Signs of Panic Attacks (& How to Cope)

Key Takeaways:

• Panic attacks can feel overwhelming
• Heart attack vs. panic attack: Know the signs
• Nocturnal panic attacks often disturb sleep
• Self-help tips include relaxation techniques
• Support and treatment bring relief

Panic attacks strike with sudden, overwhelming terror, often leaving us gasping for air, clutching our chests, and desperately searching for answers. Many of us have found ourselves gripped by these moments of intense fear, feeling as if we're losing control or worse, about to die. If you've ever experienced the crippling grip of panic, you're not alone. The good news? You can learn to manage and even overcome these terrifying experiences.

Understanding the nature of panic attacks and panic disorder can offer a beacon of hope. When we face these fears head-on and take proactive steps, we can regain control over our lives. Let's dive deep into the signs, symptoms, and actionable advice for anyone struggling with panic attacks.

What are panic attacks?

Picture this: you're going about your day, everything seems normal, and then, out of nowhere, a wave of intense fear hits you. Your heart races, your breath quickens, and your entire body feels like it's in overdrive. This sudden surge of terror? That's a panic attack. It can happen to any of us—whether you're at the grocery store, stuck in traffic, or even relaxing at home. These attacks aren't just about feeling nervous; they are episodes of sudden, overwhelming fear that seem to come without warning.

From a psychological perspective, panic attacks are often described as your brain's "fight or flight" response going haywire. Your mind and body react as if there's an immediate threat, even if there's none in sight. This disconnect can leave you feeling bewildered and shaken. Dr. Claire Weekes, an authority on anxiety, explained it best: "It's not the panic that is the problem, but the fear of the panic that keeps it alive." The more we fear it, the more we get trapped in its vicious cycle.

But here's the thing: although it feels like something catastrophic is happening, panic attacks themselves are not dangerous. They can't cause lasting physical harm. Yet, they feel utterly terrifying, which makes understanding them crucial in managing those symptoms effectively.

Common signs and symptoms of panic attacks

The signs of panic attacks can vary from person to person, but some symptoms stand out as universal. You might suddenly feel your heart pounding so loudly it drowns out your thoughts. Or perhaps you find yourself gasping for air, as if your lungs simply forgot how to breathe. It's common to feel dizzy, shaky, or as if you're about to pass out. Many people describe a sense of impending doom, as if something terrible is about to happen but you can't pinpoint what.

Here are some of the most common panic attack symptoms:

• Rapid heartbeat or palpitations
• Shortness of breath or a feeling of being smothered
• Dizziness, lightheadedness, or faintness
• Chest pain or discomfort
• Sudden chills or hot flashes
• Feeling detached from reality, like you're watching yourself from the outside

Interestingly, these physical sensations stem from the body's natural reaction to stress. Your adrenal glands flood your system with adrenaline, causing these intense feelings. The problem? There's usually no real danger, which makes these symptoms all the more confusing. This disconnect leaves many people questioning if there's something much more serious happening to them.

Is it a heart attack or just a panic attack?

This is one of the most frightening parts about experiencing a panic attack: it can feel identical to a heart attack. The chest pain, racing heart, and difficulty breathing can mirror cardiac symptoms so closely that many people end up in the emergency room, convinced they're having a heart attack. And it's understandable—your mind jumps to the worst-case scenario when your body goes into full-blown crisis mode.

So, how can you tell the difference? In general, heart attack pain tends to be more localized to the chest and may radiate to the arms or jaw, often triggered by physical exertion. Panic attacks, on the other hand, typically come on suddenly and reach their peak within minutes. The good news? If you've been evaluated by a doctor and told your heart is healthy, that crushing chest pain is more likely your body's way of sounding a false alarm.

Dr. David Carbonell, author of “The Panic Attacks Workbook,” emphasizes: “The key difference is in the onset—panic attacks strike suddenly, often without a clear trigger, while heart attacks generally build up over time.” Taking deep breaths, reminding yourself that it's a panic attack and not a heart attack, can help ease the fear in the moment.

Panic attacks vs. anxiety attacks: Key differences

Many people use the terms "panic attack" and "anxiety attack" interchangeably, but they are not the same. While both involve intense feelings of fear, their causes, symptoms, and durations differ significantly. Let's break it down.

Panic attacks hit suddenly, seemingly out of the blue, and the symptoms peak within minutes. They are often accompanied by severe physical reactions, like trembling, sweating, or feeling like you're choking. Anxiety attacks, in contrast, are typically linked to a specific stressor. For example, you might feel your anxiety building up over the course of a day if you're worried about an upcoming exam or a stressful meeting.

