A panic attack is a sudden and intense surge of fear or anxiety that can feel paralyzing or even life-threatening. Sometimes mistaken for a heart attack due to sensations like racing heartbeat, dizziness or shortness of breath, a panic attack may occur without warning or without any clear trigger — making the experience all the more terrifying and confusing.

The good news about panic attacks is that the episodes are short-lived, and even though they can recur unexpectedly, there are ways of managing these feelings of panic and the underlying anxiety that can cause them. Learning to recognize the signs of a panic attack, identifying possible triggers, becoming familiar with coping mechanisms and seeking outside support are all components of a successful strategy for overcoming panic attacks.

How common are panic attacks?

There is no specific data on the prevalence of panic attacks, but sources suggest that up to 35% of people have at least one panic attack at some point in their lives. This means that panic attacks are quite common, even if not everyone experiences them. A rarer but potentially serious condition called panic disorder — characterized by chronic anxiety and frequent panic attacks — is thought to affect nearly 5% of adults in the United States at some time in their lives. This makes panic and anxiety disorder one of the most common mental health conditions among the population.

For these reasons, it is vital to understand that if you or someone you know has ever had a panic attack, you are not alone, and a wealth of resources are available to help manage the threat of attacks and continued anxiety.

Reasons you may experience a panic attack for the first time

There is a first time for everything, so you may suddenly find yourself experiencing a panic attack, even with no history of panic disorder or any serious anxiety. Panic attacks can happen to anyone and in response to a variety of situations, including:

• Experiencing the loss of a loved one or another cause of grief.
• Intense periods of work-related or school-related stress.
• Sudden changes in your environment (for example, moving to a new home or new school).
• Leading a lifestyle that increases stress and anxiety (not getting the right amount of exercise, excessive caffeine consumption, not getting enough sleep).

Having one panic attack does not necessarily mean that you’ll have them more often, but it does mean you should pay attention to the symptoms and the possible triggers. Understanding panic attacks is the first step in knowing how to manage the situation if it happens again.

Understanding panic attacks

Whether you personally experience these frightening episodes or you have a loved one who does, it is important to understand how panic attacks happen, how to recognize the signs of a panic attack, and how to navigate safely through them.

Panic attacks vs. panic disorder

Though the terms panic attack and panic disorder are related, they are not the same thing. A panic attack is a singular episode of overwhelming fear or discomfort which may happen with or without a clear trigger. Panic disorder, as the National Institute of Mental Health explains, is a diagnosable condition characterized by frequent panic attacks, often without a clear trigger, coupled with persistent worry about future episodes.

In other words, just because you experience a panic attack once — or even a few panic attacks from time to time — it does not necessarily mean that you have panic disorder. Panic disorder is a chronic and more serious condition, but one that psychiatrists can treat with prescriptions when it is diagnosed.

Symptoms of a panic attack

Whether or not you have ever experienced one, learning to recognize the symptoms of a panic attack is important in case it ever happens to you. Additionally, you may be able to help someone else who is experiencing a panic attack if you can identify the signs. Symptoms vary widely from person to person, but a panic attack generally produces any of the following sensations:

• Trembling or shaking in various parts of the body
• Rapid heartbeat or heart palpitations
• Hyperventilation or difficulty breathing
• Discomfort or pain in the chest
• Chills, hot flashes or perspiration
• Nausea, stomachache or cramping in the abdomen
• Feelings of instability, dizziness or faintness
• Lightheadedness or headache
• Tingling or numbness in the limbs or extremities
• Feelings of imminent danger or impending doom
• Perception of being detached from reality

These symptoms can also range widely in severity. While you may one time experience only mild sensations, another attack may feel like an overwhelming surge. That, along with the fact that panic attacks often cause serious bewilderment, can make an attack difficult for the sufferer and for those around them to recognize.

How serious are panic attacks?

Though typically brief in duration, panic attacks are not to be dismissed as fleeting moments of anxiety. An intense panic can be temporarily debilitating, and it may leave lingering effects like trembling, aching or elevated heart rate for some time after the immediate terror subsides. This sometimes leads people to seek urgent medical care or even emergency help for panic attacks.

In fact, the effects can be so severe that people sometimes mistake a panic attack for a heart attack. If you ever think a heart attack is happening, you should definitely call emergency help just to be safe. As long as it really is a panic attack, however, the episode won’t be fatal. So although you can’t die from a panic attack like you can from cardiac arrest, the very real impacts of the experience should not be underestimated.

