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 can 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 oneself is not really present

• Fear of going crazy, losing control, or fainting

• Intense fear of dying or 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

If the concern is: Can you die from a panic attack? While panic symptoms may make it feel 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 phsyical symptoms seriously. If you believe you may be having a heart attack, doctors recommend going to the hospital to rule out the possibility. 

How can a panic attack be treated?

It is not only possible to prevent panic attacks, but also to stop one that is already occurring. For either result, a person may need to visit a qualified doctor or psychiatrist for assessment and a treatment plan.

Stopping the attack

When in the grips of a panic attack, a person likely won’t be able to function properly, and they will often need to take time out 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. It may be erroneously assumed that one should take deep breaths to calm down. When it comes to panic attacks, this action of deep breathing is likely to exacerbate the problem, as there is too little carbon dioxide in the bloodstream due to over-oxygenation while breathing deeply. This is why 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, should 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 is the ideal time to do so.

Treatment and long-term management of panic attacks

To limit or eliminate panic attacks, the underlying causes may need to be identified by a medical doctor. Frequent panic attacks are often a symptom of an anxiety disorder. However, physical causes need to 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 major changes.

It is important to manage anxiety and stress to limit panic attacks and other intrusive symptoms. There are several treatment options available for those with anxiety disorders, including dietary changes, such as limiting caffeine and sugar, exercise, and medication. It can also be helpful to manage other mental health conditions you are experiencing, which may be causing you stress. In addition, exercise and breathing exercises can be good 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 triggers 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. 

Always check with your doctor before taking supplements, especially as they can interact with prescribed medicines.

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 patients often receive book recommendations so that they have multiple options to find relief when they identify potential panic attack symptoms. This may reduce the severity of the experience. 

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.

Myth: Panic attacks can cause fainting spells

While a person may feel dizzy and faint 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 tantamount 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. In fact, research has shown that such avoidance can reinforce anxiety and panic. With the correct treatment, most people, with or without an anxiety disorder, can engage in normal activities.

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

For many who live with panic attacks, this could not be further from the truth. Many with panic disorders report that having a comforting person to calmly talk them through the attack can help them overcome fears or feelings that may be causing the episode. Others may prefer distraction – it all depends on the individual experiencing the attack. However, a nonjudgmental and compassionate approach from others is likely to help those who experience panic attacks.

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

As mentioned above, 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.

Online therapy for panic attacks

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 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 has been found to be cost-effective, with treatment effects maintained at one-year follow-up.

The benefits of online therapy

BetterHelp’s licensed therapists have provided CBT for anxiety disorders, including panic disorder. Read below for some reviews of BetterHelp therapists from people experiencing similar issues.

Counselor reviews

“Lisa was just an incredible person to work with. I work in the healthcare industry and was feeling like I was going to lose my mind with the COVID-19 virus first and second wave, she was just the best person for me during this time. She guides you on how to work with your feelings and grow from them, how to workout your brain and how you can train your thoughts to make life a little bit more manageable each day. I was suffering from crippling anxiety (that eventually turned into physical symptoms), panic attacks, depression and fatigue from work/COVID. She listens to you and reflects with you about how these situations are hard and that you have every right to these feelings. She also would provide a different perspective that would just help bring you back down to earth and remind you that you are human and we can all grow from every hard situation and scenario. I thoroughly enjoyed working with Lisa and will always be grateful to her for the new perspective on life, and all of the new tools I have to help manage life which has made me feel like a better person. Thank you Lisa! I hope to reconnect with you soon!”

“Michele has been such an incredible source of comfort for me. I have struggled with anxiety for a long time, but Michele provides me with patience, understanding, and clinical expertise that helps me on a daily basis. I will always be grateful for Michele’s care and presence in my life. I still struggle sometimes, but I know I can always talk about it with her and figure it out. Overall, working with Michele has been wonderful. Not to mention her sense of humor and authenticity!”