How To Treat And Manage Panic Attacks

Content Warning: Please be advised, the below article discusses prescription medication. The information found in the article is not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health providers with any questions you may have.

In 2004, viewers of ABC News learned firsthand what a panic attack can look like. Anchor Dan Harris was reporting the headlines when he experienced a panic attack so severe broadcasting had to be cut short.

What causes panic attacks? For many, panic attacks are still shrouded in mystery. For some, like Dan Harris, recurring panic attacks can be an extremely uncomfortable, potentially debilitating symptom of an underlying mental disorder. Unexpected panic attacks can be a difficult experience to go through if you aren’t sure what is occurring. Because of this, learning how to treat panic attacks and manage the symptoms of panic disorder may help you find relief.

What is a panic attack?

The American Psychiatric Association defines a panic attack as “a sudden surge of overwhelming fear that comes without warning and without any obvious reason.” Recurring panic attacks can be symptomatic of an anxiety disorder—especially panic disorder.

• Palpitations, racing heart, or increased heart rate

• Sweating, trembling, or shaking

• A dry mouth not due to dehydration or medication side effects

• Difficulties with breathing

• The sensation of choking

• Chest pain or discomfort

• Nausea or upset stomach

• Physical sensations of dizziness, unsteadiness, fainting, and lightheadedness

• Feeling that one's surroundings are unreal or that one is not really present

• Fear of going crazy, losing control, or fainting

• Intense fear of dying or a sense of doom

• Hot flashes or feeling cold

• Numbness or tingling sensations

These panic attack symptoms are fairly common, and many people report that they have experienced one or more in response to severe stress at least once in their lifetime. In some cases, a person's first panic attack may actually be a misinterpretation of a similar condition. That being said, panic attacks shouldn't be underestimated in terms of unpleasantness, and under certain circumstances, they can indicate disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, or panic disorder.

A panic attack is characterized by some or all of the above symptoms plus the following criteria:

• It is a distinct episode of great fear or discomfort

• Its onset is sudden

Can you die from a panic attack? While panic symptoms may make it seem like you’re dying or having a heart attack, panic attacks cannot kill a person directly and aren’t usually a sign of a life-threatening emergency. However, if you’re not diagnosed with panic disorder and have never had a panic attack before, take these physical symptoms seriously. If you believe you may be having a heart attack, doctors recommend going to the hospital to rule out the possibility. 

Stopping a panic attack

It is possible to prevent and stop panic attacks. When in the grips of a panic attack, a person may struggle to function properly and want to take time afterward to gather themselves. Doing the following during your next panic attack may be helpful, either to stop or ease the symptoms of a panic attack while it's happening. 

Don't fight the attack

Paul Salkovskis, clinical psychologist and professor at the University of Bath, UK, suggests that it's necessary to fight the fear of panic attacks rather than the attack itself. In some cases, fighting what is happening may make panic attacks worse. While distressing, these episodes are not permanently harmful. Salkovskis advises those experiencing panic attacks to "ride out the attack. Try to keep doing things . . . Confront your fear. If you don't run away from it, you're giving yourself a chance to discover that nothing's going to happen." 

Focus on surroundings

Salkovskis also recommends focusing on your surroundings as the anxiety starts to pass, adding: "If you're having a short, sudden panic attack, it can be helpful to have someone with you, reassuring you that it will pass and the symptoms are nothing to worry about."

Become aware of and manage breathing

When panic attacks occur, they often present with hyperventilation or over-breathing. People often advise deep breathing when someone they love is panicking. However, for some, deep breathing may exacerbate the problem, as there is too little carbon dioxide in the bloodstream due to over-oxygenation while breathing deeply. For this reason, breathing into a paper bag is a well-known and time-honored remedy for treating a panic attack. This advice may seem counterintuitive, but breathing in less oxygen may have the desired outcome. If no bag is available, taking short, deliberate, and gentle inhalations through the nose, with equally short exhalations through the mouth, may have the same effect.

Immediately take medication

If you have been prescribed a fast-acting medication or use another fast-acting remedy to assuage panic attacks, the onset of one may be the time to take it. However, follow your doctor’s and pharmacist’s instructions on your medication, as everyone is different. Do not take more than your prescribed dosage and do not stop your medication for panic disorder without talking to your doctor. 

The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional. 

