A panic attack is a sudden feeling of intense fear or disabling anxiety. It can result in such acute distress that a person fears they are losing control or dying.

Knowing how to prevent feelings of panic from spiraling out of control is an important skill for people who experience panic symptoms.

Conditions such as stress and anxiety can lead to panic attacks. Heart conditions and blood disorders such as anemia can cause similar symptoms.

The intensity of the attack typically peaks at around 10 minutes, but symptoms can persist beyond that. A panic attack usually occurs without warning and may be unrelated to any real danger or apparent cause. They may even wake a person from a sound sleep.

An estimated 1 in 10 people in the United States (U.S.) experience occasional panic attacks.

Twice as many women have panic attacks than men.

Fast facts on panic attacks

  • Panic attacks are an overreaction by the amygdala, or the fear center of the brain
  • Symptoms include a racing heart, sweating, difficulty catching breath, and a feeling of impending death or doom.
  • Twice as many women than men experience panic attacks.
  • Preparing calm breathing techniques and mindfulness strategies can help to keep panic attacks at bay.

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Panic attacks can cause a sense of impending doom, but they are easily treatable.

To stop a panic attack, a person first needs to recognize the symptoms and warning signs.

A panic attack will lead to at least four of the symptoms below:

  • a pounding, racing heart
  • sweating
  • shaking
  • shortness of breath
  • choking sensation
  • chest discomfort
  • nausea
  • dizzy, feeling faint
  • feelings of unreality or detachment
  • tingling or numbness
  • chills or heat sensations
  • fear of losing sanity
  • fear of dying

Although panic attacks can be terrifying for an individual, they typically last between 10 and 20 minutes and are not life-threatening.

There is not always a clear pattern to panic attacks. Some people may experience several attacks in a day and then go months without another. Others may have attacks on a weekly basis.

However, a pattern can be identified. In conditions such as agoraphobia, or a fear that being in public places may trigger a panic attack, people have the pattern of avoiding public places.

Panic attacks can mimic other health conditions. Anyone experiencing these symptoms should be evaluated by a healthcare professional to determine if there is an underlying medical cause.

Certain heart problems, respiratory conditions, overactive thyroid glands, and stimulants such as caffeine can all cause similar symptoms.

The reason for panic attacks is not fully understood, but research indicates that a combination of genetic, biological, psychological, and environmental factors can make an individual more prone to panic.

For example, panic attacks can be caused by brain biology that is over-sensitive to a fear stimulus or an overreactive fear center of the brain, a structure known as the amygdala.

A panic attack occurs when the body experiences a sudden surge adrenaline out of proportion to any perceived danger or threat.

During a panic attack, the amygdala reacts with a high-stress response when exposed to an unfamiliar situation or after facing a stressful life event.

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Panic attacks are caused by the emotional center of the brain overreacting to stimuli.

Adrenaline is the hormone involved in the fight-or-flight response. A sudden release of this hormone prepares the body to flee from or physically confront danger by increasing the heart and breathing rates, amongst other things.

In the case of a panic attack, this sudden increase in adrenaline causes disturbing feelings and sensations that are out of proportion with the actual danger or threat.

When the nervous system reacts in a normal way to a fearful situation, adrenaline levels quickly drop back to their normal levels once the source of fear is removed. This does not happen with a panic attack, and an individual may take an hour or more to recover fully from the symptoms.

Often there is no obvious trigger for the panic symptoms. This can cause people to attempt an explanation of the experience with thoughts such as, "I must be dying," or "I am losing my mind." These thoughts can lead to further panic symptoms.

A panic attack can also be triggered by an intimidating event, such as public speaking or flying.

The good news about panic attack symptoms is that they are highly treatable. There are many excellent ways for people to self-manage panic reactions.

Education

Knowledge is a huge part of overcoming panic attack symptoms. Learning about the way the fear center of the brain works can empower people to recognize a panic attack for what it is: A misfiring of the amygdala causing a surge of adrenaline.

It is vital to understand that the symptoms of panic are not associated with a serious illness. Despite the feelings of terror and sense of impending doom, an attack will not lead to death.

Knowing this can divert those worrisome thoughts that can make an attack worse.

