How to Stop Panic Attacks
You're going about your normal routine when suddenly, it strikes - an overwhelming surge of heart-pounding anxiety floods your body. Your thoughts start racing with fears of losing control or that something's terribly wrong. You begin gasping for air as intense nausea sets in.
If you've ever experienced this type of abrupt, intense episode, you know the sheer terror a panic attack can bring on. It feels like your worst nightmare is happening - that you're dying, going crazy, or bracing for some impending disaster.
While panic attacks feel terrifying, they themselves don't actually cause any direct physical harm. However, this knowledge provides little comfort when your entire reality has narrowed into an intense pit of dread.
Understanding what panic attacks are, what likely triggers them, and techniques to regain control during an attack can make a tremendous difference in restoring your sense of security.
What are Panic Attacks?
A panic attack is an abrupt surge of intense fear or discomfort that peaks within minutes. It involves a rapid piling on of physical and psychological symptoms including:
Pounding heart, chest pain, shortness of breath
Chills, hot flashes, or nausea
Trembling, shaking, or tingling sensations
Dizziness, lightheadedness, faintness
Feelings of unreality or detachment
Overwhelming sense of impending doom or loss of control
While panic attacks seem to strike out of nowhere, this extreme fear response emerges from your body's fight-or-flight system. As unbelievable as it might sound, this response is theorized to be meant to help you - it’s just being misused, and happening in the wrong context.
If you were to face an immediate threat in the wild, like an animal that was chasing you, a rapid burst of adrenaline would be needed to get you out of there. For the most part, though, panic attacks take place not because of an immediate and visible threat, but because of a threat that is perceived mentally or even subconsciously. As a result, you have nothing to run away from; you’re activated physically, but also feel trapped.
The Neurobiology of Panic
At the first perception of a potential threat, whether real or imagined, physical symptoms start as your brain activates the fear circuitry known as the amygdala. This triggers a chemical cascade:
The amygdala signals to release stress hormones from the hypothalamus
The pituitary gland then unleashes adrenaline and cortisol into the body
Breathing accelerates as your lungs take in more oxygen
Your heart starts pounding as blood is diverted toward major muscle groups
These physiological changes were evolutionarily designed to prepare your body to either fight or flee from harm. The problem with panic attacks is that the same biochemical response gets unleashed even though there is no tangible danger present.
According to research published in the The Journal of Clinical Psychiatry, people with panic disorder appear to have imbalances in brain chemicals like serotonin, as well as increased sensitivity in their fear circuits. This makes them prone to misinterpreting ordinary bodily sensations as threats, igniting the panic feedback loop.
What You Can Do During a Panic Attack
Self-Soothing and Acceptance
When the gripping fear of a panic attack first emerges, it can be extremely tempting to fight against it or try to make the overwhelming symptoms stop. However, it's crucial to understand that panic attacks represent an intensive biological process unfolding.
Once the body's fight-or-flight response has been triggered, certain physiological changes like rapid breathing, pounding heart, and rushes of adrenaline are going to occur. Fighting against this only risks escalating the panic sensations further.
Rather than engaging in a futile struggle, the most effective approach is to practice self-soothing techniques from a stance of acceptance:
Allow It to Pass Over You
Tell yourself repeatedly "This is temporary - I can ride it out without making it worse." Don't resist the feelings but imagine they will crest over you like a wave then subside.
Remind yourself if possible that once a panic attack starts, you’re playing out a temporary physiological process - your body can’t keep pumping adrenaline like this forever (which is a relief!), but once adrenaline is in your system you also can’t make it stop doing its job prematurely (which is disappointing).
You’re stuck letting adrenaline do its job for a while. But if you let yourself feel trapped and panicked at what’s happening in your body, you risk getting locked into a cycle of struggle that will prolong the terror.
To deal with this, try the following:
Focus on Breathing
While it may feel unnatural, consciously slowing your breathing rate back down can restore a sense of control. Follow a inhale-4, hold-2, exhale-6 rhythm. You’ll still feel tense and like there’s a lot of energy flowing through you, but you might find some relief in noticing that you still can control your breath.
Use Grounding Sensations
Counter panic's derealization by firmly planting yourself in the present moment through sights, sounds, smells or tactile objects around you. Look around notice 5 things you can see. Focus on colors and shapes in your environment. Notice the feeling of objects around you. See if you can notice any sounds or smells.