In essence, panic attacks are more acute and intense but tend to be short-lived. Anxiety attacks can last much longer and are more of a slow burn. Think of panic attacks as an unexpected storm that hits out of nowhere, while anxiety attacks are like a lingering rain cloud that hangs over you all day. Understanding these differences can help you find better coping strategies and, importantly, recognize that what you're experiencing has a name. It's not just “all in your head”—it's your mind's response to perceived threats.

Understanding the signs of panic disorder

Panic disorder goes beyond the occasional panic attack; it's a persistent, underlying fear that another attack could strike at any moment. For those who live with this condition, every day can feel like walking on eggshells, anticipating that sudden wave of terror. But the signs aren't always straightforward. In fact, panic disorder can manifest in ways that make us question whether what we're experiencing is truly psychological or something far more sinister.

The hallmark sign? Recurring, unexpected panic attacks, followed by at least a month of constant worry about having another one. You might also find yourself avoiding certain places or situations that you fear could trigger an attack. This fear-driven avoidance can shrink your world, making everyday activities feel like insurmountable challenges.

Physical symptoms often mirror those of panic attacks: racing heart, shortness of breath, dizziness, or feeling faint. But with panic disorder, the dread of the next attack often looms larger than the actual episodes. You might start to feel disconnected from yourself or the world around you, a phenomenon psychologists call “derealization.” It's like you're watching life through a foggy window, unable to fully engage with what's happening.

Living with panic disorder isn't just about coping with the attacks themselves. It's also about battling the constant anxiety of when the next one will strike. Understanding the signs early on can make a significant difference in managing the condition and regaining control over your life.

Experiencing nocturnal panic attacks

Imagine being jolted awake in the dead of night, heart pounding, gasping for breath, convinced something terrible is happening. That's what a nocturnal panic attack feels like. Unlike typical panic attacks that occur during the day, nocturnal panic attacks strike while you're sound asleep, catching you completely off guard. You wake up disoriented, confused, and terrified, unsure if what you're experiencing is real or just a bad dream.

These attacks are particularly distressing because they disrupt your sense of safety in your own bed, the very place where you should feel most relaxed. They can leave you anxious about going to sleep, which only worsens your anxiety in the long run. You might find yourself lying awake, dreading that moment when your body betrays you once again with an unexpected surge of fear.

Nocturnal panic attacks don't necessarily stem from nightmares. Instead, they seem to originate from your body's internal stress responses kicking into overdrive while you rest. Research suggests that high levels of stress hormones like cortisol can trigger these episodes, particularly if you're already prone to daytime panic attacks. If you're dealing with nocturnal panic attacks, focusing on a calming bedtime routine can make a difference—think relaxation exercises, deep breathing, or even listening to soothing music before bed.

Though these attacks can feel utterly terrifying, they do not pose any real threat to your health. However, the lingering fear they instill can rob you of peaceful sleep, which is essential for overall well-being. By acknowledging the signs and seeking help, you can begin to reclaim your nights and your peace of mind.

Nocturnal panic attacks vs. nightmares and night terrors

At first glance, nocturnal panic attacks, nightmares, and night terrors might seem like variations of the same experience. After all, they all involve waking up abruptly in the middle of the night, drenched in sweat, heart pounding. But they're not quite the same. Let's break down the differences.

Nightmares are simply frightening dreams that can wake us up feeling unsettled, but they are rooted in our dream state. You usually remember them in vivid detail when you wake up. Night terrors, on the other hand, are more intense. They can cause screaming, thrashing, and extreme panic, often without the person being fully aware of what's happening. Unlike nightmares, people who experience night terrors may not recall them the next morning.

Nocturnal panic attacks, however, occur while you are in a non-dreaming sleep state. They're not triggered by any specific dream content but rather by an overactive stress response. You wake up, not from a nightmare, but because your body believes it's in immediate danger. And unlike night terrors, you remain fully aware of your surroundings, which makes the experience all the more terrifying. Understanding these distinctions can help you pinpoint what you're dealing with and find effective coping mechanisms.

How panic disorder links to agoraphobia

One of the most debilitating aspects of panic disorder is its potential to evolve into agoraphobia. When you've experienced enough panic attacks, the fear of having another one can become so intense that you start avoiding places where attacks might occur. Agoraphobia isn't just about being afraid of open spaces or crowded places—it's the fear of being in situations where escape feels impossible or embarrassing if a panic attack strikes.

