Signs of a Panic Attack That Everyone Should Know
While they may not be the topic of choice during Sunday brunch or a common discussion amongst friends in a group text, panic attacks are far from rare. In fact, at least 11 percent of American adults experience a panic attack each year, according to the Merck Manual. And the National Institute of Mental Health estimates that nearly 5 percent of U.S. adults experience panic disorder at some point in their life. ICYDK, panic disorder is a type of anxiety disorder characterized by unexpected and repeated episodes of intense fear that can technically occur at any time, according to the NIMH. But, here's the thing, you don't need to be clinically diagnosed with panic disorder to experience panic attacks, says Terri Bacow, Ph.D., a New York City-based licensed clinical psychologist. "While panic attacks are a symptom of panic disorder, plenty of people have stand-alone panic attacks or get panic attacks in the context of other anxiety disorders, such as phobias." (Related: Why You Should Stop Saying You Have Anxiety If You Really Don't)
A panic attack takes typical feelings of stress and anxiety to the next level. "During a panic attack, the body goes into fight or flight mode and prepares itself to fight or flee," explains Melissa Horowitz, Psy.D., director of Clinical Training at the American Institute for Cognitive Therapy. (Quick refresher: Fight or flight is essentially when your body is flooded with hormones in response to a perceived threat.) "But the reality is that there's no true danger. It's the somatic sensations and our interpretation of them that lead to a worsening of symptoms," she says.
Those somatic sensations include a laundry list of symptoms including nausea, tightening in the chest, racing heart, choking sensations, and shortness of breath. Other signs of a panic attack? Shakiness, trembling, tingling, dizziness, sweating, and more. "Some people get a few [of these signs of a panic attack], some people get many," notes Bacow. (If you're wondering, "what are the signs of a panic attack?" then you'd probably be interested to know that you can actually have a panic attack in your sleep, too.)
"During a panic attack, there's a sudden onset of fear that's intense and brief, lasting less than 10 minutes," says Horowitz. "These sensations can feel like you're having a heart attack, losing control, or even dying." The fear and uncertainty around what's happening can make you feel even worse, acting like fuel on your anxiety-filled fire. And that's why Bacow says, "the key is not to panic about the panic. If you freak out, the sensations get stronger."
Think of it this way: The signs of a panic attack — be it dizziness, shortness of breath, sweating, you name it — are your body's way of responding to a perceived threat and, in turn, "running drills" to prepare you to take on the so-called threat, explains Bacow. But when you start to hyperfocus on or stress about feeling these sensations, you send your body into overdrive and exacerbate the somatic sensations.
Either way, if you've experienced a panic attack, make an appointment with your doctor. "You wouldn't want to shrug off a serious medical condition, such as a heart problem, as panic," says Horowitz. And if you're experiencing attacks frequently, you'll want to seek treatment, such as cognitive behavioral therapy because symptoms could compromise your day-to-day life. (Related: Free Mental Health Services That Offer Affordable and Accessible Support)
While the symptoms of panic attacks are well-known, the causes are less so. "There may be a genetic or biological predisposition," says Horowitz. A major life event or a series of life transitions that occur during a short amount of time could lay the groundwork for experiencing a panic attack, too.
"There may also be some things that act as triggers for people who experience panic," she adds. Riding public transportation, being in an enclosed space, or taking an exam can all be triggers and enough to bring on any of the aforementioned signs of a panic attack. Certain medical conditions could boost your risk too. For example, people with asthma are 4.5 times more likely to experience panic attacks than those without the respiratory illness, according to a study in the American Journal of Respiratory and Critical Care Medicine. One theory: Symptoms of asthma, such as hyperventilation, can cause fear and anxiety, which can set off a panic attack.
If you experience panic, there are things you can do to help yourself recover more quickly (and none require breathing into a paper bag). While you should always see a doc — and take panic attacks seriously — if you notice the signs of a panic attack coming and experience an attack, these tips can help you in the heat of the moment.
1. Change your environment. It could be as simple as closing your office door, sitting in a bathroom stall, or stepping into a quiet spot in Starbucks. While in the throes of a panic attack, it can be very hard to slow down. Momentarily finding a place that's quieter — and has fewer distractions — can make a big difference in stopping the cycle of panic that you feel, says Horowitz. "Sit down, close your eyes, and take slow, deep breaths in and out."
2. Use self-talk. Either out loud or in your mind, talk yourself through what you're experiencing. For example, you could say, "My heart is beating rapidly, it feels as though it's getting faster than it was five minutes ago." "Being able to expose yourself to what feels so dangerous or threatening helps you remember that they're only sensations and although they're uncomfortable in the moment, they are not dangerous and won't last forever," explains Horowitz.
3. Get ahead of yourself. With your eyes closed, picture yourself being able to cope. "Imagine yourself in a place where you're no longer experiencing those [panic attack] symptoms and getting back to your everyday life," she says. This helps your brain believe that it's possible, which can help put an end to your panic more quickly. (Up next: Train Your Body to Feel Less Stressed with This Breathing Exercise)