Panic Attacks: What They Are and What You Can Do Immediately

Panic attacks are sudden episodes of overwhelming fear and anxiety, often striking without warning. During a panic attack, your body’s “fight-or-flight” alarm misfires; you experience intense fear and physical symptoms even though you’re not in real danger. Common symptoms include a racing heart, shortness of breath, chest pain, dizziness, sweating, and trembling. It’s also common to feel like you’re losing control, about to faint, or even dying. While extremely distressing, these attacks are not life-threatening and will not cause you physical harm. In fact, most panic attacks peak and subside within minutes (usually within about 10–20 minutes). Panic attacks are fairly common; by some estimates, up to about one in ten people experience one each year. Understanding what panic attacks are and knowing how to respond can make them less frightening. The guidance below explains why panic attacks happen and outlines simple steps you can take immediately to cope with an attack in progress.

What Are Panic Attacks?

A panic attack is essentially a false alarm of your body’s survival response. In a real threat (for example, encountering a wild animal or danger), your body would release adrenaline and trigger a rapid heart rate, fast breathing, and other changes to help you escape harm. During a panic attack, that same surge of fear happens when there is no real threat present. In other words, your body reacts as if you are in danger even though you’re safe, leading to intense physical symptoms and terror out of proportion to the situation. Panic attacks typically begin suddenly, reaching a peak of fear within minutes. You might experience palpitations, chest tightness, sweating, shaking, nausea, lightheadedness, numbness, or a choking feeling. Many people feel an acute fear of losing control or imminent disaster while an attack is happening. The good news is that these episodes do end on their own. Although panic attacks feel terribly alarming, they are temporary and not dangerous. After the storm of a panic attack passes, it’s common to feel exhausted or drained, but your body will return to normal.

Some individuals only ever have a single panic attack or a few isolated episodes. Others may develop panic disorder, where panic attacks recur and lead to ongoing worry about future attacks or avoidance of certain places. Panic disorder affects a smaller percentage of people and is diagnosed when someone has frequent, unexpected attacks and persistent anxiety about having more. Remember that not everyone who has a panic attack will develop panic disorder. Panic attacks can also occur alongside other conditions like anxiety disorders, depression, or post-traumatic stress disorder in some cases. If you’ve had panic attacks repeatedly, consider speaking with a health professional to explore possible underlying causes and supports.

What Causes Panic Attacks?

The exact cause of panic attacks isn’t fully understood. However, most experts think it’s a combination of biological and psychological factors. Many panic attacks occur “out of the blue” with no clear trigger. You could be relaxing or even asleep and suddenly be hit with a wave of terror. In other cases, there are triggers or contributing factors. For example, going through major stress or trauma can predispose you to panic attacks. Certain situations that provoke anxiety, such as crowded places, public speaking, flying, or reminders of past traumatic events, can sometimes set off a panic attack in susceptible individuals. Phobias or fears (like fear of heights or needles) may trigger panic in those specific situations. Even some physiological triggers exist: consuming too much caffeine or other stimulants, for instance, can produce sensations (racing heartbeat, jitters) that might spiral into a panic attack.

There are also internal factors that can make someone more prone to panic attacks. These include genetics (a family history of anxiety or panic disorder), and having a very sensitive “alarm system” in the brain that misinterprets harmless bodily sensations as threatening. In people who experience panic, the brain’s fear centre and stress hormones (like adrenaline) may overreact to stress or subtle changes in the body. Essentially, the body sends a false panic signal. It’s important to know that you did nothing wrong to “cause” a panic attack; it can happen to anyone. Understanding that panic attacks are a bodily reaction (and not a sign of actual danger or “going crazy”) can help you feel less afraid of the experience.

How to Respond During a Panic Attack

If a panic attack strikes, there are immediate steps you can take to feel calmer and safer. These techniques won’t stop the feelings instantly, but they can greatly reduce your distress and help the episode pass more quickly. Remember to be gentle with yourself and take things one step at a time. Here is a simple, step-by-step approach to managing a panic attack in the moment:

1. Stay where you are, if it’s safe. Try not to run away or leave the situation in a panic. If you are driving, safely pull over. If you are at work or in a public place, you might simply remain seated. Staying put can prevent the panic from snowballing. Remind yourself that you are okay here and now, you are experiencing a panic attack and not an actual medical emergency.
   
