A panic attack is a sudden rush of physical symptoms — like shortness of breath, muscle spasms, and nausea — coupled with uncontrollable anxiety and sometimes a sense of impending doom. Visits to the emergency room and desperate late night phone calls to doctors often result, as do test results that often reveal nothing. If you’ve ever had a panic attack, you can probably empathize with the frustration and hopelessness of not knowing exactly what happened.

By educating yourself about panic attacks, you can begin to gain control of the problem. You don’t have to live in fear and uncertainty any longer. We’ll get you started on your journey toward well-being.

Accepting a panic attack for what it is can help to lessen its effect. To start feeling in control of your anxiety, make an appointment with your doctor and get a full physical exam. This will help you focus your approach, as you’ll find out for certain that you’re coping with panic attacks and not some other ailment. A clean bill of health can also help alleviate irrational fears of dying and doom, which can surface during a panic attack.

Also, your doctor can differentiate between occasional panic attacks and a more serious panic disorder, which may require professional treatment and possibly medication. Working with your doctor, you can also determine if you have a genetic susceptibility to panic attacks, and if your episodes are triggered in part by other conditions, such as a thyroid disorder or lactose sensitivity.

Recognize the Symptoms of a Panic Attack

Familiarizing yourself with panic attack symptoms can help you feel more in control while one’s happening. Once you realize you’re experiencing a panic attack and not a heart attack, allergic reaction, or some other serious ailment, you can focus on techniques for calming yourself.

Being able to recognize it for what it is will help you decide what action to take to overcome it. Although symptoms differ from person to person, and only a trained professional can provide a definite diagnosis, some common ones include:

  • Irregular heartbeat
  • Dizziness and lightheadedness
  • Shortness of breath
  • Choking sensations and nausea
  • Shaking and sweating
  • Fatigue and weakness
  • Chest pain and heartburn
  • Muscle spasms
  • Hot flashes or sudden chills
  • Tingling sensations in your extremities
  • A fear that you’re going crazy
  • A fear that you might die or be seriously ill

Understanding Your Body

A panic attack is often a reaction to fear (either conscious or unconscious), and some of the strange physical reactions you experience during one are the result of your body reacting to this fear. Common catalysts of panic attacks include:

Anticipatory anxiety. You become mentally anxious over a past, traumatic event, and your body responds as if it will happen again right away. Catalysts can include photographs, conversations, or anything that triggers the bad memory.

Self-defeating visualization. You may not only picture yourself re-experiencing a traumatic event, but you may also fear losing control of a current situation and not being able to handle it. You interpret the situation as potentially dangerous, and your body secretes adrenaline to prepare for crisis.

Understanding how your body and mind work during these episodes can help you develop a healthier response to frightening situations. Although there are innumerable variations, common reactions to panic include:

Your body goes on alert. Your brain sends a message to your body to protect it against the perceived danger, and your body prepares for the pseudo-emergency. For instance, the eyes may dilate to improve vision, your heart rate quickens to circulate blood faster to vital organs, breathing increases to get more oxygen to the circulating blood, and your muscles tense in case you have to move quickly.

Your mind remains stuck on fearful thoughts. Instead of reacting to either solve the problem or remove yourself from the situation (which you’d likely do in a real emergency), you get stuck on the perceived threat and remain unable to let go of the fear.

Your breathing becomes more rapid. Inhaled oxygen reacts with your cells to produce carbon dioxide, which is then exhaled. During a panic attack, breathing rates increase so your body can absorb oxygen more quickly in preparation for any necessary action. During rapid, heavy breathing (also called hyperventilation), your lungs exhale more carbon dioxide than your cells produce, causing the level of carbon dioxide in your blood and brain to fall. The results (which may include dizziness and heart palpitations) can cause some people to panic further, thereby increasing breathing even more.

Relax Your Breathing and Muscles

If you feel an attack coming on, simple breathing and relaxation techniques can help you feel more in control. But don’t wait until you’re having a panic attack to perfect the techniques. Practicing them twice a day for just 10 minutes at a time may make your panic attacks less frequent and easier to conquer.

Relax your breathing. Put one hand on your upper-chest, and the other over your diaphragm (where your rib cage meets your stomach).

Take in a slow, deep breath through your nose while counting to five. The hand on the chest should stay still, while the one over your diaphragm should raise with your breath. This is how you know the breath is deep enough.

When you reach the count of five, let the breath out slowly (through your nose) at the same rate. Concentrating on your hands and the counting will help focus you and calm you down. Continue these breaths until you feel relaxed.

Relax your muscles. Find a comfortable position to sit in (or lie down).

Close your eyes and begin to focus solely on your toes. Curl them under tightly for a count of five, squeezing the muscles together as hard as you can, then relax.

Next, concentrate on your feet. Contract all of their muscles tightly for a count of five, then relax.

Continue up your body, isolating each muscle group (calves, thighs, buttocks, stomach, chest, shoulders, neck, fingers, hands, and arms) all the way up to your face.

By the time you contract and relax your face muscles, you should feel much more calm.

Exercise

A panic attack can trick you into feeling fatigued, but often the opposite is true. Instead of retreating to your couch or bed, try these activities:

Walking. During a panic attack, it may seem like nothing short of an emergency room will help you. But sometimes the most basic of activities–like a walk through a quiet park, down a street you find relaxing, or anywhere that helps you take your mind off your anxiety–can be the best medicine. Light aerobic exercise also helps your body produce endorphins. And getting fresh air and sunshine can have a positive effect on your overall outlook.

Yoga and stretching. Like deep breathing, these activities can reduce muscle tension and help you regain composure. Lie flat on your back and bring one knee up to your chest. Hold it there for 20 seconds with your hands, while also breathing deeply through your nose. Repeat with the other knee.

Or, stand with your feet a little more than shoudler distance apart and your knees straight. Bend forward from the waist, touching your fingertips to the ground. Hold that pose for 10 seconds, then gently come back to a standing position (being careful not to strain your back). Repeat these stretches as necessary.

Using peripheral vision. Let your field of vision broaden until you can see from the outside corners of your eyes. Breathe deeply and let your jaw muscles relax. This exercise activates the parasympathetic nervous system, which calms your body.

Confront Your Fear

The more you understand your fear, the better you’ll be able to control it. Try writing in a journal before, during, and after a panic attack; record your thoughts, ailments, and worries. When you’re feeling better, go back and reread the entry. This can prepare you for another attack (as you’ll know what to expect) and can help you look for patterns between attacks. Some other ways to understand your panic include:

Paradoxical intention. The goal of this exercise is to trigger a panic attack and stand up to it, thereby feeling in control of what frightens you. Go into the feared situation with the tools you’ve learned, and perhaps with a friend for support, and actually dare the attack to happen. This can help you train yourself to not be afraid of the situation, and give you an opportunity to learn from it.

Talk to a therapist. A therapist can help you get to the root(s) of the problem and devise a plan to overcome it. To find a therapist who’s right for you, ask for a referral from your doctor.

Join a support group. A therapist, your doctor, or a friend may be able to recommend a support group for sufferers of panic attacks. Group meetings can give you further insight into your situation, as you’ll get a chance to hear how others are coping with their problems.

As frightening as it may seem at first, once you start to learn about panic and stand up to it, you’ll experience newfound wisdom and freedom–a great first step toward all sorts of new possibilities.