The impact of panic attacks on daily life

Beyond the immediate experience of panic, these attacks can leave lasting impressions on an individual’s daily life. Recurring episodes can disrupt daily routines, affect your job, strain relationships and sap a lot of emotional energy. People who experience panic attacks may also develop agoraphobia, which is serious anxiety about entering certain situations for fear of becoming overwhelmed.

Although doctors can treat agoraphobia and therapists can help with anxiety, there are earlier steps you can take to deal with panic attacks on your own. The first step is to accept the real gravity of these episodes, rather than dismissing them as insignificant or “all in your head.” After that, seeking appropriate support and adopting management techniques can help with mitigating these attacks and reducing their future occurrences.

Techniques for managing panic attacks

Coping with panic attacks may ultimately be a lifelong journey, but it’s one that you are capable of managing, and one that you can start today. Upon accepting the reality and the risk of panic attacks, you can begin learning strategies that range from preemptive preparation to long-term lifestyle changes.

Knowing the risk factors

The first step in dealing with panic attacks is to recognize the risk factors and potential triggers. Certain circumstances can amplify an individual’s likelihood of experiencing attacks or of developing panic disorder. These include:

• Family history of panic attacks or panic disorder
• Significant life stress or traumatic experiences
• History of physical or emotional abuse
• Excessive caffeine, alcohol or nicotine intake
• History of other mental health issues such as anxiety disorder or depression

Having any of these histories does not necessarily mean that a person will be more prone to panic attacks, but panic triggers are more likely to come from an association to negative past experiences.

Recognizing a panic attack

Realizing when a panic attack is coming on makes a pivotal step in getting through it. Though the onset can be overwhelming, recognizing the symptoms will help you keep a clearer head and may reduce the severity of the episode.

After you’ve accepted the attack for what it is, it’s OK to let your emotions run their course. Though that may seem paradoxical, this level of mindfulness can actually be more effective than trying to fight the fear or run from it.

Getting through a panic attack

Once you’ve accepted that you are having a panic attack, there are several methods you can try for de-escalating. These include:

• Positive affirmations: Gently remind yourself that the situation is temporary, and that you will get through it.
• Controlled breathing: Focus on taking deep, regular breaths. This can prevent hyperventilation, lessen other symptoms and even help shorten the episode.
• 5-4-3-2-1 technique: Use the five senses grounding method to identify your surroundings with all of your senses, helping to redirect and anchor your attention to the present.
• Retreat to a safe spot: If possible, go to a familiar or private place where you feel safer and more comfortable.

All of these calming methods require practice to be most effective, but you don’t have to be in the midst of a panic attack to get familiar with them. In fact, you can try out different anxiety management techniques and practice them any time. Doing so will leave you better prepared mentally and emotionally for any future attacks.

Coping with the aftermath

Though they are short-lived, panic attacks can leave lingering feelings of exhaustion, embarrassment and worsened anxiety about when the next one might occur. Addressing these feelings and caring for your overall mental health are the next steps in the successful mitigation of panic attacks. Here are some self-help tips to consider.

• Intentional relaxation: Habitually practicing techniques like deep breathing and progressive muscle relaxation can help relieve chronic anxiety, and provide practice for relaxing in case a panic attack happens again.
• Regular mindfulness exercises: Studies have shown that mindfulness practice can be just as effective as medication for reducing anxiety. Helpful techniques include breathing exercises, meditation and mindful movement.
• Hydration: Though it sounds overly simple, drinking enough water is one of the best ways to help your body stay physically and mentally content.
• Reflection: Consider journaling about your experience. Documenting feelings and noting the possible triggers can offer insights and emotional release.
• Rest: Never underestimate the value of sleep for your mental health. Be sure to get adequate rest each night and keep from over-exerting yourself during the day.

In addition to these daily habits that can help you build resilience to panic attacks, there are further-reaching lifestyle changes that mental health professionals often recommend for managing overall anxiety and stress.

Making lifestyle changes

Working toward a generally healthier and well-balanced lifestyle can help with panic attacks while also reducing your risk of other health conditions affected by stress, such as asthma and cardiovascular disease. Consider the following lifestyle goals that can improve your total wellness in the long term.