   
2. Breathe slowly and deeply. Focus on your breathing, as this is one of the most effective ways to calm your body. Panic can make you breathe fast or hyperventilate, which actually increases symptoms. Instead, take control of your breath. Inhale gently through your nose for a count of 4, feeling your belly expand. Then exhale slowly through your mouth for a count of 4 or more. Continue this slow, deep breathing rhythm. You might close your eyes while doing this to help concentrate on the breath. Deep breathing sends a signal to your nervous system to relax, counteracting the adrenaline rush.
   
   
3. Acknowledge what is happening and reassure yourself. Tell yourself (silently or out loud): “This is a panic attack. I know these feelings are intense, but they will pass. I am not in danger.” Acknowledging the panic for what it is (and not catastrophising it as something worse) can reduce the fear. Remind yourself that you’re not having a heart attack or “going crazy,” but experiencing a temporary surge of anxiety. This self-talk can be grounding. Many people find it helpful to repeat a calming phrase or mantra such as “This will pass” or “I will be OK.”
   
   
4. Ground yourself in the present. Panic can make you feel detached or trapped in frightening thoughts. To break out of that loop, refocus your attention on the here and now. One simple grounding technique is to use your senses: look around and name five things you see, four things you can feel (touch your chair or the floor under your feet), three things you can hear, two things you can smell, and one thing you can taste. Describing your surroundings or objects near you in detail can also help. For example, silently observe: “I see the room’s walls, the pattern of the carpet, a clock ticking on the wall,” and so on. By engaging with your environment, you gently shift focus away from the internal panic. Some people also find it soothing to visualise a peaceful scene (like a calm beach) or to listen to familiar, calming music. Choose whatever sensory input feels reassuring and helps you feel more anchored in reality.
   
   
5. Release muscle tension. During a panic attack, your muscles may be extremely tense (you might be clenching your jaw, shoulders, or fists without realising). Try to consciously relax your body. You can do this by unclenching your fists and rolling your shoulders down and back. If possible, take a moment to do a quick body scan, notice areas that feel tight, and intentionally loosen them. For example, let your shoulders drop, wiggle your fingers and toes, and unclench your jaw. Another technique is progressive muscle relaxation, which means tensing a muscle group for a few seconds and then letting it go, moving through one group at a time. Releasing physical tension can signal to your body that the emergency has passed and help you feel calmer and in control.
   
   
6. Ride out the surge of panic. Once you’ve taken the steps above, the best thing you can do is allow the panic symptoms to rise and fall without fighting them. Remember that no panic attack lasts forever; it will peak and then ease up. You have taken measures to keep yourself safe and grounded; now give your body a little time to recover. Continue steady breathing and gentle reassurance to yourself. You might notice after several minutes that your heart rate is slowing and the dizziness or chest pain is improving. Each minute that passes, you are getting through it. Trust that the wave will recede, because it always does.
   
   

Throughout these steps, do your best to maintain a compassionate inner voice. It can be scary and uncomfortable, but remind yourself, “I will be okay. This will pass.” If you have someone with you whom you trust, tell them you’re having a panic attack. They can help by staying with you, talking calmly, or breathing with you. Simple words of reassurance from someone else, like “You’re safe; I’m here,” can also be very comforting.

After the Attack

Once the worst is over, you might feel tired, shaken, or emotional as that’s normal. Take a moment to care for yourself. Drink some water, sit or lie down, and breathe quietly. It can help to reflect on what happened: remind yourself that you got through it. This can build confidence that you can handle future episodes too. Ask yourself, “Is there anything in my life out of balance, or stimulating my fight or flight system?”; however don’t always expect to find a specific trigger, as there may not be one. If you have frequent panic attacks, consider reaching out to a healthcare provider for additional support. Treatments such as therapy (for example, cognitive behavioural therapy) and, in some cases, medication can effectively reduce panic attacks over the long term. Most importantly, know that you are not alone and panic attacks are treatable. With understanding and the right coping strategies, panic attacks can become much less intimidating, and you can regain control of your well-being.

References:

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