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panic attacks

What are panic attacks and how to cope with them

Table of Contents

A panic attack is an onset of intense fear, which can happen anywhere and at any time. It typically lasts five to twenty minutes, but even one minute can feel terrifying. There are many ways to cope with panic attacks, but the most important thing is to breathe. Let’s take a look at why panic attacks happen and how you can get through them.

What does a panic attack feel like?

A panic attack isn’t something that only takes place in the mind — the symptoms can affect your whole body. Doctors agree on a lot of common symptoms:

  •     chest pain
  •     rapid heartbeat
  •     difficulty breathing
  •     nausea
  •     chills
  •     shivering
  •     numbing or tingling in fingers
  •     dizziness

Other symptoms are much more individual. People describe their experiences as «my body forgot how to breathe», «I can’t stop yawning», «I go into coughing fits», and «everything around me looks unnatural».  

It may even seem like you’re dying, but this is not the case: usually, you start feeling better within ten minutes. The symptoms subside entirely within a half hour.

If you feel chest pain that lingers for a long time, radiating to your arm, neck, or jaw, or you feel nauseous — and all of this is happening after a period of physical exertion — you may be having a heart attack, not a panic attack. If this is the case, seek medical assistance immediately. 

Why do panic attacks happen?

Panic attacks occur when your body feels like it’s in danger. This danger response can be caused by high stress levels or major life changes — the loss of a loved one, a divorce, or moving to a different country. It can even be the result of a positive life event, like the birth of a child. The trigger for a panic attack can be anything, from a loud noise to drinking too much coffee.

While we don’t yet fully understand how panic attacks work, the most likely explanation is that our brain responds to a stressful situation(regardless of whether it’s actually stressful or not), by  releasing adrenaline. This stress hormone speeds up our heart rate and breathing. Meanwhile, the brain logically understands there is no actual danger, and is confused by its own response. This means adrenaline levels continue to rise, making symptoms worse.

Not everyone experiences panic attacks, and it is still unclear as to why. Most likely, it’s a combination of hereditary factors, stress levels, personality traits, and differences in certain areas of the brain.

While most people only experience one or two panic attacks in their lives, there is no surefire way to prevent them.

I think I’m having a panic attack — what can I do?

  • First and foremost: breathe slowly and deeply. Slowly breathe in, and count in your brain: one, two, three, four, five. Then breathe out at the same speed.

  • Remember that you are not dying or losing your mind, regardless of what your brain is trying to tell you. Verbalizing your thoughts helps with this. For instance, say to yourself «I am not ok right now, but I am not in danger». If this isn’t your first panic attack, remind yourself that you’ve made it through similar experiences in the past.

  • Trying to force yourself to relax or stop panicking will often not work. One strange-sounding but effective approach is to try to actively increase your panic. This method can actually make the panic pass quicker. You can even actively defy your panic. Say to yourself something like «Come at me, panic!» or «Is that it? That’s the best panic attack you can hit me with, brain?»

  • Try to distract yourself. Sing a favorite song, or pick up a favorite item and focus on it: examine it in detail, describing its color, shape, texture, size, etc.

  • Focus on your senses on the world outside your body: look around and identify five objects that you can see, four sounds that you can hear, touch three different surfaces, try to identify two smells, and one taste.

  • Eat something sour or spicy: a slice of lemon, a piece of sour candy, some wasabi, or a drop of hot sauce. A strong taste can jolt your attention away from the panic response. 

Methods for managing panic attacks are different for everyone. Some people find it helpful to go for a run, while others take time to sit in a dark room, or eat some minty chocolate. If you experience panic attacks regularly, a good strategy is to carry around any items that help you focus on something other than your panic symptoms.

 For instance, some people keep carry a checklist of things to do in a panic attack, and phrases that help them return to reality:

panic attack to-do list

Source: Reddit

What if I’m having a panic attack at work or in public?

Experiencing a panic attack when you’re not at home can make the situation even more terrifying. Your usual panic symptoms can be exacerbated by worries that you’re bothering other people with your strange behavior, feeling like everyone is looking at you. Try to remember that most people won’t recognize your behavior as a panic attack, and will go about their day unless you ask them for help. Your safety and mental state are your top priority, try to find a quiet, safe place where you can practice the previously-mentioned calming routines.

 If you’re having trouble getting through a panic attack on your own, don’t be afraid to ask for help. It’s best to clearly state what you need — a glass of water or a cab, for example.

Someone nearby is having a panic attack. How can I help?

Your initial approach will depend a lot on whether you and the distressed person know each other. Some people might be going through their own self-calming techniques, and a stranger’s attention or distraction would only make the situation worse. 

If you do approach them, try to ask direct, simple questions, such as «Excuse me, are you having a panic attack?» or «Do you need help?». It’s important to establish that this is actually a panic attack and not a heart attack or some other crisis, and to determine what assistance they need. 

  • Start by establishing a connection. For instance, suggest that they make eye contact with you. This can help them momentarily escape their anxious thoughts.
  • Once they have accepted your offer to help, continue to ask questions, such as «Would you like some water?», «Is there anyone I can alert for you?», or «Can I help you get somewhere safe?».  Try to make the questions as simple as possible, ones that can be answered with a simple «yes» or «no», or with a gesture.
  • Breathing exercises. Try to gently guide them in breathing slowly and deeply, or better yet breathe together with them. Breathe in and mentally count: one, two, three, four, five. Then breathe out doing the same.
  • Try to engage them in conversation if they seem up for it. It can be about anything – if you don’t know each other you can start by asking them their name, or how old they are. Ask about their favorite music or what their favorite time of the year is – anything to keep them talking and distracted from their anxious thoughts.
  • Your goal is to try to refocus their attention outside of their brain, so you can attempt a refocusing exercise: suggest that they look around and identify three blue items, four red ones, and five white ones, and then take a turn doing the same. Or you can describe the building you’re in in as much detail as you can, and then invite them to join in

During your interaction, it is very important that you yourself remain calm, and don’t use platitudes such as «it’s all in your mind» or «just try to relax». Let the person know that you’re with them and they can rely on you – say something like «I’m here to help, you’re not alone, you’re safe, I’m here as long as you need». Try not to promise anything you can’t control – «you’ll be ok» or «everything will be fine» aren’t things you can guarantee. 

Do your best to remind them that the panic attack will definitely subside sooner or later, and remain with the person for as long as you can. 

Welltory Team, 23 Feb. 2023

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