Calm breathing

Taking control of breathing is the first step to controlling a panic attack. The goal is to create a slow stream of air by breathing in and out. This prevents hyperventilation and a buildup of carbon dioxide in the blood.

It is helpful to practice mindful breathing outside of panic attacks. This equips people who experience panic attacks with the techniques designed to stop them.

To practice calm breathing:

  1. Take slow, regular breaths in through your nose, and then out through slightly puckered lips.
  2. Breathe in for the count of five, hold for 1 second, and then exhale slowly to the count of four.
  3. Pause for 2 seconds, and then repeat.
  4. Repeat this for several cycles or until you feel the body start to calm down.

Muscle relaxation

Another helpful strategy is learning to relax the body.

This technique involves tensing and untensing various muscle groups. This lowers overall tension and stress levels that can contribute to panic attacks. Start with the feet and work up to your forehead.

Tighten the muscle while taking a deep breath in, hold for a few seconds and then release the tension while breathing out. Move up the body, one muscle group at a time.

Mindfulness and cognitive behavioral therapy

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Calm breathing can help to reduce overreactions in the brain.

Mindfulness is the act of accepting thoughts as they come, but not letting them blow out of proportion. It is a mental framework designed to help people stay present in the moment without overanalyzing the stressful elements of life.

Mindfulness incorporates many relaxation and meditation techniques.

Panic attacks can originate from thoughts that spiral into deep-seated worries. Cognitive behavior therapy (CBT) is an effective, lasting treatment for controlling panic attack symptoms.

CBT is a helpful option for people who experience repeated panic attacks. CBT challenges fearful thoughts. What are you afraid will happen? Is there evidence to support these fears? A practitioner trained in CBT can equip an individual with the tools to successfully control and defuse a full-blown panic attack.

Exercise

Regular exercise is necessary for maintaining good health and should be incorporated into daily life. From neighborhood walks to competitive sports, finding an activity of interest is important. Exercise helps with stress management and encourages the body to produces natural chemicals called endorphins that are vital for pain relief and a feeling of well-being.

Regularly exercising in a social setting can also help improve a person's confidence and sense of community. This can minimize future triggers for panic attacks and foster a supportive network of people who can help if a panic attack does occur.

Planning ahead

Preparing for known triggers and stressful situations can be helpful.

What is it about the situation that causes feelings of terror? If it is flying, for example, talk to a friend who loves to fly and ask what they enjoy about it. Maybe seek reassurance from a flight attendant.

Other methods that many people find helpful include:

  • finding ways to distract yourself, such as through music, movies, puzzles, or talking with friends.
  • dressing in layers or carrying a portable fan to avoid overheating
  • having water on hand to keep hydrated and cool
  • internalizing reassuring statements or mantras, such as "I am safe," "I can handle this," or "This too shall pass."

Eat a healthy diet

Eating regular meals can help maintain normal blood sugar levels. Low blood sugar levels can contribute to panic symptoms. A healthy diet involves:

  • never going more than 4 hours without eating
  • correcting any dietary deficiencies
  • avoiding caffeine and alcohol as they can trigger or worsen panic attacks

Rule out underlying causes

Visit a doctor for a checkup to address any potential medical issues. Anemia, asthma, and some heart conditions can lead to panic attacks.

If you find it difficult to visit a physician, bring a friend or family member for support, and be sure to find a personable, professional, and encouraging family physician.

Any smokers who experience panic attacks should quit smoking as it is a contributor to panic. It may feel like smoking calms feelings of anxiety, but nicotine is a stimulant and can make long-term anxiety worse.

Complementary and alternative medicine

There is a growing interest in using alternative medicine interventions in the U.S. for both medical and anxiety related disorders. Acupuncture, aromatherapy, and some herbs may be an effective, helpful additional method of controlling panic.

Medication

Medication should not be used as initial management for panic attack symptoms. If all other measures have not helped, some drugs have been successful in controlling panic attacks. These include benzodiazepines and selective serotonin uptake inhibitors (SSRIs).

The calming of panic attack symptoms depends more on having a strong and reassuring support network than medicinal treatment.

Panic attacks are a common experience for millions of people across the world. Although they can be alarming, they are not life-threatening and can be successfully controlled.