How to survive a panic attack

About one third of Americans will experience a panic attack in their lifetime. The episodes can happen at any time and are described as a feeling of sudden fear or terror that is unexpected or the result of a particularly stressful or upsetting experience. 

During a panic attack, intense and frightening sensations occur in the body that might lead you to believe that you are losing control or having a heart attack. Situational panic attacks, or those caused by stressful events, are more obvious but they can also come out-of-the blue, even when not feeling stressed. 

“Panic attacks aren’t life-threatening, but they can be debilitating,” says Dr. Laura K. Campbell, PhD, ABPP, adult psychologist. “When they happen frequently and lead to avoiding things due to fear of having another panic attack, they can develop into panic disorder.” 

Physical symptoms of a panic attack include rapid or pounding heartbeat, shaking, shortness of breath, sweating, chest pain, nausea, vomiting, dizziness, chills or hot flashes. Emotional symptoms include feelings of detachment, fear of dying and the feeling of losing control. 

“Panic attacks usually last a few minutes, but the sensations and worry about them can go for much longer,” says Dr. Campbell. 

Understanding panic disorder

After two or more panic attacks, you should make an appointment with your primary care doctor to rule out any medical causes and explore treatment options. 

“After their second panic attack, many people begin to anticipate their next episode, creating a self-fulfilling prophecy,” explains Dr. Campbell. “This cycle can lead to agoraphobia—the fear of any person or place that could possibly panic or trap you—or other mental health concerns like depression, that can worsen over time.” 

Though there is no formal test for panic disorder, your doctor will screen you for other health issues as well as depression—a condition commonly shared by people with panic disorders—and provide a diagnosis and guidance based on their findings. They may also refer you to a behavioral health provider such as a psychologist or psychiatrist. 

Minimizing impact and long-term treatment

“The key to minimizing the length and severity of a panic attack is learning how to respond differently to the physical sensations and realizing they are not dangerous,” notes Dr. Campbell. “Research has shown cognitive-behavioral therapy (CBT) to be a very effective treatment to start with.” 

“CBT gives you an opportunity to understand why some triggers have such an outsized effect, while anti-depressant or -anxiety medications can suppress some of the uncontrollable emotions.” 

Certain medications that are traditionally used for depression can also be helpful in managing panic attacks, especially when used in combination with therapy.

There are several at-home methods for calming a panic attack. 

• Focus exercises force you to take your mind off of the panic attack and its triggers. For example, using senses other than sight to identify and differentiate objects can have a distracting and calming effect.
  
  
• Deep breathing and meditation can help slow the heart rate and clear the mind. 
  
  “Today there are a variety of apps that offer pre-recorded, guided meditations you can cue up on-demand,” says Dr. Campbell. “Many of them include focus exercises and personal affirmations during the program, which can improve confidence in the moment and provide comfort in stressful situations.”

“Removing yourself from your triggers by entering a dark, quite space may help calm a panic attack,” adds Dr. Campbell, “but you should only use this as a last resort, as this isn’t an adequate treatment and can increase your risk of developing agoraphobia.”

Anxiety attacks can be intense and frightening, but the good news is that they can be managed so that they don’t get in the way of your life.

Geisinger’s psychiatry and behavioral health team offers a broad spectrum of services to help people whose lives have been touched by psychiatric, emotional and behavioral challenges, including depression, general anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD), phobias, post-traumatic stress disorder (PTSD), social anxiety and others.

Dr. Laura Campbell sees patients at several Geisinger locations. To make an appointment with Dr. Campbell or another caring behavioral health specialist, call 800-275-6401 or visit Geisinger.org.