The Tyranny of Panic Attacks: Healthy Tips for Coping

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About 6 million American adults experience a panic attack every year. Panic attacks are bi-products of anxiety that occur regularly or intermittently. Either way, they are frightening to say the least. Panic attacks can cause major disruptions in people's lives and left untreated, may cause deterioration of social and occupational functioning.

Panic attacks are associated with an unmistakable period of intense fear and distress accompanied by multiple physical and mental symptoms. The mental symptoms can be paralyzing and create fear and confusion. The mind becomes overwhelmed with disturbing thoughts of danger, imminent death, and going crazy. The physical symptoms happen suddenly and peak rapidly, seizing the body and causing discomfort.

However, interestingly enough panic attacks are also very treatable, and there are many helpful coping tools individuals can engage in immediately, or during a panic attack that can help reduce symptoms on a consistent basis. How do I know I am having a panic attack?


- Fear of dying
- Thoughts of going crazy,
- Fear of a heart attack or some other severe, hidden illness
- Fear of losing control and humiliating oneself in public
- Fear of the next big panic attack, etc.
- Feeling weak and inferior


- Rapid heart rate/palpitations
- Labored breathing/shortness of breath/hyperventilation
- Trembling or shaking
- Nausea or abdominal distress
- Choking sensation
- Chest pain
- Sweating
- Numbness or tingling sensations in fingers and toes
- Lightheadedness/dizzy/unsteady
- De-realization (Feeling detached from reality)
- De-personalization (Feeling detached from your body)


Ground yourself:

Grounding yourself in a concrete task can be helpful to distract the mind from your racing negative thoughts. Grounding de-escalates your symptoms via healthy diversion. For example, run your fingers along the teeth of your house keys, squeeze a stress ball or hold an ice cube in your hand for as long as you can, then switch to your other hand. You can also engage in a chore, like cleaning or tidying up your home, anything to keep your mind focused on something else. Remember, the mind cannot be in two places at once.

Use "thought replacement" exercises:

Identifying your negative thoughts and then replacing them with rational ones also works to de-escalate the severity of our symptoms. It's a process of learning to be more reflective than reactive. Reflecting instead of reacting switches your mind from being a victim of your thoughts to being an observer of your thoughts. It takes some practice but in the end, it helps a great deal.

Accept your anxiety:

Contradictory as it sounds, acceptance of the unacceptable is key here. We are not saying to surrender to your panic and let it take over your life, but allow it to run its course. Don't try to accelerate your healing. The more people fight it, the harder it is to overcome. Acceptance can also mean it's time to look inward and see what areas in your life might be fueling the anxiety. So, you don't give up the cause to get well, but you accept the fact that you are anxious today and that the anxiety might stick around for a while. A good acceptance motto is: "It's not danger, it's discomfort."

Educate yourself on the anatomy of a panic attack:

Learning why you are having symptoms helps a lot too. Read up on the flight, flight or freeze response system that all living organisms have. It's an adaptive function placed there by God, the universe, evolution, etc., to protect the body from harm. The more you learn about how anxiety is not fatal and does not cause people to go crazy is very important to know. The more you understand about your condition, the better you will feel.

Create structure:

Spending your days idle without structure will cause you to over-magnify your negative thoughts. The mind is not built to be idle and unstructured. And couch "potato-ing" at home in front of the TV and "white knuckle-ing" your symptoms hoping they will go away is a mistake. Consider the directive: "Move a muscle, change a thought." Don't stay in bed all day. Get up at a reasonable hour and make sure you go to bed at a normal time as well. During the day, plan on doing some light exercise like walking or riding a bicycle (can be a stationary bicycle too). Plan to engage with people at least one time per day too. Meet a supportive friend or relative for lunch, etc.

Here are a few things to avoid:

Do not believe everything you think:

In the midst of a panic attack, don't assume that what you are thinking is actually true. Panic attacks cause catastrophic thinking which means your thoughts are most likely irrational and out of proportion to reality in the moment. And, although they sometimes say, "trust your gut," with a panic attack, it is not a good idea. Also, don't put so much importance on your thoughts. Just because you are having a thought, any thought, does not mean you have to pay attention to it. Thoughts are random and sometimes insignificant.

Do not fight it:

Don't assume that resisting and fighting your condition is going to help. Don't assume that a panic attack leads to fainting or losing control of yourself. Don't assume it will lead to psychosis or "going crazy." And, don't assume that it will cause a heart attack or some other serious illness. Typically, panic attacks are caused by an excess of adrenaline and other natural chemicals in the body. Symptoms of panic attacks are not fatal and they don't lead to "losing your mind."

Do not isolate and initiate "avoidance" behavior:

Withdrawing from people and isolating in your home is also not a good idea. The more you keep the anxiety bottled up and unexpressed, the worse it gets. Also, avoidance behavior by staying in your home 24/7 will begin to make your world smaller and smaller. Then, leaving your home for work or school or even for minor errands will begin to get harder and harder.

Do not stigmatize yourself:

Don't call yourself weak or inferior because you are suffering from panic attacks. Don't tell yourself you should be "handling" this better. Or that "a stronger person" wouldn't have this problem. Anxiety disorders are real, legitimate conditions that must be reckoned with. The more you see yourself as a failure because you are suffering, the worse you will feel in the long run.

Do not self-medicate:

Using alcohol or any other mood-altering substance could potentially induce more panic. For example, after the sedating effect of alcohol wears off, your panic will come back two-fold. The hangover the next day will not be pretty. Also, regardless of what people say about marijuana today, if you are suffering from panic attacks, it can exacerbate anxiety levels and could make you paranoid. Marijuana is a "reality" altering drug that can impair your ability to think clearly and be rational. Also, do not drink any caffeine whatsoever. Drinking caffeine while having panic attacks is like pouring gasoline on a fire.