Treatment and long-term management of panic attacks

To limit or eliminate panic attacks, one might consider seeing a doctor or therapist to address the underlying causes. Frequent panic attacks are often a symptom of an anxiety disorder. However, physical causes may be ruled out, too. While the tips below for treatment and ways to manage symptoms of panic attacks may be helpful, be sure to consult with a doctor before making any significant changes.

Managing anxiety and stress may limit panic attacks and other intrusive symptoms. There are several treatment options available for those with anxiety disorders, including nutritious eating, exercise, and medication. Managing other mental health conditions you are experiencing may also be helpful, as they may be causing you stress. In addition, exercise and breathing exercises can be positive ways to manage stress. You can set up a daily regimen to practice breathing exercises or an exercise routine. One form of stress-relieving exercise is yoga, which is designed to calm both the body and the mind. You may also consider hiking in nature and dancing, as these can have soothing and stress-releasing effects.

Cognitive-behavioral therapy (CBT) is sometimes referred to as “treatment for panic attacks without medication,” and evidence strongly supports its efficacy for panic disorder. CBT includes a combination of interventions, such as:

• Relaxation techniques

• Cognitive restructuring (becoming aware of thought patterns that contribute to feelings of anxiety and panic and replacing them with more accurate, constructive thinking)

• Mindfulness (a meditation technique)

• Stress reduction

• Gradual exposure to anxiety or panic-inducing situations for desensitization

A medical doctor may prescribe psychiatric medications to help with panic attacks, such as selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, or serotonin-norepinephrine reuptake inhibitors (SNRIs). However, medications may have side effects, and it is often possible to reduce symptoms or even eliminate panic attacks without medication. Some nutritional supplements have been known to help with panic attacks as well, but the evidence is unclear on their potential benefits, and significant interactions are possible with herbal remedies and pharmacologic medications. Always check with your doctor before taking supplements, especially as they can interact with prescribed medicines.

Do not start, stop, or change any medications without consulting with your physician.

Try reading self-help books for panic attack management 

Reading self-help books with information about home panic attack treatment can help you address the experience when you’re by yourself. Therapy and psychiatry clients often receive book recommendations so that they have multiple options to find relief when they identify potential panic attack symptoms. Many self-help books for panic attacks include CBT techniques developed for severe anxiety, agoraphobia, social phobia, and other related experiences. 

Myths about panic attacks

Perhaps because the episodes associated with this mental health condition are so distressing, there may be misconceptions about panic attacks, including the following myths. 

Myth: Panic attacks can cause fainting spells

While a person may become dizzy during a panic attack, they are unlikely to pass out. Fainting is caused by low blood pressure, while during an attack, the blood pressure rises.

Myth: Avoid stressful situations to avoid panic attacks

This advice can be considered equivalent to saying that one should avoid doing anything in their daily life that could possibly bring them stress. While stress management often forms part of a therapeutic regime to reduce panic attacks, avoiding stressful situations as such is typically not advised. Contrarily, research has shown that such avoidance can reinforce anxiety and panic. With the correct treatment, those with or without an anxiety disorder can find a healthy daily routine. 

Myth: A person with a panic attack should be left alone until it passes

For many who live with panic attacks, being alone may worsen symptoms. Some with panic disorders report that having a comforting person to talk them through the attack calmly can help them overcome fears or feelings that may be causing the episode. Others may prefer distraction. However, a nonjudgmental and compassionate approach from others can be helpful. 

Myth: Panic attack symptoms don’t need to be taken seriously

The physical symptoms of a panic attack lead many people to the emergency room because they can be similar to those caused by serious medical problems. If you’ve never had a panic attack before or you’re not sure if your current symptoms are concurrent with what you’ve experienced in the past, doctors recommend going to the hospital or urgent care for your own safety. There, you may have bloodwork and electrocardiogram (EKG) tests performed to confirm that you are not in physical danger. 

Finding help and panic attack treatment

Only a qualified doctor or mental healthcare professional can diagnose panic attacks as part of an anxiety disorder. Once a diagnosis is made, psychotherapy is often a key part of treating most panic attacks. Through online platforms like BetterHelp, qualified therapists can help you remotely.

Cognitive-behavioral therapy (CBT) can help people with panic disorder and other mental health conditions challenge maladaptive thought patterns and replace them with constructive ones, resulting in more positive emotions and healthier behaviors. CBT is considered a front-line treatment for anxiety disorders; recent research shows that online CBT can treat anxiety disorders just as effectively as in-person therapy. Not only is online CBT as effective as face-to-face talk therapy for conditions including panic disorder, but online treatment is cost-effective, with treatment effects maintained at one-year follow-up.