For someone with panic disorder, even a trip to the grocery store can feel like a mission to the moon. The thought of being trapped in a line, surrounded by strangers, with no easy exit can trigger waves of anxiety. This avoidance can snowball until it shrinks your world to the four walls of your home. Eventually, some people become so paralyzed by fear that they avoid leaving their house altogether, a condition known as “homebound agoraphobia.”

Agoraphobia feeds off the fear of fear itself. The more we avoid situations, the more our anxiety grows. The key to breaking this cycle lies in gradually exposing yourself to the places you fear. Cognitive-behavioral therapy (CBT) and exposure therapy are highly effective in treating both panic disorder and agoraphobia, helping you reclaim the freedom to live your life without constant fear.

Exploring the causes of panic attacks and panic disorder

So, what exactly causes panic attacks? Why do they strike some people and not others? Unfortunately, there's no one-size-fits-all answer. The reality is, panic attacks result from a complex interplay of factors—psychological, biological, and environmental. Some of us may have a genetic predisposition to anxiety. If you have a parent or sibling with panic disorder, you're at a higher risk of experiencing it yourself.

Biologically, an overactive amygdala—the brain's emotional center—plays a significant role. When the amygdala misfires, it can send your body into panic mode without a clear external threat. This is why panic attacks can strike even when everything seems calm and normal. Hormonal imbalances, especially in serotonin and norepinephrine levels, can also contribute to heightened anxiety and panic.

On the environmental side, stress is a major trigger. Traumatic events, prolonged pressure at work, or even sudden life changes can tip your brain's stress response into overdrive. Dr. Bessel van der Kolk, a leading trauma researcher, notes, "The body keeps the score." Past trauma can manifest in unexpected ways, including panic attacks years after the original event.

Ultimately, while you may not control the initial cause of panic attacks, you can control how you respond to them. By understanding their roots, you can start working towards managing them more effectively.

Self-help strategies for managing panic attacks

When panic strikes, it's easy to feel like you're losing control. But there are concrete steps you can take to regain your footing. Let's explore some strategies that can help you weather the storm when panic rears its head.

One of the most effective self-help tools is simply education. The more you understand panic attacks, the less power they hold over you. Knowing that what you're experiencing is a surge of adrenaline, not a heart attack or a sign that you're going crazy, can bring tremendous relief. Knowledge really is power in this case.

Another helpful approach is to experiment with relaxation techniques. Deep breathing exercises, progressive muscle relaxation, or mindfulness meditation can interrupt the panic cycle. For example, the “4-7-8” breathing technique involves inhaling for four counts, holding for seven, and exhaling for eight. This method activates your parasympathetic nervous system, helping to calm your body down.

Beyond that, reframing your thoughts about panic can shift the way you respond. Instead of seeing a panic attack as an enemy, view it as a signal that your body needs your attention. Try to remind yourself: “This will pass. I've survived this before, and I will again.” The way we talk to ourselves during a panic attack can make a world of difference in how quickly we recover.

Lastly, don't underestimate the power of self-care. Regular exercise, a balanced diet, and good sleep hygiene can create a more resilient mental state. Taking time to decompress, whether it's through journaling, spending time in nature, or simply soaking in a hot bath, can reduce your overall anxiety levels and lower the chances of a panic attack catching you off guard.

Tip 1: Educate yourself about panic and anxiety

One of the most empowering things you can do for yourself when it comes to panic attacks is to learn everything you can about them. The more you understand, the less fear they'll hold over you. Think about it: when you know exactly what's happening in your body and why, it takes away a lot of the uncertainty that feeds your anxiety.

Panic attacks might feel like they're coming out of the blue, but they're not as random as they seem. They are your body's natural alarm system going haywire. Your heart races, your breath shortens, and your muscles tense up because your body believes there's a threat. But here's the good news: it's just a false alarm. Recognizing that these intense sensations are simply your body's misguided attempt to protect you can make them less terrifying.

Read up on the science of anxiety. Books like “The Anxiety and Phobia Workbook” by Edmund Bourne offer practical advice and exercises to help you understand the roots of your panic. Knowledge doesn't eliminate the fear completely, but it does reduce its intensity. After all, once you understand the mechanics behind your panic attacks, they lose a bit of their power to control you.

Tip 2: Practice relaxation techniques regularly

Let's face it: when panic strikes, it feels impossible to relax. But here's the thing—you don't need to wait for a panic attack to start practicing relaxation. In fact, the key is to make relaxation techniques a part of your daily routine. By regularly engaging in activities that calm your nervous system, you build up resilience. So, when that adrenaline surge hits, you're better prepared to handle it.

