By JRose Wellness
Your heart pounds. You can't catch your breath. A wave of fear tells you something terrible is happening. Then, minutes later, it fades and leaves you shaken. If this has happened to you, you are not alone, and it does not mean you are weak or “losing it.” Panic attacks are common, and they are treatable.
What is a panic attack?
A panic attack is a sudden surge of intense fear or discomfort that builds fast, usually peaking within minutes. Everyday anxiety tends to build slowly. Panic hits all at once, and it can feel as physical as it is emotional.
One panic attack does not mean you have panic disorder. When attacks keep coming back, and you start to worry about the next one or change your routine to avoid them, it is worth getting evaluated.
Recognizing the symptoms
During a panic attack, you may notice several of these at once:
- A racing or pounding heartbeat (palpitations)
- Sweating, trembling, or shaking
- Shortness of breath or a feeling of being smothered
- Chest pain or discomfort
- Nausea or an upset stomach
- Dizziness, lightheadedness, or feeling faint
- Chills or hot flashes
- Numbness or tingling
- Feeling unreal (derealization) or detached from yourself (depersonalization)
- Fear of losing control
- Fear of dying
Many people having their first panic attack think it is a heart attack. The symptoms are real, and they deserve to be taken seriously. If you have chest pain or trouble breathing that is new or different, call 911 or go to the nearest emergency room. Your primary care clinician can also help rule out other medical causes, such as thyroid or heart rhythm problems.
Panic attacks are frightening, but they pass. Understanding what is happening in your body is often the first step toward taking back some control.
Common triggers and risk factors
Some panic attacks seem to come out of nowhere. Others are tied to certain places or situations. Noticing your own patterns gives you and your clinician something concrete to work with.
Situations that can set off panic
- Crowded places or public transportation
- Enclosed spaces, such as elevators or tunnels
- Social situations or public speaking
- Driving, especially on highways or bridges
- Stressful events or big life transitions
Things that can make panic more likely
- A family history of panic or anxiety
- Ongoing stress or past trauma
- Major life changes, such as a move, a job loss, or a breakup
- Certain medical conditions, such as thyroid or heart rhythm problems
- Caffeine, alcohol, nicotine, or other substances
- Stopping certain medications suddenly
How panic can affect daily life
Beyond the attacks themselves, many people start to dread the next one. That fear can lead to avoidance: skipping the grocery store, the highway, or the meeting where an attack happened before. Little by little, your world can start to feel smaller.
For some people, avoidance grows into agoraphobia, a fear of places where escape might feel hard. Panic can also show up alongside low mood or heavier drinking. These are all good reasons to reach out sooner rather than later.
Treatment options
Panic attacks and panic disorder are treatable. Treatment is personal, and it often combines more than one approach.
Cognitive behavioral techniques
Cognitive behavioral therapy (CBT) helps you notice the thoughts that turn a racing heart into “something is terribly wrong,” and practice new ways of responding. A key part is gradually and safely facing the sensations and situations you have been avoiding, so you learn that panic is uncomfortable but passes.
At JRose Wellness, Jessica uses cognitive behavioral techniques, mindfulness, and practical coping strategies within your visits. In her words: “Many Psych NPs offer medication management and brief therapeutic interventions. I will provide supportive therapy during our sessions and may refer you to a therapist if needed.”
Medication
Medication can make panic attacks less frequent and less intense for some people. Antidepressants such as SSRIs and SNRIs are commonly used for panic disorder. Any medication decision should be made with a qualified prescriber who knows your full history.
How Jessica approaches it: “Decisions are based on your symptoms, history, past medication responses, side-effect sensitivity, lifestyle, and preferences.” Medication is always optional. Learn more about medication management.
Daily habits that support treatment
Regular movement, steady sleep, and cutting back on caffeine and alcohol can make your body less reactive. Mindfulness and slow breathing can help you ride out symptoms. These habits support treatment. They do not replace it.
What to do during a panic attack
Professional care helps over the long run. In the moment, these steps can help:
- Slow your breathing: breathe in through your nose for a count of four, hold for four, then breathe out through your mouth for a count of six.
- Ground yourself: name five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste.
- Talk to yourself kindly: “This is uncomfortable, and it will pass.”
- Stay in the present: notice what is happening now instead of what might happen next.
- Stay put if it is safe: leaving brings quick relief but teaches your brain the situation is dangerous. Letting the wave pass shows you it ends on its own.
When to seek professional help
If you have had more than one panic attack, you live in fear of the next one, or you have started avoiding places because of panic, it is a good time to talk with a professional. You don't have to wait until it gets worse.
A psychiatric evaluation looks at your symptoms, history, and goals, and ends with a plan that fits you. At JRose Wellness, Jessica Logel, MSN, PMHNP-BC, FNP, a board-certified psychiatric nurse practitioner, sees adolescents 15 and older, adults, and older adults in Connecticut by secure video. Read more about how anxiety and panic are treated.
Living with panic can feel isolating. Reaching out is a sign of strength, and it is the first step toward feeling steadier.