of intense fear or terror. Individuals who experience reoccurring panic attacks may have Panic Disorder, a DSM anxiety disorder that affects around 6 million adults in the United States. Panic attacks are often sudden and reach their peak within minutes. They can occur spontaneously or be triggered by a situation or feared object. An individual experiencing a panic attack may develop a fear of future attacks, increasing their anxiety and causing them to avoid situations or locations where they experienced the attack. Some symptoms that occur during a panic attack include:

  • Chest pain, heart palpitations, and shortness of breath
  • Sweating, trembling, and dizziness or light-headed
  • Numbness or tingling
  • Chills or hot flashes
  • Nausea or abdominal pain
  • Feelings of impending doom, detachment, losing control or dying

What causes panic attacks?

When faced with danger, real or imagined, your brain kicks into gear with a fight-or-flight response. Chemicals like adrenaline flood your body and cause hormonal reactions, such as increased heart rate and heavy breathing. Panic attacks happen when you have the hormonal response of fight or flight, but there’s no immediate danger.

There are different factors thought to play a role in causing panic attacks:

  • chronic and ongoing stress
  • experiencing a sudden traumatic event
  • a change in environment (like walking into a crowded store)
  • too much caffeine
  • being a person who’s sensitive to stress or negative emotions
  • illness (like inner-ear problems or diabetes)
  • genetics i.e., if a close family member has suffered from panic attacks in the past

Panic attacks are jarring and terrifying, so here are some tips on how to cope with them:

  1. Educate yourself about panic and anxiety.Knowing the causes of panic and the fight-or-flight response can help you understand that unexplained panic is generally a false alarm. It is a trigger that lets you know you are uncomfortable, either because of the physical sensations you are experiencing or your situation; there is nothing worse than that.
  2. Notice the sensations.Identify what is happening in your body by nonjudgmentally labeling your physical experiences. Observing calmly, “I am experiencing a faster heartbeat and feeling warm in my face and neck,” can be helpful for slowing down what is happening without jumping to conclusions like, “I must be having a heart attack.”
  3. Recognize panic for what it is.When you recognize that you are having a panic attack, you can remind yourself that it is temporary and will pass. Take away the fear that something worse is happening.
  4. Take deep breaths.Breathing in deeply through your nose for a count of 4, holding for 1-2 seconds, and breathing out for a count of 5 not only can start to slow your breathing but also gives you something else to focus on that you have some control over. Diaphragmatic breathing stimulates the relaxation response and turns off the fight-or-flight response.
  5. Relax your muscles.A muscle relaxing technique called Progressive Muscle Relaxation involves squeezing or tensing a specific muscle group and then releasing that area. One option is to start at your toes and, after tensing and relaxing there, gradually move up your body until you reach your neck and head.
  6. Ground yourself in the present moment.Using a strategy called mindfulness can help focus your mind on something specific other than your panic. One exercise involves noticing and experiencing 5 things around you that you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Don’t just name the things; immerse yourself in the experience using each of your senses.
  7. Close your eyes.Sometimes we are overwhelmed by the multitude of things happening around us. Closing your eyes can reduce much of the input, making it easier to think clearly or work on relaxation strategies.
  8. Repeat a calming phrase.By focusing on something like a mantra or statement, you can help focus your mind, but also remind yourself that you are thinking clearly and that everything will be okay. It could be something like, “this will be over soon” or whatever phrase speaks to you. Pick your phrase before you are panicking, however, as it will be much harder to choose when stressed.
  9. Go to your happy place in your mind.Visualize a safe, comfortable, or calm place (real or imaginary). Maybe you start with what you see but be sure to explore and experience the place using all five of your senses. If you are imagining swinging in a hammock between trees, also take note of sounds (e.g., birds chirping, water running nearby), smells (e.g., sap from pine trees), feelings (e.g., the breeze as you rock back and forth), and tastes (e.g., a lemonade with ice and a sprig of mint).
  10. Drink cold water.Take a drink of water and feel the coolness radiate down your throat, through your chest, and throughout your body. When you feel anxious, you may feel warm, so drinking cold water, running your hands under cold water, or putting a cool washcloth on your neck can help.

Talk Therapy Can Help

Talk therapy (CBT) can help you understand and manage panic episodes. In therapy, you will learn how to:

  • Understand and manage skewed perceptions of life stresses, including other people’s conduct or life circumstances.
  • Recognize and replace panic-inducing ideas to reduce feelings of powerlessness.
  • When symptoms appear, manage tension and relax.
  • Consider the sources of your anxiety, beginning with the least concerning to the most anxiety-provoking.
  • Conquer your anxiety by practicing gradual exposure to real-life scenarios that typically trigger your anxiety.

You don’t have to live with constant fear of panic or avoid situations where you feel anxious. Therapy can help you overcome panic and anxiety and escape its constricting grasp. Anxiety treatment works. You can feel better.


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