For those who suffer from panic attacks, the onset of symptoms is undeniable. These episodes are often marked by a sudden wave of fear or anxiety that can occur without warning. Panic attack symptoms include both physical and emotional manifestations, such as rapid heartbeat, sweating, trembling, and intense feelings of dread, that can mimic medical emergencies like a heart attack. The pressure and mounting stress set off a chain of unpleasant events in the body, leading to a panic attack.
While many people experience panic attacks, not everyone will develop panic disorder.
Why Panic Attacks Happen
Panic attacks happen when the body’s nervous system activates the fight-or-flight response. This response has an important biological function as it alerts the body to possible danger and prepares to fight or run away. The fight-or-flight response evolved to protect us in life-threatening situations, helping our ancestors survive extreme danger. The problem with the fight-or-flight response is that it can become overly cautious and activate when there is no identifiable danger. It may be a smell, sound, sight, or internal sensation that triggers the response, leading to panic-like symptoms.
When the body activates the fight-or-flight response unnecessarily, it does not know how to protect itself from the unseen danger. As a result, the body is ready to run or fight without a known reason or direction, which causes panic sensations. This reaction is often accompanied by intense physical sensations and bodily sensations, such as a racing heart, sweating, or dizziness. This is especially a common reaction for people with a history of traumatic events, but panic attacks can happen to those without past trauma as well.
Physical Symptoms and Signs of a Panic Attack
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) characterizes panic attacks as including the following symptoms:
- Increased heart rate
- Racing heartbeat
- Sweating
- Shaking
- Shortness of breath
- Pressure in the chest
- Nausea
- Light-headed or dizzy sensation
- Feeling hot or cold for no reason
- Numbness or tingling
- Feelings of detachment from reality or body
- Fear of losing control or dying
Panic attacks can also be unexpected panic attacks, occurring without warning or a clear trigger. These unpredictable episodes are a key feature of panic disorder and can significantly impact daily life.
Understanding Your Symptoms
When experiencing symptoms of panic attacks, it’s a good idea to rule out any major medical health issues. Medical conditions, including heart or thyroid problems, can mimic symptoms of panic attacks, so it is important to distinguish between panic disorder and other causes (Moideen Sheriff et al., 2023). Thyroid problems, in particular, can present with similar symptoms. Panic disorder is diagnosed by identifying recurrent panic attacks, assessing related worry or behavioral changes, and experiencing symptoms, while ruling out other medical or mental health conditions.
Panic attacks are scary and uncomfortable. The symptoms can often seem to come out of nowhere. If it is determined that the symptoms are related to panic attacks and not some other condition, there are strategies to help the body reduce the intensity of the symptoms and calm the nervous system.
Tips for Handling Panic Attacks
The first thought for many people when first experiencing panic is that something is seriously wrong with their bodies. The second thought is often, “Make this stop!”
When a panic attack starts, fear tends to take over, and it feels like there is a real danger. Many struggle to know how to calm themselves and may feel helpless. The following steps can help stop a panic attack in progress and restore calm in the body. Regular practice of these strategies can help prevent panic attacks and reduce the likelihood of experiencing more panic attacks in the future. These seven steps may help to calm the panic and restore calm in the body.
1. Step Away from the Situation
The first step is to move away from the situation or current location. Even if there is no danger in the current situation, this is an important protective step since moving to a different location may help reduce the brain’s alarm. If possible, find a quiet place with limited noise, light, screens, etc. This may help the brain to focus more on the body and less on the distractions of the outside world.
2. Deep Breathing
This strategy is often suggested when talking about anxiety and panic attacks. Breathing exercises are a recommended strategy because they can help manage panic attacks and anxiety disorders. It has become a little cliché as it is used to encourage people to calm down in all situations, but the reason it is mentioned often is that, biologically, it works. Here’s why. As the fight-or-flight response starts, it activates the body to fight or run by increasing heart rate, promoting shallow breathing, and slowing down digestion and non-essential body functions. This can lead to uncomfortable physical sensations, such as a racing heartbeat.
By focusing on slow, deep breaths that go to the diaphragm and abdomen, the body is flooded with oxygen, which helps to regulate the nervous system and decrease the stress hormone in the body. Deep breathing can help manage these physical sensations, including a racing heartbeat, making it easier to regain a sense of control during a panic attack.
Try this: Focus on your breath. Notice it going all the way to the belly and slowly inflating the abdomen. Notice the breath going in and out in a slow rhythmic pattern. If the mind wanders, return your focus to the breath.
3. Grounding Strategy
Grounding is a technique used to help center the mind and body to the present place and time. It is done by noticing the connection between your feet and the ground, your chair under your body, or something held in your hands. Grounding helps you become aware of bodily sensations, which can reduce anxiety by shifting your focus away from panic and helping you manage physical symptoms. The purpose of grounding is to get the brain to stop focusing on the perceived threat and connect back with the moment.
Try this: Notice the connection between your feet and the ground. Feel the pressure and sensation. Notice where the pressure decreases. Notice how your body feels sitting on a chair. Pay attention to temperature, pressure, or sensations.
4. Orient to the Environment
Orienting is similar to grounding, except this strategy uses sight to center the body back into the environment. Orienting involves looking around the room or area and noticing the colors, textures, or light. This strategy can be calming as it helps the brain to scan the environment for threats, and while orienting to the room, the brain can notice the safety within the space.
