Chest pain or discomfort Dizziness or faintness Fear of dying Fear of losing control or impending doom Feeling of choking Feeling of detachment Feeling of unreality Nausea or upset stomach Numbness or tingling in the hands, feet, or face Palpitations, fast heart rate, or pounding heart Sweating, chills, or hot flashes Trembling or shaking
One method to slow your breathing is to take a deep breath and hold it for as long as you can. This balances levels of oxygen and carbon dioxide and reduces the feeling that you cannot breathe. After holding your breath, then begin deep, diaphragmatic breathing. Breathe in slowly and deeply, then exhale even more slowly. To practice diaphragmatic breathing, try sitting in a chair with 1 hand on your chest and the other a little below your rib cage. Sit comfortably with bent knees, and relaxed shoulders and neck. [5] X Trustworthy Source Cleveland Clinic Educational website from one of the world’s leading hospitals Go to source Next breathe in slowly through your nose and let your stomach expand, keeping your upper chest as still as possible. Slowly exhale, tightening your stomach muscles, and keep your upper chest still. The hand on your stomach area should move out as you inhale, then back in as you exhale, with the hand on your upper chest remaining as still as possible. [6] X Trustworthy Source Cleveland Clinic Educational website from one of the world’s leading hospitals Go to source Another method is the 5-2-5 method. Inhale with your diaphragm for 5 seconds. Hold your breath for 2 seconds. Then exhale for 5 more seconds. Repeat 5 times. [7] X Research source Breathing into a paper bag is not routinely recommended anymore. It may not be as beneficial as was believed in the past, and may even be detrimental.
Common drugs used to treat panic attacks that are classed as benzodiazepines include alprazolam, lorazepam, and diazepam. These agents have a fairly rapid onset and can help to relieve symptoms within 10 to 30 minutes. Other agents prescribed that fall in the group of benzodiazepines start to work a little slower but stay in your blood stream longer. Examples of these agents include clonazepam, chlordiazepoxide, and oxazepam. These agents are often prescribed in low doses to take regularly until the panic attacks become more manageable by using other types of medication, such as selective serotonin reuptake inhibitors, or participating in cognitive behavioral therapy.
Continue talking, moving, and keep your thoughts focused. By doing so, you are sending messages to your brain, and your panic, that there is no danger, no alarm, and no reason to be in a fight-or-flight state. [10] X Research source
By staying where you are, and taking control of your symptoms, you are taking steps to train your brain in recognizing the absence of real danger in the grocery store. [12] X Research source If you run away, your brain begins to associate that place, and maybe all grocery stores, with danger, and may create feelings of panic each time you enter a grocery store. [13] X Research source
Examples include drinking something either warm or cold, taking a short walk, singing along to a favorite song, talking with a friend, and watching TV. Additional things to try in order to focus on something other than the panic include stretching exercises, doing a puzzle, changing the air temperature, rolling down the window if you are in a car, going outside for some fresh air, or reading something that is interesting to you.
Stressful experiences happen to everyone at one time or another. The body’s natural fight or flight instinct may be activated during a stressful or anxious situation, just as it is during a panic attack, but there is always a trigger, event, or experience that is directly tied to the reaction. Panic attacks are not tied to an event, are unpredictable, and the severity of an attack can be extreme and terrifying.
If you suffer from panic attacks or panic disorder, working with a cognitive behavioral therapist will help you learn relaxation strategies to take control of the panic when it starts.
Use your eyesight to notice pleasant things in your immediate surroundings. If you are in a safe place, try closing your eyes and visualizing your favorite flower, favorite painting, favorite beach, or something that makes you feel more relaxed. [16] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source Stop and listen to what is around you. Try to find music in the distance, hear the birds, the wind or the rain, or even the hum of traffic on a nearby highway. Try to find something new that you can hear, other than the sounds of your heart beating and sounds that are part of the stressful event. [17] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source Continue to apply the senses by identifying the smells around you. Perhaps you are inside and someone is cooking, or you are outside and you can smell rain in the air. [18] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source Focus on the sense of touch. You may not realize it but you are always touching something. If you are seated, focus on the way the chair feels, or notice if the table your arm is resting on is cold, or warm, or if you can feel a breeze on your face. [19] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source By taking those few moments to review what your senses are experiencing, you have redirected the focus away from the panic, anxiety, or stress. This is clearly not resolving the cause of the panic, anxiety, or stress, but concentrating on your senses is useful in addressing the unwanted physical reaction your body may be experiencing.
Many panic attacks are commonly related to other underlying disorders, including some mental health conditions and some medical problems. Talk to your doctor to rule out an underlying medical condition.
Benzodiazepines are considered addictive, so be sure to take them exactly as your doctor advised. Taking more than is recommended is dangerous and can cause serious and potentially fatal withdrawal effects if taken chronically.
Take these agents only when needed to avoid becoming tolerant to the prescribed dose. Examples of medications prescribed to take when an attack begins, on an as needed basis, are lorazepam, alprazolam, and diazepam.
These medications are often prescribed for routine dosing, to help you avoid attacks, until further steps, such as cognitive behavioral therapy, can be taken. Examples of intermediate acting agents include clonazepam, oxazepam, and chlordiazepoxide.
SSRIs that are FDA approved for use in treating panic symptoms include fluoxetine, fluvoxamine, citalopram, escitalopram, paroxetine, and sertraline. Duloxetine is a closely related agent and is also approved for use in the treatment of panic symptoms. [22] X Research source
Know what to expect from cognitive behavioral therapy. Therapists trained in this form of psychotherapy use 5 fundamentals as they work with people that suffer from panic attacks. The 5 areas of focus include the following:[24] X Research source Learning about the illness helps you to better understand what is happening that causes the frightening symptoms experienced when a panic attack occurs. [25] X Research source Monitoring and recording dates and times of events, like keeping a diary or a journal, helps both you and the therapist to identify triggers that cause the attacks to begin. [26] X Research source Breathing and relaxation techniques are a part of the tools used to reduce the severity of symptoms. [27] X Research source Rethinking is used to help alter the perception of an attack from what feels catastrophic to what is realistic. [28] X Research source Providing exposure, safely and in a controlled manner, to places or events that are triggers for your attacks, helps to train your brain and body to react differently. [29] X Research source
Early treatment for panic disorder improves overall outcomes and reduces possible complications associated with continued attacks.
