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For people who have experienced a panic attack, the stress of it can be all-consuming, not only preventing you from functioning in the moment, but potentially even impeding your ability to function between attacks for fear of experiencing another one.
Panic attacks seem to come out of nowhere and can be disruptive. Here are some tips for how to stop a panic attack, prevent them in the first place, and handle panic attacks when you’re out in public.
6 ways to stop a panic attack
There are many techniques that may help you stop a panic attack. It’s important to know that everyone responds differently to these techniques, and you may need to try several before you find something that works for you.
1. Recognize that you’re having a panic attack
The first step to stopping a panic attack is recognizing it for what it is. If you’ve never had one before, it can feel like a life-threatening medical emergency requiring immediate treatment, even though it isn’t. That said, the first time you have one, it’s a good idea to get checked out by a medical professional to make sure there’s nothing else going on.
The most common signs of a panic attack include (Bonevski, 2019; Locke, 2015):
- Rapid breathing (hyperventilating)
- A racing heart or heart palpitations
- Trembling or shaking
- Shortness of breath or feeling like you’re choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Dizziness or lightheadedness
- Chills or heat sensations
- Numbness or tingling sensations
- Feelings of unreality or being detached from yourself
- Fear of dying, losing control, or “going crazy”
Panic attacks: signs, causes, and treatment
A single panic attack generally peaks at around 10 minutes and lasts up to 20 or 30 minutes. Although panic attacks are typically short-lived, they can greatly disrupt your life (Bonevski, 2019)
If you have repeated panic attacks with significant emotional and behavioral effects, that may be a sign of a panic disorder. For some people who suffer from panic disorder, these feelings may cause them to start to avoid situations they think may trigger an attack. In extreme cases, they may avoid going out altogether (a condition called agoraphobia). People with panic disorder may experience problems at school or work, be at risk of substance abuse, or become depressed (Bonevski, 2019).
Once you recognize the mental and physical symptoms of a panic attack and that it’s a temporary situation, you can use some of your other skills to help shorten it.
2. Try breathing exercises
Since rapid, shallow breathing often characterizes a panic attack, breathing exercises aimed at helping you breathe more slowly and deeply may help bring an attack under control.
There are many different types of breathing exercises. One commonly used for anxious thoughts is diaphragmatic breathing or “belly breathing.” This technique involves breathing in deeply, allowing your belly to swell, and focusing on how your body expands with each breath in and contracts with each breath out (Ma, 2017).
This slows your breathing and maximizes the amount of oxygen in your system. Research shows that diaphragmatic breathing can improve concentration and mood and lower cortisol levels (a marker for stress) by triggering your body’s relaxation responses (Ma, 2017).
Meditation is a form of mental training to help you calm your mind to achieve a state of “detached observation,” which people describe as being able to observe your thoughts almost as if you’re on the outside looking in.
How to meditate: meditation for beginners
Researchers have studied many different approaches to meditation in people with anxiety. The most common are mindfulness-based, and these may also be helpful to use during a panic attack. They help you focus on being aware of the present moment without letting your thoughts run to areas that may perpetuate the panic.
Medical research shows that mindfulness-based meditation is moderately effective at reducing anxiety symptoms and improving mood. There are no documented negative effects, and you can combine meditation with other interventions such as therapy or medication to enhance their benefits (Saeed, 2019).
4. Use muscle relaxation
Progressive muscle relaxation (PMR) is a technique where you tighten and then relax your muscles progressively (usually from head to toe). It helps you learn to release physical tension. The technique is based on the notion that relaxation of the body results in relaxation of the mind.
One study looked at the effects of PMR on volunteers with a diagnosis of anxiety or depression. During each session, participants closed their eyes and were led through various exercises involving tensing and relaxing muscle groups. The participants reported reduced feelings of anxiety, tension, and anger (de Lorent, 2016). While the technique has never been evaluated in people at the height of a panic attack, you may find that it serves as an effective distraction to help dissipate the attack.
5. Give grounding techniques a try
Grounding techniques are effective coping strategies for dealing with panic, strong emotions, or flashbacks. They help you connect with your body in the present moment and pull your mind away from negative thoughts or anxiety.
Many grounding techniques involve engaging your senses to connect with your physical surroundings. They can include yoga, dancing, distractions, or an anchoring phrase (sometimes called a mantra). You may need to experiment with different grounding skills to find the most helpful ones.
Panic attack vs. anxiety attack: what’s the difference?
6. If appropriate, take medications
If you’re under the care of a healthcare provider, they may recommend using certain medications (usually benzodiazepine drugs) to stop panic attacks if they’re getting in the way of your life in a major way. Since these medications are highly addictive, they’re typically only used short-term to stop a panic attack. Your healthcare provider may also prescribe other long-term anxiety medications, which may help prevent panic attacks (Cackovic, 2022).
How to stop panic attacks before they happen
Having a single panic attack is quite common, affecting around one in every eight people at some point in their life. If you have recurrent panic attacks and have changed your behavior significantly as a result, you may have panic disorder.
Panic attacks can also result from other conditions, such as medication use or substance abuse, other anxiety disorders, and other medical conditions. Getting a proper diagnosis requires evaluation by a healthcare professional. They can use the information to design a treatment plan that may involve therapy or medications for long-term prevention or those that can help stop an anxiety attack as it’s happening (Cackovic, 2022).
Cognitive behavioral therapy (CBT), a type of therapy that involves identifying and replacing the thoughts, feelings, and beliefs that don’t serve you, has been proven very effective for panic disorder (Lim, 2018).