Try this: Pick a color and look around the room to notice all objects of that color. Move your head and neck slowly to see the whole room. Count or name the items of that color.
5. Visualization
The parts of the brain responsible for the fight-or-flight response are primitive in that their main functions are to alert you to possible danger and automatic body responses. As a result of these basic features, this part of the brain does not differentiate between memories and the present. That is why thinking about traumatic events can trigger the same bodily response that occurred during the event. Calming visualization can help soothe this part of the brain, thus calming the nervous system.
Try this: With your eyes closed, visualize a serene and calm environment. It may be a mountain, stream, forest, cozy cottage, your bedroom, or your grandparents’ home. Visualize being in that space. Imagine the smell, the sounds, the colors, the sensations, and the feelings.
6. Repeat a Mantra
Repeating a mantra during a panic attack may help calm the brain and encourage the brain to focus on the mantra rather than the anxiety. The mantra may be “This will pass soon,” “I am in control,” or something more specific to help calm the most challenging symptoms, like “There is enough air in this room.” It is helpful to have these planned before a panic attack, as thinking of a mantra to repeat may be difficult in the moment.
Try this: Repeat the mantra slowly over and over out loud or internally. Be sure to go slowly and notice each word.
7. Therapy
This is a long-term strategy and not something that can help you at the moment, but for those who regularly suffer from panic attacks, therapy is a must. A therapist can help process the trauma or anxiety that may be causing the panic attacks. The therapist will also be able to help teach and practice strategies to help reduce the frequency and intensity of the attacks.
Popular therapeutic approaches used in treating people suffering from panic attacks include cognitive behavioral therapy, which focuses on modifying negative thoughts and behaviors, and exposure therapy. Exposure therapy helps individuals confront and manage their fears and physical sensations associated with panic attacks in a safe environment, which can reduce anxiety and avoidance behaviors.
Panic attacks are scary and uncomfortable. The symptoms can often seem to come out of nowhere. It’s a good idea to rule out any major medical health issues. If it is determined that the symptoms are related to panic attacks and not some other condition, these strategies can help the body reduce intensity of the symptoms and calm the nervous system.
8. Medication
Medication options are also available for panic disorder. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed and are effective in treating panic disorder, as well as treating depression. Sometimes, a combination of therapy and medication is used to treat panic disorder effectively. It is important to consult a mental health professional for evaluation and treatment planning, and to initially speak with a primary care provider who can help with diagnosis and referrals.
A comprehensive evaluation is essential, as panic attacks can occur alongside other anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, and other mental health conditions. Identifying co-occurring conditions ensures that all aspects of mental health are addressed in the treatment plan.
9. Creating a Support Network
Building a strong support network is a vital part of managing panic attacks and panic disorder. When you’re facing the intense fear and physical symptoms that come with panic attacks, having people you trust by your side can make a world of difference. A support network can help you feel less isolated, provide emotional reassurance, and offer practical help in moments of distress.
Family and friends play a key role in supporting individuals with panic disorder. By learning about panic attacks and how they affect daily life, your loved ones can better understand what you’re going through. During an attack, they can help by staying calm, reminding you that the panic symptoms will pass, and encouraging you to practice deep breathing or other relaxation techniques. Open communication is essential; let your support network know what you need, whether it’s a listening ear, a gentle reminder to use coping strategies, or simply their presence.
Lastly, support groups, whether in-person or online, offer a sense of community and connection. Sharing your experiences with others who understand what it’s like to experience panic attacks can be incredibly validating. Support groups are also a great place to learn new coping strategies and hear how others manage their symptoms and prevent future panic attacks.
Final Thoughts
Panic attacks can be frightening, and the sense of losing control of one’s body may exacerbate the underlying causes. While most people focus on how to make symptoms go away, it’s also important to listen to what your mind and body are trying to tell you: that you have some deeply disturbing emotions that need to be addressed. The tips above can help you address panic attacks as they’re happening, but in the long term, treating the underlying causes will not only prevent future attacks, it can also improve your overall well-being.
Sources
- Cackovic, C. (2022, June 21). Panic disorder. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK430973/
- Ham, P., Waters, D. B., & Oliver, M. N. (2005). Treatment of panic disorder. American Family Physician, 71(4), 733–739.
- Panic Disorder | Anxiety and Depression Association of America, ADAA. (n.d.). https://adaa.org/understanding-anxiety/panic-disorder
- Porges S. W. (2009). The polyvagal theory: new insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic journal of medicine, 76 Suppl 2(Suppl 2), S86–S90. https://doi.org/10.3949/ccjm.76.s2.17
- Moideen Sheriff, S., Singh, G., Chukwunyelu, N. K., Ezeafulukwe, C. J., & Hassan, O. A. (2023). Hyperthyroidism Masquerading as an Anxiety Disorder: A Report on a Misdiagnosed Case. Cureus, 15(8), e44071. https://doi.org/10.7759/cureus.44071
- National Institute of Mental Health. (2025). Panic disorder: When fear overwhelms. U.S. Department of Health and Human Services, National Institutes of Health. https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms
Dr. Shannon McHugh is a Licensed Clinical and Forensic Psychologist in Los Angeles, California. She specializes in assessment and treatment of children, adolescents, and adults who have developmental and social delays, behavioral difficulties, and those who have experienced traumatic events