Relaxation techniques can be as simple as setting aside five minutes each morning to breathe deeply or stretch your muscles. Yoga, tai chi, or even just taking a walk in nature can do wonders to lower your stress levels. And let's not forget the power of sound—listening to soothing music or nature sounds can instantly shift your mind into a calmer state. The trick is consistency. The more you practice, the easier it becomes to tap into that state of calm when you need it most.

Simple breathing exercises to try

When panic takes over, one of the first things that happens is that your breath becomes shallow and rapid. This only fuels your anxiety. By focusing on your breath, you can slow down your body's panic response and start to regain control. Here are a couple of easy techniques to try:

1. Box breathing: Inhale slowly for four counts, hold your breath for four counts, exhale for four counts, and hold again for four counts. Repeat this cycle a few times. It's called box breathing because you're creating a mental “box” with each step. This technique helps calm your mind and slow your racing heart.

2. The “4-7-8” technique: Breathe in through your nose for a count of four, hold the breath for seven counts, then exhale slowly through your mouth for eight counts. This exercise activates your parasympathetic nervous system, which is responsible for bringing your body back to a state of rest and calm. It's like a reset button for your mind.

These exercises don't just work in the middle of a panic attack. Practicing them regularly can reduce the likelihood of future attacks, giving you a valuable tool to have in your back pocket when anxiety strikes.

Tip 3: Reframe your perspective on panic

Let's be honest—when you're in the midst of a panic attack, the last thing you want to hear is “just calm down.” It's frustrating because if it were that easy, you'd have done it already. But there's a way to shift your mindset that can change the way you respond to panic attacks in the long run.

Instead of seeing panic as a monster that you need to run away from, try viewing it as your body's way of alerting you to something deeper. Yes, it's uncomfortable, and yes, it's scary, but it's also a sign that your mind and body need some attention. A shift in perspective can turn a panic attack from a terrifying experience into an opportunity to learn about yourself.

For example, instead of thinking, “I can't handle this,” try telling yourself, “I've been through this before, and I know it will pass.” Cognitive reframing like this isn't just about positive thinking—it's about reminding yourself of your strength. It takes time and practice, but the more you work on reframing your thoughts, the less power panic will have over you.

Psychologist Carl Rogers once said, “The curious paradox is that when I accept myself just as I am, then I can change.” Accepting your panic attacks doesn't mean you're resigned to them forever; it means you're no longer fighting against yourself. And that acceptance can be the first step towards lasting change.

Tip 4: Prioritize self-care routines

Let's be real—when life gets busy, self-care is often the first thing to go. We tell ourselves we'll rest “when there's time” or that we'll finally take a break after that next big project. But when you're prone to panic attacks, prioritizing self-care isn't just a nice-to-have. It's a non-negotiable.

Taking care of yourself isn't selfish; it's essential. Regular self-care routines can help you stay grounded, reduce overall stress, and minimize the likelihood of a panic attack sneaking up on you. It's not about grand gestures either. You don't need a week-long retreat to decompress. Sometimes, the most effective forms of self-care are the simplest ones. A hot bath, sipping a cup of herbal tea, reading a few pages of a book you love—these small moments add up.

Sleep is also a major player in keeping anxiety at bay. Studies show that lack of sleep increases levels of the stress hormone cortisol, which can heighten anxiety and make panic attacks more likely. So, guard your sleep routine like it's your most precious asset. Try to go to bed and wake up at the same time each day, and avoid screens at least an hour before bedtime. If you need to, set an alarm—not just to wake up, but to remind you when it's time to start winding down for the night.

Tip 5: Seek support from trusted sources

No one should have to face panic disorder alone. Reaching out for help can be one of the hardest, yet most powerful, steps you take. Sometimes we convince ourselves that we're a burden, that we should “tough it out” on our own. But the reality is, sharing your struggles with someone you trust can lighten the load.

This support can come from various sources. Maybe it's a friend who understands, a family member who listens without judgment, or even a therapist who can guide you through coping strategies. If you're not ready to talk face-to-face, consider joining an online support group. The internet is filled with forums and communities where people share their experiences with panic attacks and offer encouragement to one another. Knowing you're not alone in this battle can be incredibly comforting.

Therapy, especially cognitive-behavioral therapy (CBT), has a proven track record of helping people manage panic attacks. Therapists can help you challenge the irrational fears that drive your panic and develop healthier ways to cope. Don't underestimate the power of a compassionate professional who's trained to help you heal.

Effective treatment options for panic disorder

Let's cut to the chase—if you're experiencing frequent panic attacks, it's crucial to explore treatment options. While self-help strategies can go a long way, sometimes professional intervention is necessary to reclaim your life. There's no one-size-fits-all approach, but the good news is that multiple treatments have shown to be effective.