Even brief CBT could be helpful for people with panic disorder. A small study looked at the effects of just four group sessions of CBT for people who were already on medication. Just a few sessions significantly reduced participants’ perceptions of the severity of their panic disorder and fears related to their panic attacks (Lim, 2018).
There are a number of medications available for treating anxiety. SSRIs (selective serotonin reuptake inhibitors), a type of antidepressant, are often the first-line therapy for anxiety and panic disorders. Treatment may begin with a low dose that can be increased as needed over several weeks. Since SSRIs can take up to 12 weeks to start working, healthcare providers may start a person on medications known as benzodiazepines at the same time. While benzodiazepines are effective, they can be very addictive, so they aren’t used for long periods. Once the SSRI begins to take effect, the benzodiazepine can be stopped (Locke, 2015; Cackovic, 2022).
Other less common medication regimens that could be used include TCAs (tricyclic antidepressants), SNRIs (serotonin norepinephrine reuptake inhibitors), and short-term use of benzodiazepines alone (Locke, 2015).
Anxiolytics: uses, side effects, and risks
Get enough sleep
Getting a good night’s sleep is important for many aspects of our health, but it’s not always simple. Still, making time to ensure a good night’s sleep (by limiting late-night screen time and caffeine later in the day) can help lower stress levels that can contribute to increased anxiety if they go unchecked (Bonevski, 2019). Sleep hygiene strategies can help you dial in your sleep.
Aerobic exercise during a panic attack likely won’t be possible (and isn’t likely to help) but getting regular exercise overall promotes reduced anxiety levels. You should aim for at least 30 minutes on most days. Walking, running, swimming, or dancing are good options (Lattari, 2018; Bonevski, 2019).
Studies have also shown that yoga can positively affect people with anxiety disorders, including panic disorder (Saeed, 2019).
Avoid caffeine, nicotine, and alcohol
Substances such as nicotine, caffeine, and alcohol can increase the stress on your body, making you more prone to anxiety. If you have panic attacks, experiment with cutting back or stopping these substances to see if your anxiety improves (Bonevski, 2019).
The symptoms of anxiety can become worse when you feel isolated. Building a support group of friends or family can help. In-person is best, but even phone or video calls can lessen feelings of isolation (Bonevski, 2019).
Manage your triggers
Many people experience anxiety attacks that come out of the blue. Other people have situations they know are highly likely to induce a panic attack. This is much more common in people who experience panic attacks due to specific phobias or traumatic events (Bonevski, 2019).
If you know that certain situations tend to trigger anxiety for you, you can come up with ways to manage them. This could mean knowing that there are certain times to avoid triggers (for instance, when you’re already stressed) or having coping strategies ready if you feel a panic attack coming on.
EMDR therapy for anxiety, grief, and PTSD
How to stop a panic attack in public
One of the hardest times to experience a panic attack is when you are out in public. In addition to the overwhelming panic, you may also fear the judgment of the people around you for being anxious.
If you find yourself experiencing a panic attack in public, first try to remind yourself that panic attacks are short-lived and will pass soon. You can excuse yourself to a quieter place where you can use one of your coping skills privately. If you’re not sure how to get some time alone, you can try saying that you need to use the restroom or make a personal phone call.
Even if you can’t easily get away, you can do some grounding techniques such as breathing exercises or muscle relaxation without anyone else noticing.
Panic attacks are not uncommon. About 13% of the population will experience a panic attack at some point (Bonevski, 2019). If you find yourself having them regularly and that they interfere with your ability to function, visit a healthcare provider or mental health professional for additional support.
- Bonevski, D. & Naumovska, A. (2019). Panic attacks and panic disorder. In R. Woolfolk, L. Allen, F. Durbano, & F. Irtelli (Eds.), Psychopathology – An International and Interdisciplinary Perspective. IntechOpen. doi:10.5772/intechopen.86898. Retrieved from https://www.intechopen.com/chapters/67723
- Cackovic, C., Nazir, S., & Marwaha, R. (2022). Panic disorder. StatPearls. Retrieved on Mar. 28, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK430973/
- de Lorent, L., Agorastos, A., Yassouridis, A., et al. (2016). Auricular acupuncture versus progressive muscle relaxation in patients with anxiety disorders or major depressive disorder: a prospective parallel group clinical trial. Journal of Acupuncture and Meridian Studies, 9(4), 191–199. doi:10.1016/j.jams.2016.03.008. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27555224/
- Lattari, E., Budde, H., Paes, F., et al. (2018). Effects of aerobic exercise on anxiety symptoms and cortical activity in patients with panic disorder: a pilot study. Clinical Practice And Epidemiology In Mental Health: CP & EMH, 14, 11–25. doi:10.2174/1745017901814010011. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827302/
- Lim, J. A., Lee, Y. I., Jang, J. H., & Choi, S. H. (2018). Investigating effective treatment factors in brief cognitive behavioral therapy for panic disorder. Medicine, 97(38), e12422. doi:10.1097/MD.0000000000012422. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160091/
- Locke, A. B., Kirst, N., & Shultz, C. G. (2015). Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician, 91(9), 617–624. Retrieved from https://www.aafp.org/afp/2015/0501/p617.html
- Ma, X., Yue, Z. Q., Gong, Z. Q., et al. (2017). The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in Psychology, 8, 874. doi:10.3389/fpsyg.2017.00874. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/
- Saeed, S. A., Cunningham, K., & Bloch, R. M. (2019). Depression and anxiety disorders: benefits of exercise, yoga, and meditation. American Family Physician, 99(10), 620–627. Retrieved from https://www.aafp.org/afp/2019/0515/p620.html