Spotting A Panic Attack & How to Respond

Written By Savannah O'Toole LMC

If you’ve had a panic attack, you know it can be scary. Especially the first time it happens. It can feel overwhelming, therefore, I’m here to make it less overwhelming, simple, and all in one place. So let’s get started!

If researching anything about a panic attack you’re wanting to know, there are three different things that may pop up: panic attack, anxiety attack, and panic disorder. Panic attacks consist of sudden feelings of fear that can create intense physical reactions when you are not in a threatening situation (Mayo Clinic Staff, 2018). An anxiety attack is typically caused by a specific stressor that will increase slowly and feel like an increase of your heart rate(heart racing) and your stomach can feel like it’s in knots (Cleveland Clinic, 2023). Panic disorder consists of consistent panic attacks over a span of time where you begin to feel fear of the next panic attack (Mayo Clinic Staff, 2018).

Physical Symptoms:

There are a variety of physical symptoms that can occur when having a panic attack. Here is a list of those symptoms that could be telling you that a panic attack is happening. One or many of these symptoms may occur. Panic attacks do not have to consist of every one of these symptoms.

  • Increased heart rate

  • Shortness of breath

  • Tightness in chest

  • Dizziness

  • Nausea

  • Sweating

  • Shakiness/trembling

  • Pain in your chest

  • Chills

There are also different symptoms you may experience outside of physical symptoms. One or many of these symptoms may occur. Panic attacks do not have to consist of every one of these symptoms. 

What you May Feel:

  • Feeling detached from self (depersonalization)

  • Unreality (Derealization)

  • Strong sense of terror or fear

  • Feeling like you are going to die

  • Choking sensation

  • Smothering sensation

  • Fear of losing control

Why might a panic attack happen?

There are a variety of reasons a panic attack happens. Below will be a list of some reasons, however, it is not limited to these reasons only.

  • High stress environments

  • Feeling claustrophobic or experiencing claustrophobia

  • Consistent heightened anxiety

  • Feelings of overwhelm stacked one on top of the other

  • Genetics or family history of anxiety and/or panic attacks

  • Sensitivity to stress or negative emotions

  • An already occurring mental health disorder

  • Trauma that occurred in childhood

  • Trauma in general

  • Phobias

  • Negative thought spiral

How to Get Through a Panic Attack:

There are a lot of different things that can help you get through a panic attack. Here is a list of a couple, however, what works for you may not be on this list and that’s okay! Find what works best for you. The number one activity I always recommend for people first is to focus on their breathing to slow down your heart rate, getting it back to normal. If you are having panic attacks and haven’t figured out something that works, start with this list and go from there. 

  • Taking slow deep breaths

    • Box breathing: Find a comfortable position, either sitting or lying down on your back. Place one hand on your heart and the other on your stomach. Breathe in through your nose slowly for four seconds, hold your breath for four seconds, exhale slowly through your mouth for four seconds, and hold for four seconds. Repeat as needed. 

    • Diaphragmatic breathing: Find a comfortable position, either sitting or lying down on your back. Placing one hand on your upper chest and the other on your stomach, right below your ribs. Slowly breathe in through your nose, breathing deeply into your lower stomach, the hand on your stomach should be rising. Exhale slowly through your lips, your abdomen tightening, while your hand on your stomach will fall back to normal. Repeat for as long as needed.

  • Taking a cool wet washcloth and placing it on your forehead, lying down or sitting in a comfortable position of your choice

  • Calling a close/safe friend or family member

  • Remove self from situation that is causing panic if possible/applicable

How to Recover Well:

It’s important to make sure you are being kind to your body and mind. A panic attack requires a significant amount of energy, therefore, don’t be surprised if you feel exhausted afterward. Here are several examples of what you can do afterward to help your body and mind heal and recover well.

  • Participating in an activity that is calming to you such as coloring, taking a bath, etc. What makes you feel calm?

  • Going for a walk

  • Positive affirmations

  • Drinking lots of water and/or electrolytes (HYDRATE)

  • Grounding/mindfulness exercises

  • Meditation/prayer

  • Yoga

I hope this information leaves you feeling lighter. I hope that it brings you hope. You are not alone in experiencing panic attacks and there are so many resources out there to help and I hope this can be one of those for you!

Resources

Grounding/Mindfulness Exercises: https://www.therapistaid.com/therapy-article/grounding-techniques-article

Apps for grounding, mindfulness and meditation:

  • Calm

  • Headspace

  • Insight Timer

  • Pause (Spiritual/Christian)

Citations

  • Cleveland Clinic. (2021). Box breathing benefits and techniques. Cleveland Clinic. https://health.clevelandclinic.org/box-breathing-benefits/ 

  • Cleveland Clinic. (2023). Panic attacks & panic disorder. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder 

  • Harvard Medical School. (2016). Learning diaphragmatic breathing. Harvard Health Publishing. https://www.health.harvard.edu/healthbeat/learning-diaphragmatic-breathing 

  • Mayo Clinic Staff. (2018). Panic attacks and panic disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021 

Savannah O'Toole LMC
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