• Regular exercise: Research suggests that frequently engaging in physical activity can reduce your body’s concentrations of stress hormones and boost endorphin production, mitigating anxiety and helping you feel generally happier.
• Balanced diet: Opting for a diet rich in whole foods, lean proteins and omega-3 fatty acids can have positive effects on brain function and mood regulation.
• Consistent sleep: Getting enough sleep and establishing a healthy bedtime routine can greatly reduce feelings of stress throughout each day.
• Limiting substances: Reducing or eliminating usage of drugs like caffeine, alcohol and nicotine can have positive effects on anxiety and mood regulation.

All of these lifestyle changes are steps that you can take on your own, but going it alone is never easy. Luckily, there are plenty of resources you can use for help in dealing with panic attacks, starting with the friends and family closest to you.

Seeking support

Navigating the complexities of panic attacks and anxiety does not have to be a solitary journey. Help is available, and sometimes the support of a good friend or a trained professional can make a world of difference. Here are some places to look for assistance:

• Personal networks: Confiding in a close friend or family member can provide you with emotional support and understanding.
• Support groups: Engaging with peers who have had similar experiences can foster a sense of belonging and shared resilience.
• Professional services: Mental health professionals like therapists and counselors, psychiatrists or your primary care doctor can offer diagnoses, personalized guidance and a judgment-free space to process experiences.

If you are the friend or loved one of someone who experiences panic attacks, it can be equally helpful for you to know about all the resources. That way you can help provide clarity and assistance steering along your loved one’s recovery journey.

Advice for friends and loved ones

If you know someone who struggles with panic attacks or panic disorder, you should not underestimate your ability as a friend to help when they may need it. In order to help someone who is experiencing a panic attack, the first step is learning to identify the signs, as discussed above, of when an attack is setting in. Next comes your role in offering support — knowing how to respond with empathy and patience to help them get through.

Providing comfort during a panic attack

When someone is in the midst of a panic attack, a calm but caring demeanor can help provide much-needed solace. Avoid the tendency to escalate your own emotions along with the person having the attack. Instead, try to maintain your own calm while offering gentle words of support. If you can, lead the person in a simple grounding exercise or get them a cold drink.

Use words of affirmation and understanding instead of dismissive phrases. Never say things like, “Just calm down” or “It’s all in your head.” Instead, assure the person that you are right there with them, and ask for permission to offer help. If they say yes, try to guide them through deep breathing or accompany them on a walk in a calm environment. Once the intensity of the attack diminishes, you should remain by their side and offer further words of encouragement until the situation comes fully under control.

Offering ongoing support

The journey of panic recovery and management extends far beyond the immediate aftermath of a panic attack, but as a friend or family member, you can offer long-term help as well. Here are some ways to do that.

• Regular check-ins: Every now and then, without being rude or intrusive, politely ask how your friend is feeling or if they would like to talk about their experiences.
• Open dialogue: Speak with encouragement and transparency, and refrain from any form of judgment when discussing sensitive topics.
• Educating yourself: Taking time to study online resources about anxiety can equip you with knowledge to offer better support, and will help demonstrate how much you care.
• Encouraging professional help: If your friend has not done so already, encourage them to seek professional guidance in the form of a doctor or therapist, but be sure to convey this as a suggestion rather than insistence.

As a friend or loved one, your ongoing support is certainly invaluable to anyone who suffers from panic attacks, but professional guidance is also recommended for those with recurring episodes. Your simple suggestion may be the crucial motivation that your friend needs, convincing them to take the extra step and find a mental health professional to speak with.

How health professionals can help

For some people, professional guidance is another crucial step in finding freedom from severe panic attacks. A range of experts in the medical and therapeutic fields have the training and credentials to diagnose, treat and monitor anxiety-related conditions. The key is finding the right type of mental health professional to suit your individual needs, but you should start by talking with your primary care doctor or with a general mental health counselor.

Doctors who treat panic attacks

Initiating a conversation about panic attacks with your primary care physician makes a reasonable first step in seeking professional support. Your doctor can assess your symptoms of anxiety and, just as critically, rule out possible signs of more severe conditions that can sometimes induce panic-like sensations.

If your doctor suspects an anxiety disorder as the underlying cause of your panic attacks, he or she can provide guidance for the next steps. This may involve a referral to a mental health specialist, such as a psychologist, who can provide more detailed evaluation and specialized treatments.

