Recognizing and Managing Panic Attacks: A Complete Guide

Panic attacks are sudden episodes of overwhelming fear with distinct physical and emotional symptoms that can be effectively managed through evidence-based techniques like cognitive-behavioral therapy, breathing exercises, and professional therapeutic support from licensed mental health providers.

Ever feel your heart racing and overwhelming fear wash over you out of nowhere? Panic attacks can feel terrifying and mysterious, but understanding what's happening and learning proven techniques to manage them can bring real relief and peace of mind.

How To Recognize And Manage Panic Attacks: A Comprehensive Guide

In 2004, viewers of ABC News learned firsthand what a panic attack can look like. Anchor Dan Harris was reporting the headlines when he experienced a panic attack so severe broadcasting had to be cut short.

What causes panic attacks? For many, panic attacks are still shrouded in mystery. For some, like Dan Harris, recurring panic attacks can be an extremely uncomfortable, potentially debilitating symptom of an underlying mental health condition. Unexpected panic attacks can be a difficult experience to go through if you aren’t sure what is occurring. Because of this, learning how to recognize panic attacks and manage their symptoms may help you find relief.

Understanding Panic Attacks

The American Psychiatric Association defines a panic attack as “a sudden surge of overwhelming fear that comes without warning and without any obvious reason.” Recurring panic attacks can be symptomatic of an anxiety disorder—especially panic disorder.

A panic attack has similar symptoms to severe anxiety disorders and related mental health conditions but with added attributes. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), symptoms may include:

• Palpitations, racing heart, or increased heart rate
• Sweating, trembling, or shaking
• A dry mouth not due to dehydration or medication side effects
• Difficulties with breathing
• The sensation of choking
• Chest pain or discomfort
• Nausea or upset stomach
• Physical sensations of dizziness, unsteadiness, fainting, and lightheadedness
• Feeling that one’s surroundings are unreal or that one is not really present
• Fear of losing control or fainting
• Intense fear of dying or a sense of doom
• Hot flashes or feeling cold
• Numbness or tingling sensations

These panic attack symptoms are fairly common, and many people report that they have experienced one or more in response to severe stress at least once in their lifetime. In some cases, a person’s first panic attack may actually be a misinterpretation of a similar condition. That being said, panic attacks shouldn’t be underestimated in terms of unpleasantness, and under certain circumstances, they can indicate disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, or panic disorder.

A panic attack is characterized by some or all of the above symptoms plus the following criteria:

• It is a distinct episode of great fear or discomfort
• Its onset is sudden

Can you die from a panic attack? While panic symptoms may make it seem like you’re dying or having a heart attack, panic attacks cannot kill a person directly and aren’t usually a sign of a life-threatening emergency. However, if you’re not diagnosed with panic disorder and have never had a panic attack before, take these physical symptoms seriously. If you believe you may be having a heart attack, doctors recommend going to the hospital to rule out the possibility.

Techniques for Managing a Panic Attack in the Moment

It is possible to prevent and stop panic attacks. When in the grips of a panic attack, a person may struggle to function properly and want to take time afterward to gather themselves. Doing the following during your next panic attack may be helpful, either to stop or ease the symptoms of a panic attack while it’s happening.

Don’t fight the attack

Paul Salkovskis, clinical psychologist and professor at the University of Bath, UK, suggests that it’s necessary to fight the fear of panic attacks rather than the attack itself. In some cases, fighting what is happening may make panic attacks worse. While distressing, these episodes are not permanently harmful. Salkovskis advises those experiencing panic attacks to “ride out the attack. Try to keep doing things . . . Confront your fear. If you don’t run away from it, you’re giving yourself a chance to discover that nothing’s going to happen.”

Focus on surroundings

Salkovskis also recommends focusing on your surroundings as the anxiety starts to pass, adding: “If you’re having a short, sudden panic attack, it can be helpful to have someone with you, reassuring you that it will pass and the symptoms are nothing to worry about.”

Become aware of and manage breathing

When panic attacks occur, they often present with hyperventilation or over-breathing. People often advise deep breathing when someone they love is panicking. However, for some, deep breathing may exacerbate the problem, as there is too little carbon dioxide in the bloodstream due to over-oxygenation while breathing deeply. For this reason, breathing into a paper bag is a well-known and time-honored remedy for treating a panic attack. This advice may seem counterintuitive, but breathing in less oxygen may have the desired outcome. If no bag is available, taking short, deliberate, and gentle inhalations through the nose, with equally short exhalations through the mouth, may have the same effect.

Long-Term Management and Treatment Options

To limit or eliminate panic attacks, one might consider seeing a doctor or therapist to address the underlying causes. Frequent panic attacks are often a symptom of an anxiety disorder. However, physical causes may be ruled out, too. While the tips below for treatment and ways to manage symptoms of panic attacks may be helpful, be sure to consult with a doctor before making any significant changes.

