Very tense person in chair

Panic attacks can be draining. Experiencing one can leave you overwhelmed and unsure of what to do. Learn things that can help both during and after a panic attack.

What Are Panic Attacks?

Panic attacks are feelings of sudden, intense distress — often in response to a stressful situation. They can also happen without warning and for no obvious reason.

Panic attacks typically last from five to 20 minutes but may continue for a few hours. During a panic attack, anxiety levels are usually worse during the first 10 minutes. In addition to anxiety, other symptoms of a panic attack include:

  • Feeling like you’re having a heart attack, dying, or losing control.
  • Feeling detached from reality.
  • Chest pain or tightness.
  • A racing or irregular heartbeat.
  • Difficulty breathing or very fast breathing.
  • Dizziness, shaking, or trembling.
  • Stomach pain or nausea.
  • Sudden diarrhea.
  • Sweating, chills, or hot flashes.
  • Clammy hands.
  • Feeling like you’re choking or can’t swallow.
  • Numbness or tingling.

Panic attacks are very common. In fact, most people will have at least one panic attack in their lifetime. Children also can experience panic attacks. Some common causes of panic attacks in children are:

  • Being overly afraid of common objects, such as bugs.
  • Worrying too much about monsters or about going to bed alone.
  • Refusing to go to school or getting unusually upset when separated from a parent.

Help During a Panic Attack

Though a panic attack can feel overwhelming, remember that you are safe and that the intense feeling of distress will pass. You may find it helpful to have a friend or family member with you. However, you may also feel overwhelmed and want to be by yourself without distractions.

During a panic attack, it can be helpful to refocus you attention. Here are some techniques to try:

  • Refocus your thoughts on your surroundings. Observe what you can see, smell, taste, and touch.
  • Pick a color and try to find as many objects as you can in that color. When you run out of objects, pick a new color and start again.
  • Choose a category (such as countries or animals) and list as many things in the category as you can.

How to Calm Down After a Panic Attack

After experiencing a panic attack, you may find it difficult to move on with your day or what you were doing. You might worry another attack will happen. Follow these tips to destress following a panic attack:
  • Try relaxation techniques, such as meditation, yoga, or guided imagery. These can give you a mental time out.
  • Practice deep breathing once symptoms have subsided. Avoid deep breathing during a panic attack as it can make symptoms worse.
  • Slowly count to 10 or recite the alphabet. This gives you something else to focus on.
  • Listen to music. Chanting can also help reduce acute stress.
  • Eat a protein-packed snack. Avoid foods high in carbohydrates and sugar. For some people, the resulting changes in blood sugar can trigger anxiety.
  • Avoid alcohol and caffeine. These can make panic attack symptoms worse.
  • Reach out to friends or family. Talking with someone can take your mind off of your distress.

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Tips for Long-term Control

What you do right after a panic attack can help you manage future panic attacks, according to the Anxiety & Depression Association of America (ADAA). Follow their tips to gain long-term control over your panic attacks:
  • Recognize that although your body or mind may feel out of control, your symptoms didn’t end in your biggest fears, such as a heart attack or stroke. This helps you learn that your panic attack isn’t life threatening.
  • Practice mindfulness meditation. This helps you gain power over the symptoms you just experienced.
  • Don’t try to escape the situation. Think about and recognize what may have caused the panic attack. Ignoring what happened can make symptoms worse next time.
  • Focus on your surroundings and continue what you were doing.

People experience panic attacks for different reasons. And not all these tips will work for everyone in every situation. Your doctor can refer you to a mental health professional who can help you figure out what works best for you.

It’s also a good idea to discuss your panic attacks with your doctor. They can help diagnose any mental or behavioral health causes. They can also rule out underlying medical conditions that can cause similar symptoms.

How to Prevent a Panic Attack

There are many things you can do to prevent panic attacks, including:
  • Limiting your use of alcohol, caffeine, and nicotine — or avoiding them completely.
  • Engaging in daily relaxation techniques. Do 10 to 20 minutes of deep breathing or muscle relaxation each day. This can include mindful meditation, guided imagery, and yoga.
  • Exercising regularly.
  • Eating a balanced diet.
  • Joining a support group such as one through the ADAA.
Treatment for panic attacks can include cognitive behavioral therapy (CBT), which therapists often use to treat anxiety disorders.
CBT helps you to change how you think. A therapist will teach you how to recognize and replace automatic negative thoughts with positive thoughts and actions.

Treatment can also include identifying panic-inducing environments or situations and developing coping skills to help decrease your stress.

Your doctor may also prescribe medicines, such as antidepressants, especially if the panic attacks are associated with depression, anxiety or panic disorder.

Panic Disorder

Repeated panic attacks can be a sign of panic disorder. Panic disorder is identified by recurring panic attacks that have no obvious cause. Those managing panic disorder may change their daily routine out of fear for future panic attacks.

In addition to antidepressants, treatment for panic disorder can include what’s known as interoceptive exposure. With this type of therapy, a trained mental health professional will trigger the symptoms of a panic attack in a controlled environment. This is a slow, step-by-step process to help you to learn to gain control over your triggers and your reaction while in a safe place.

Treatment may not prevent all panic attacks. But it should reduce their number and severity.

Continue to take any prescribed mental health medicine even if your panic attacks lessen or stop. Symptoms can return once treatment ends. You should also work closely with your therapist before ending therapy session for panic disorder. This will help you retain progress you made during treatment.

Talk to your doctor if you’re concerned about your panic attacks, especially if they interfere with daily life. Your health care professional can help find a treatment plan that works for you.

If you are in crisis or need immediate counseling, reach out for help. Call resolve Crisis Services at 1-888-796-8226 or the National Suicide Prevention Lifeline at 1-800-273-8255.

For more information, call UPMC Western Psychiatric Hospital at 1-877-624-4100 or 412-624-1000.

Coping with Panic Attacks. Anxiety & Depression Association of America. Webinar. Link.

Tips to Manage Anxiety and Stress. ADAA. Link.

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is the hub of UPMC Behavioral Health, a network of community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors. Our mission is to provide comprehensive, compassionate care to people of all ages with mental health conditions. UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. We are here to help at every stage of your care and recovery.