Types of therapy

Whether or not you see a primary care physician as the first step, you can always talk with a therapist about your anxiety. Therapy makes another vital avenue for support, and there are various types of therapy that can aid in coping with panic attacks.

• Psychotherapy: Often simply called talk therapy, psychotherapy involves a one-on-one conversation with a therapist about emotional difficulties and behavior patterns. This is one of the most common therapy formats, and online sessions for psychotherapy are widely available.
• Cognitive behavioral therapy (CBT): A more specific form of psychotherapy, CBT is a scientific approach to identifying and modifying negative thoughts and behaviors. The goal in the case of panic attacks is to root out underlying causes and develop helpful coping strategies with time.
• Exposure therapy: In this particular type of therapy, a psychologist leads you to re-create triggers or symptoms of a panic attack in a safe environment and helps you control your body’s response. Exposure therapy can lessen fears about encountering the situation again, and provides critical practice with calming techniques.
• Group therapy: Group therapy can take various forms, including guided conversation with a therapist among other people with similar experiences. Another form is seeing a therapist with a close friend or loved one who can help facilitate the professionals’ recommendations for you in everyday life.

This list of therapy options may seem overwhelming, but fortunately, the choice is not one you have to make on your own. That is exactly what a therapist or counselor is for — to suggest methods and to recommend a different qualified professional if necessary. You can start by simply chatting with a counselor online or in person, and he or she will help you navigate the next steps from there.

Medication options

For some individuals grappling with severe panic attacks or panic disorder, medication in tandem with therapy and self-care makes a comprehensive treatment strategy. A psychiatrist is the type of doctor who typically handles such prescriptions, but primary care doctors may prescribe certain types of anxiety medicines as well. Some common prescriptions for panic attacks include:

• Selective serotonin reuptake inhibitors (SSRIs): This is a class of commonly prescribed antidepressants, and they are also effective for the treatment of panic disorder. They work by increasing levels of serotonin in the brain, giving a mood-stabilizing effect. 
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): This is another common class of antidepressants, and they have shown success in treatment for various anxiety disorders including chronic panic attacks.
• Benzodiazepines: These are nervous system sedatives that may be prescribed for fast action against severe attacks. While effective, they are generally used only on a short-term basis and should be regarded with caution due to habit-forming properties and possible side effects.
• Beta blockers: While primarily used for treating cardiovascular diseases, beta blockers are sometimes prescribed for managing certain physical symptoms of panic attacks like high blood pressure and rapid heartbeat.
• Tricyclic antidepressants (TCAs): Traditionally used to treat depression and post-traumatic stress disorder, TCAs may also be prescribed for panic disorder that occurs with generalized anxiety.
• Monoamine oxidase inhibitors (MAOIs): Another major class of antidepressants, MAOIs are also sometimes used to treat panic disorder.

The decision to use any form of medication should always be made in consultation with a qualified medical professional. All of these drugs come with possible complications and side effects, so it is important to avoid self-medicating and follow your doctor’s recommendations regarding treatment.

Additional resources online

In addition to the help from those around you and from mental health professionals, you can find a wealth of additional resources online. From self-care guides to scientific research, and platforms for booking virtual therapy sessions, the internet provides diverse avenues for understanding, coping and healing. Exploring these resources can further empower you on your journey to overcoming panic attacks and achieving all-around better well-being.

• National Alliance on Mental Illness (NAMI): This nonprofit offers a live helpline, in-person and online support groups, educational resources, and advocacy for people with mental illnesses including panic disorder.
• SAMHSA’s National Helpline: A service of the Substance Abuse and Mental Health Services Administration (SAMHSA), this is another helpline providing free and confidential, 24/7 support for people in crisis, including those experiencing panic attacks.
• Department of Veterans Affairs (VA) Mental Health: This VA webpage can connect veterans to services for all kinds of mental health conditions, including panic attacks.
• NIMH’s Digital Shareables on Anxiety Disorders: The National Institute of Mental Health (NIMH) website contains a variety of educational materials on anxiety disorders and panic attacks in a variety of formats.
• American Psychological Association (APA) Anxiety Blog: This collection of content on the APA’s website provides educational information and self-help resources on anxiety disorders including panic attacks.

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