Spend at least a minute noticing what’s happening in your senses and see if it helps you feel more connected with your surroundings.
Repeat Coping Statements
Having pre-planned positive mantras can interrupt catastrophic thoughts: "I've survived this before..." "These feelings are scary, not dangerous..."
The panic attack will reach its peak intensity and begin subsiding within 10-20 minutes through allowing, breathing, grounding, and reassuring self-talk. While difficult, the more you practice accepting the sensations, the more you realize how quickly they can go away.
What You Can Do After It Passes
Reflect
Once the panic has passed, be sure to give yourself time to process the experience without judgment. Notice the physiological aftereffects of shakiness, fatigue, and muscle tension, and gently allow your body to recover.
It can also help to reflect in a journal about:
Any specific triggers that may have set off the panic attack
Unhelpful thoughts or self-statements that fueled it
What coping strategies worked or didn't work well
Reminders of your resilience in getting through it
Recharge
Resting, hydrating, and practicing self-care after panic helps restore your equilibrium. Don't fight residual feelings of anxiety. They will dissipate naturally as you resist the urge to dwell on the distressing experience. You might feel exhausted, or you might have some excess energy and feel like stretching or going for a walk until you feel calmed down again.
How Therapy Helps Stop Panic Attacks
While you can implement many coping techniques yourself, therapy provides a structured, long-term approach for overcoming panic and anxiety.
When I’m working with panic, I find it useful to approach it from a few angles:
Addressing Symptoms with Cognitive Behavioral Therapy (CBT) Techniques
CBT involves carefully exploring the thoughts, beliefs and behaviors that contribute to panic. When I’m working with clients, I help them:
Identify and reframe catastrophic thoughts that come up during panic, sorting through what’s realistic and what’s distorted
Gradually confront feared bodily sensations and emotions
Develop preventative strategies like diaphragmatic breathing
Process underlying stressors, anxieties, and emotional conflicts
Exploring Deeper Roots with Psychodynamic Therapy
Psychodynamic therapy explores the unconscious sources and meanings behind attacks through techniques like:
Exploring early childhood experiences that shaped fear conditioning: how your family treats stress/anxiety/panic, what you’ve learned about needing to be in control, etc.
Working through your relationship with yourself and how you treat yourself when you’re experiencing panic
Developing greater self-awareness and coping skills
Directly Confronting Panic with Exposure Therapy Techniques
Sometimes the monster really is just that harmless once you really get a good look at it.
Finally, we look at ways to empower you by directly exposing you to situations that you worry might create panic. As long as you avoid these situations, your fear of panic will persist. I work with clients to gradually enter into these situations until they feel confident that panic won’t happen.
In panic disorder, panic attacks are kind of like a monster in a cheesy horror movie: you spend most of the movie seeing its shadow and its effect, and you believe that it’s scary. Then toward the end you finally see it in the light, and you can see that it’s actually not that scary at all. Exposure is about finding situations where we can start to see that even though panic is overwhelming, you’re actually far more capable of managing it than you think.
Starting Therapy
Panic is very treatable - again, it’s the avoidance of panic that tends to make it worse. Many people find that as soon as they have some support to begin countering it, they start seeing results quickly.
Conclusion
As terrifying as panic attacks can be, they don't have to control your life. Through understanding their biological roots, practicing coping techniques, and seeking professional treatment, you can overcome this condition.
The path involves being patient with yourself, cultivating self-compassion, and viewing each attack as an opportunity to practice your skills. With commitment, profound relief and freedom from panic's grip is possible.
FAQs
Q: Are panic attacks dangerous or life-threatening?
A: No, panic attacks themselves are not physically harmful, despite how frightening they feel. They represent an overactive fear response, not a medical emergency. However, persistent panic can take a major toll on quality of life.
Q: I had one panic attack, does that mean I have panic disorder?
A: Not necessarily. Many people experience isolated panic attacks in highly stressful situations. A panic disorder diagnosis involves recurrent, unexpected panic attacks and an onset of anticipatory anxiety or avoidance behavior.
Q: Can panic attacks be caused by an underlying medical condition?
A: Certain medical issues like thyroid disorders, low blood sugar, asthma, and heart problems can produce panic-like symptoms. I encourage all clients to get medically evaluated to rule out any physical health causes.