Coping with Panic Attacks

“He who fears he shall suffer, already suffers what he fears.” – Michel de Montaigne

If you have ever had a panic attack, you probably know what it feels like to experience a sudden burst of intense and overwhelming fear. Panic attacks are often accompanied by unpleasant physical symptoms, such as shortness of breath, chest pain, or choking sensations. It’s not uncommon during a panic attack to feel an overwhelming sense of impending doom, fear of “going crazy,” or losing control. Even though panic attacks generally don’t last very long, they can feel terrifying and overwhelming in the moment.

If you haven’t personally experienced a panic attack, it can be helpful to understand how intense and “real” they feel to the person who is experiencing them. By increasing awareness and knowledge of what it means to have a panic attack, you are better equipped to provide practical assistance and emotional support to a friend or loved one who may struggle with panic.

What is a Panic Attack?

According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013), the essential element of a panic attack is a sudden surge of intense fear or discomfort that reaches its highest level within minutes… usually 10 minutes or less. Perhaps surprisingly, this abrupt surge into a state of panic can arise when in a calm state or an anxiety state. This discrete time period of panic is accompanied by at least 4 out of 13 physical and mental symptoms. The vast majority of these symptoms (11) are physical, although these unpleasant symptoms are not necessarily the result of a medical condition or substance.

It’s worth noting that the DSM-5 does not define a panic attack as a “mental disorder.” Panic attacks often do occur within the context of anxiety disorders, depressive disorders, post-traumatic stress disorder (PTSD), substance abuse disorders, and some medical conditions. If you are struggling with panic attacks or experiencing other distressing physical, mental, or emotional symptoms, it is a wise decision to discuss your symptoms with your medical doctor or mental health professional.

Coping with Panic Attacks

You can learn to cope with panic attacks so that they no longer have the same power to frighten or unnerve you. Given time and practice, you have the ability to reduce the intensity and frequency of panic attacks. Effectively coping with panic attacks requires willingness and dedication on your part to becoming an active participant in making changes to how you think and behave.

Maybe you have noticed that the more you resist, deny, or fight back against those initial panic symptoms, the worse they tend to become. It’s understandable to feel a powerful urge to resist panic attack symptoms… they aren’t exactly pleasant, so it makes sense to try fighting back against those uncomfortable feelings. Perhaps paradoxically, pushing away, running from, or avoiding anxiety-related symptoms usually doesn’t make them disappear… at least not for good. It is by confronting the panic head-on that you can overcome it.

Face symptoms of panic… don’t run away.

When you push down or run from those early signs of an impending panic attack, you may be inadvertently sending yourself the message that you can’t handle the situation. Naturally, if you believe you’re not capable of managing a panic attack, you might end up feeling even more panic.

A more effective way to handle the situation is to develop an attitude that is calm and confident. When you notice those early signs of a panic attack coming on, tell yourself something like, “Here comes that panic again. I can allow my body to experience these sensations. I can handle this. I’ve done it before.”

Accept the physical sensations of panic… don’t fight them.

Remember how the bulk of those symptoms of a panic attack listed in the DSM-5 are of a physical nature? It’s expected that your body will experience symptoms such as an accelerated heart rate, sweating, chest pain, dizziness, nausea, or trembling when having a panic attack. When you try to fight back against those physical symptoms, your body tenses up even more and creates more anxiety.

Instead of fighting your body’s reaction, apply mindfulness to your body’s state of physiological arousal. Notice and observe what is happening, however uncomfortable it may feel. Take several slow, deep breaths. Allow the physical sensations to occur, taking solace in the the fact that you know they will soon pass.

Reduce Panic Attacks with Lifestyle Changes

Lifestyle changes can dramatically reduce the intensity and frequency of panic attacks. It’s important that desirable new behaviors become a part of your regular routine, not just a passing fad. Based on your personal preferences, health, and current activity level, you may decide that some lifestyle changes appeal to you more than others. A few healthy lifestyle changes to cope with panic attacks include:

  1. Deep relaxation / stress reduction
  2. Physical exercise
  3. Reduced stimulants from your diet (e.g., coffee, sugar, nicotine)
  4. Identifying and expressing emotions
  5. Self-talk that promotes a more accepting and calm attitude

Can you think of ways to apply this information about panic attacks and ways to cope with them to your own life? Even if you don’t struggle with panic attacks or find it difficult to imagine what it might be like to have one, you’ve probably felt “out of control” at some point in time. For most people, this isn’t a desirable or enjoyable state of being. By accepting the things that are truly outside of your control, it often becomes easier to see the many things that are within your control.

I doubt many people “like” to have panic attacks any more than they “like” to feel out of control. When you take a step back and become a mindful investigator of your experience, notice patterns behind anxiety, and observe what works and what doesn’t work, you’re building self-awareness and skills to get back into the proverbial driver’s seat.

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This article is for information purposes only and is not intended for self-diagnosis or as a substitute for consultation.  If you have questions about panic attacks or any other mental health issue described above, consult with a mental health professional.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Bourne, E. J. (2010). The anxiety & phobia workbook (5th ed.). Oakland, CA: New Harbinger Publications, Inc.

Featured image: Overcoming Math Anxiety by welcome to learn / CC BY 2.0

About Laura K. Schenck, Ph.D., LPC

I am a Licensed Professional Counselor (LPC) with a Ph.D. in Counseling Psychology from the University of Northern Colorado. Some of my academic interests include: Dialectical Behavior Therapy, mindfulness, stress reduction, work/life balance, mood disorders, identity development, supervision & training, and self-care.

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