Cognitive-behavioral therapy (CBT) remains one of the most effective therapies for panic disorder. In CBT, you learn how to identify and challenge the distorted thoughts that trigger your panic. You also develop coping mechanisms to reduce the frequency and intensity of your attacks. Over time, you can essentially “rewire” your brain to respond differently to the same triggers.

Another highly effective option is exposure therapy. This involves gradually exposing yourself to the sensations or situations that trigger your panic in a safe, controlled environment. The goal is to desensitize your brain to the panic triggers, proving to yourself that they aren't as dangerous as they feel. The process isn't easy, but many people report significant improvements after just a few sessions.

Medication can also be an option, particularly if your panic attacks are so severe that they interfere with your day-to-day functioning. Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines are commonly prescribed. SSRIs like sertraline or fluoxetine can help balance the brain chemicals linked to anxiety, while benzodiazepines like Xanax can provide immediate relief during a panic attack. However, these medications come with their own set of pros and cons. Always consult with a healthcare professional to weigh the benefits and risks.

Ultimately, the most effective treatment plan may involve a combination of therapies and lifestyle changes. It's about finding what works best for you. Don't get discouraged if the first approach doesn't provide instant results—healing from panic disorder takes time, patience, and persistence. But with the right tools and support, you can regain control and live the life you deserve.

Considering medication for panic disorders

When panic attacks feel relentless, medication can be a lifeline. Let's face it—sometimes the sheer intensity of panic can make it hard to function day to day. Medication isn't a cure, but it can help you manage the symptoms so that you can get back to a place where other treatments, like therapy, can be more effective.

One of the most commonly prescribed classes of medication for panic disorder is selective serotonin reuptake inhibitors (SSRIs). These medications, like sertraline (Zoloft) or escitalopram (Lexapro), work by increasing levels of serotonin, a neurotransmitter that helps stabilize mood. They don't work overnight—it often takes several weeks to feel their full effects—but they can reduce the frequency and intensity of panic attacks over time.

Benzodiazepines, such as lorazepam (Ativan) or alprazolam (Xanax), act much faster, sometimes within minutes. But they're typically used for short-term relief due to their potential for dependency. If your panic attacks are severe and infrequent, a doctor might prescribe a low dose to use as needed. However, because of the risk of dependence and side effects like drowsiness, they are generally not a long-term solution.

Keep in mind that medication is not a one-size-fits-all answer. You may need to try a few different medications to find the one that works best for you. And medication should ideally be combined with therapy to address the underlying causes of your panic attacks. It's important to have an open and honest conversation with your healthcare provider about the risks, benefits, and possible side effects. Remember, you have options, and it's okay to take the time to figure out what works for you.

How to support someone experiencing a panic attack

Watching someone go through a panic attack can be heart-wrenching, especially if you're not sure how to help. It's natural to want to fix the problem or say something to make it better, but the most important thing you can do is just be there. Your calm presence can be incredibly grounding during their storm of anxiety.

The first thing to remember is to remain calm yourself. Panic is contagious—if you start to panic too, it can amplify their fear. Instead, focus on staying steady. Speak in a soft, reassuring voice. Simple phrases like “I'm here with you” or “This will pass” can offer a sense of comfort.

Encourage them to take slow, deep breaths. You can even model it for them. Try breathing in for four counts, holding for four, and exhaling for six. This can help slow their racing heart and steady their breath. But don't push it—sometimes people in the midst of a panic attack just need space. Let them guide you on what they need.

Avoid saying things like “calm down” or “it's all in your head.” While well-intentioned, these phrases can come off as dismissive. Instead, acknowledge their feelings: “I know this feels terrifying right now, but you're safe.” Remind them that panic attacks, while intense, are not dangerous. If they're comfortable, you might gently guide them to a quiet place or offer them water to sip on, which can help ground them in the present moment.

Lastly, if you notice someone having frequent panic attacks, encourage them to seek professional help. Being supportive doesn't mean you have to be their therapist. Sometimes the best support you can give is helping them find the right resources to get the help they need.

Recommended Resources

• “The Anxiety and Phobia Workbook” by Edmund J. Bourne – A comprehensive guide with practical exercises to manage anxiety and panic attacks.
• “Dare: The New Way to End Anxiety and Stop Panic Attacks” by Barry McDonagh – A fresh approach to overcoming panic using evidence-based techniques.
• “When Panic Attacks” by David D. Burns – Insightful strategies from cognitive-behavioral therapy to change how you respond to anxiety and panic.