How to Survive a Panic Attack

Panic attacks are super scary – so scary that many people even go to the hospital for evaluation to make sure they’re not having a heart attack! When they get evaluated, they often get an anticlimactic diagnosis that sounds like, “It’s probably just anxiety.” Even if it’s “just anxiety,” panic attacks are debilitating, and it’s useful to have some strategies for getting through them. Today, we’re diving into what not to do when you’re having a panic attack and what to do when you’re having a panic attack.

What Is a Panic Attack?

A panic attack is an abrupt surge of intense fear. You’re not just upset…you’re panicked. The intensity of the symptoms usually peaks within a few minutes. Panic attacks can have lots of symptoms, including a pounding heart, feelings of choking, and numbness or tingling. For more details about the symptoms of a panic attack, here are 20 signs you might be having a panic attack.

There are actually four components to a panic attack that interact with each other to create a downward spiral into panic. Because today’s article is more about surviving a panic attack than learning about panic attacks, head to this article to discover more about the four-part spiral that creates panic. Make sure you look at the graphic to really understand how they work together to create a panic attack.

There’s a lot of overlap between anxiety attacks and panic attacks, so if you’re curious about the difference, I give you all the details in this article comparing and contrasting anxiety and panic attacks. Grab this chart to see side-by-side how panic differs from fear and anxiety — similar but different!

With that basic foundation, let’s dive into the dos and don’ts of panic attacks.

What Not To Do When You’re Having a Panic Attack

1. Don’t try to stop the panic attack.

When your body suddenly fills with intense panic, your urge is to do everything you can to stop it. But that’s actually the absolute worst thing you can do! Trying to stop the panic attack just feeds the panic even more. The more anxious you get about the panic attack, the more cortisol you’re dumping into your blood stream, which intensifies and prolongs the panic attack. Whatever you do, don’t try to stop it.

2. Don’t avoid situations you associate with panic.

Once a person has had a panic attack in a certain location or situation, their brain starts to try to convince them not to return to that place or event. It tells them that they’ll probably have another panic attack if they go back. For example, maybe you had a panic attack while driving down the freeway; your brain will then try to convince you to avoid the freeway and take back roads “just in case” you have another panic attack.

This approach is another one that sounds like it’d be a good thing — I mean, a panic attack while driving can be dangerous! But it actually just feeds the panic even more. Every time you choose to take a back road instead of the freeway, your brain becomes more and more convinced that the freeway really is dangerous. And that means that the next time you try to get on the freeway, you’ll have even more anxiety and a much stronger likelihood of panicking.

Instead, try to keep up with your normal activities, even if you’ve had a panic attack in that situation before. A therapist is a great resource for helping you navigate this.

3. Don’t believe what the panic attack is telling you.

Panic attacks (like all forms of anxiety) are liars. Their lies are really convincing and they make the panic worse. Listen for lies like, “You’re probably dying,” or “You’re going crazy,” or “This is never going to end,” or “You can’t survive this.” Hear those lies, recognize that they’re lies, and do what you’d do with anyone else who is outright lying to you — let that lie go in one ear and out the other.

What To Do When You’re Having a Panic Attack

1. Remind yourself that panic attacks are uncomfortable but not dangerous.

A fear that you’re dying is actually a symptom of panic attacks, not a reality. Panic attacks come with some scary symptoms — your heart may never have beat so hard and so fast! As scary as the symptoms are, they aren’t dangerous. Don’t ignore the symptoms (that just makes them worse), but remember that uncomfortable doesn’t equal dangerous.

2. Remind yourself that panic attacks don’t last forever.

Panic attacks don’t last forever. They can’t. Your body will run out of the fuel to keep the panic attack going. In fact, most panic attacks subside within 10 to 20 minutes. If you’ve survived a panic attack before, you know that eventually it ended, and this one will, too. If this is your first, know that panic attacks last only a few minutes. It will feel like forever, but in 10 to 20 minutes, you’ll likely be much more comfortable.

3. Focus on your breathing.

The way you breathe is one of the most powerful ways you have to communicate with your brain and try to convince it to turn off the panic attack. When the panic attack starts, your brain will make you breathe quick, shallow, panicky breaths. If you swap these out with long, slow, deep breaths, your brain will start to slow down the panic attack altogether. Your body needs oxygen to fuel the panic attack, so breathing more slowly starves its oxygen supply and slows down the panic attack. Try breathing in for 4 counts, holding your breath for 7 counts, and breathing out for 8 counts a few times.

4. Replace the lies your panic attack is feeding you with more helpful thoughts.

As we discussed earlier, your panic attack is going to lie to you and convince you that you’re in serious danger. It’s going to exaggerate how awful your situation is and make you much more afraid than is warranted. Recognize that’s what your panic is doing and learn how to replace those exaggerated fears with more helpful thoughts.

5. Do a grounding exercise.

It’s not helpful to ignore the panic attack, but it’s also not helpful to obsess over it. Try to get right in the middle by acknowledging that you’re having a panic attack and then completing a grounding exercise. Here’s one of my favorites. Take a deep breath and then list

• 5 things you can see
• 4 things you can touch
• 3 things you can hear
• 2 things you can taste
• 1 thing you can smell

When To Get Emergency Help

Panic attacks are uncomfortable, but they’re not dangerous. That said, the symptoms can sometimes mimic symptoms of conditions that really are dangerous. Reach out for emergency help if you notice any of the following symptoms:

• your symptoms have persisted past 20 minutes and have worsened rather than improved
• shortness of breath doesn’t improve
• chest pressure lasts more than a minute or two
• chest pain feels like squeezing rather than stabbing and moves into your arms or shoulders

Resources for Surviving Panic Attacks

Really, there’s nothing special you need to do to survive a panic attack. They’re not dangerous or life threatening, so you’ll survive regardless. However, panic attacks can be easier to navigate with a few resources.

• Use this chart to monitor your panic symptoms. This will give you a better idea of how your body responds to stress, anxiety, fear, and panic, which will help you identify when you’re having a panic attack.

• Learn how to rewire the thoughts that fuel the panic spiral. Here’s an article and an accompanying worksheet to help you do just that.

• If panic attacks are frequent, intense, or severe for you, get a therapist who is trained in “interoceptive exposure.” This is a specific evidence-based treatment for people with panic disorder, so ask specifically whether the therapist delivers that treatment. Here are some other questions to ask a potential therapist, along with how to choose a therapist and how to maximize what you’re getting out of your therapy sessions (+ free worksheets to take to your sessions!).

How to Stop Worrying About Things You Can’t Control

One of the things that fuels panic attacks is worrying, especially about things that are beyond our control. We start to overestimate how awful things will be, which feeds into the panic spiral. Next week, we’ll chat more about that anxiety you have about things you can’t control, and I’ll tell you what to do about it. Don’t miss it.

Talk to you soon,

Dr. Finch

P.S.    Remember, this is education, not treatment.  Always consult with a psychologist or therapist about your mental health to determine what information and interventions are best for you.  See the disclaimer for more details.