Lifestyle Modifications

Managing anxiety and stress may limit panic attacks and other intrusive symptoms. There are several approaches available, including nutritious eating, exercise, and stress management techniques. Managing other mental health conditions you are experiencing may also be helpful, as they may be causing you stress.

Exercise and breathing exercises can be positive ways to manage stress. You can set up a daily regimen to practice breathing exercises or an exercise routine. One form of stress-relieving exercise is yoga, which is designed to calm both the body and the mind. You may also consider hiking in nature and dancing, as these can have soothing and stress-releasing effects.

Therapeutic Approaches

Cognitive-behavioral therapy (CBT) is sometimes referred to as “treatment for panic attacks without medication,” and evidence strongly supports its efficacy for panic disorder. CBT includes a combination of interventions, such as:

• Relaxation techniques
• Cognitive restructuring (becoming aware of thought patterns that contribute to feelings of anxiety and panic and replacing them with more accurate, constructive thinking)
• Mindfulness (a meditation technique)
• Stress reduction
• Gradual exposure to anxiety or panic-inducing situations for desensitization

At ReachLink, our licensed clinical social workers are specially trained in evidence-based therapeutic approaches like CBT that have proven effective in treating panic attacks and anxiety disorders. Through our telehealth platform, you can access these therapeutic services from the comfort of your home, eliminating additional stressors that might come with traveling to in-person appointments.

Self-Help Resources

Reading self-help books with information about home panic attack management can help you address the experience when you’re by yourself. Therapy clients often receive book recommendations so that they have multiple options to find relief when they identify potential panic attack symptoms. Many self-help books for panic attacks include CBT techniques developed for severe anxiety, agoraphobia, social phobia, and other related experiences.

Common Myths About Panic Attacks

Perhaps because the episodes associated with this mental health condition are so distressing, there may be misconceptions about panic attacks, including the following myths.

Myth: Panic attacks can cause fainting spells

While a person may become dizzy during a panic attack, they are unlikely to pass out. Fainting is caused by low blood pressure, while during an attack, the blood pressure rises.

Myth: Avoid stressful situations to avoid panic attacks

This advice can be considered equivalent to saying that one should avoid doing anything in their daily life that could possibly bring them stress. While stress management often forms part of a therapeutic regime to reduce panic attacks, avoiding stressful situations as such is typically not advised. Contrarily, research has shown that such avoidance can reinforce anxiety and panic. With the correct treatment, those with or without an anxiety disorder can find a healthy daily routine.

Myth: A person with a panic attack should be left alone until it passes

For many who live with panic attacks, being alone may worsen symptoms. Some with panic disorders report that having a comforting person to talk them through the attack calmly can help them overcome fears or feelings that may be causing the episode. Others may prefer distraction. However, a nonjudgmental and compassionate approach from others can be helpful.

Myth: Panic attack symptoms don’t need to be taken seriously

The physical symptoms of a panic attack lead many people to the emergency room because they can be similar to those caused by serious medical problems. If you’ve never had a panic attack before or you’re not sure if your current symptoms are concurrent with what you’ve experienced in the past, doctors recommend going to the hospital or urgent care for your own safety. There, you may have bloodwork and electrocardiogram (EKG) tests performed to confirm that you are not in physical danger.

Finding Professional Support for Panic Attacks

Only a qualified healthcare provider can diagnose panic attacks as part of an anxiety disorder. Once a diagnosis is made, psychotherapy is often a key part of treatment. Through telehealth platforms like ReachLink, qualified licensed clinical social workers can help you remotely.

Cognitive-behavioral therapy (CBT) can help people with panic disorder and other mental health conditions challenge maladaptive thought patterns and replace them with constructive ones, resulting in more positive emotions and healthier behaviors. CBT is considered a front-line treatment for anxiety disorders; recent research shows that online CBT can treat anxiety disorders just as effectively as in-person therapy. Not only is online CBT as effective as face-to-face talk therapy for conditions including panic disorder, but online treatment is cost-effective, with treatment effects maintained at one-year follow-up.

Important Reminder About ReachLink Services

It’s important to note that ReachLink provides therapeutic counseling services through licensed clinical social workers, not medication management. If your treatment plan might benefit from medication, our therapists can help coordinate with appropriate healthcare providers who can prescribe medications when necessary.

Takeaway

Panic attacks can be scary and challenging to cope with, but they are manageable with the right support and strategies. Coping mechanisms like mindfulness and lifestyle changes may be helpful. In addition, cognitive-behavioral therapy can be an effective way to treat panic attacks and panic disorder. Consider seeking support through ReachLink’s telehealth platform, where our licensed clinical social workers are ready to help you develop personalized strategies for managing panic attacks and improving your overall mental wellbeing.