A panic attack is a very sudden and frightening experience that can feel like you are

having a heart attack, dying, or losing control. Many adults experience only 1 or 2 attacks
in a lifetime, but others have recurrent attacks, which may be an indication of an
underlying condition called panic disorder. A panic attack is an abrupt onset of intense
fear for no apparent reason, accompanied by very real physical changes, such as a rapid
and pounding heart rate, sweating, and rapid breathing. Steps can be taken to stop a panic
attack, and to help prevent further attacks from happening.

Part1
Getting Immediate Relief

1
Recognize the physical symptoms. During a panic attack, your body goes into a natural fight-
or-flight response, just as if you were in a truly terrifying and dangerous situation, only no
dangerous situation is actually occurring.[1] Symptoms that are commonly experienced during
a panic attack include:
.

. 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
.
.

2
Control your breathing. Most panic attacks cause rapid and shallow breathing which fuels the
attack, causing the symptoms to linger. By controlling your breathing, you can help to return
your heart rate to normal, lower your blood pressure, slow the sweating, and re-establish a
feeling of being in control.[2]
.

. 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.[3]
. After holding your breath, then begin deep, diaphragmatic breathing. Breathe in slowly and
deeply, then exhale even more slowly.[4]
. 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]
. 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]
. 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]
. 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.
.

3
Take prescription medication. One of the most effective ways to stop a panic attack is by taking
oral agents classed as anti-anxiety medications, usually benzodiazepines.[8]
.

. 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.[9]
. 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.[10]
. 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.[11]
.

4
Try to continue your activity. As much as possible, carry on normally and continue with your
current activity and daily routine to prevent the panic from consuming you.[12]
.

. 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.[13]
.

5
Avoid running away. If you have a panic attack at a specific place, maybe a grocery store, then
you may want to run away and leave the store as quickly as possible.[14]
.

. 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.[15]
. 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.[16]
.

6
Focus on other things. With the help of a therapist, you can learn ways to naturally focus your
thoughts, and take control of the panic.[17]
.

. 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.
.

7
Distinguish between a stressful experience and a panic attack. While both types of experiences
are similar in that physical reactions occur, such as elevated blood pressure, sweating, and
increased heart rate, they are distinctly different events.
.
. Stressful experiences happen to everyone at one time or another. The bodys 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.
.

8
Implement relaxation techniques. Take steps to calm down by using established methods of
relaxation to take control of the exaggerated stressful or anxious experience.
.

. 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.

9
Use your senses to tackle the attack. Whether you experience a panic attack, an anxiety attack,
or find yourself in a stressful situation, by focusing on your senses, even for just a few
moments, you can slow down the unwanted physical symptoms that are happening.[18]
.

. 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.[19]
. 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.[20]
. 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.[21]
. 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.[22]
. 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.
Part2

Preventing Future Attacks

1
Talk to your doctor about your attacks. Your doctor may treat you with recommended
medications or may refer you to a mental health professional to evaluate and prescribe
medications. Both a regular doctor and a mental health physician will likely recommend a
cognitive behavioral therapist.
.

. Panic attacks are commonly 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.
.
.

2
Seek medical help sooner rather than later. Studies show that people that are treated for panic
attacks and panic disorder early, have better overall outcomes with fewer complications.[23]
.

3
Take medications as prescribed. Commonly used agents include benzodiazepines, both rapid
acting and intermediate acting.[24]
.

. 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.
.

4
Take rapid acting agents only when needed. Rapid acting agents help to manage the symptoms
when you feel a panic attack beginning. These are often prescribed to have available if needed,
or when you begin to have a panic attack.[25]
.
. 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.
.

5
Take longer acting agents routinely, or as prescribed. The intermediate agents take a little
longer to start working, but have longer lasting effects.
.

. These medications are often prescribed for routine dosing, to help you avoid attacks, until
further steps, such as cognitive behavioral therapy, can be taken.[26]
. Examples of intermediate acting agents include clonazepam, oxazepam, and chlordiazepoxide.
.

6
Take an SSRI. Selective serotonin reuptake inhibitors, commonly known as SSRIs, are
effective in treating panic attacks and panic disorder.[27]
.

. 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.[28]
.

.
 7
Work with a cognitive behavioral therapist. This form of therapy is key in training your brain
and your body to overcome panic attacks, and help you reach a point where they no longer
occur at all.[29]
.

. 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:[30]
. Learning about the illness helps you to better understand what is happening that causes the
frightening symptoms experienced when a panic attack occurs.[31]
. 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.[32]
. Breathing and relaxation techniques are a part of the tools used to reduce the severity of
symptoms.[33]
. Rethinking is used to help alter the perception of an attack from what feels catastrophic to what
is realistic.[34]
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.[35]

.
8
Consider an evaluation for panic disorder. Panic disorder is diagnosed when 4 or more of the
above symptoms are present.[36]
.
. Early treatment for panic disorder improves overall outcomes and reduces possible
complications associated with continued attacks.

Community Q&A

Is it normal for my chest to hurt for multiple days?

 wikiHow Contributor

Yes. Anxiety can cause your chest to hurt. See your doctor to be on the safe side.

Flag as duplicate

Not Helpful1 Helpful29

What if none of the suggestions work, and I can't stop the panic attack?

wikiHow Contributor

Always tell yourself that nothing bad is going to happen. Panic attacks, although severely unpleasant,
are not harmful. Sometimes, if we read tips and tricks that claim to 100% stop any panic attack, it can
actually worsen our anxious state if we don't find they work. Remember that panic attacks WILL
PASS. You cannot die from them, and they cannot hurt you. The quicker you can get your breathing
under control, the quicker you'll feel better, as this slows down your heart rate, relaxing your body.
Easier said than done, but persevere!

Flag as duplicate

Not Helpful0 Helpful11

I get panicky around a certain person and my body goes into a different mode. Can I get panics
attacks from being around people that stress me out?

wikiHow Contributor

 Yes, you can! You may also be suffering from severe anxiety or fear from that person. If it interferes
with your daily life, consider talking to a therapist.

Flag as duplicate

Not Helpful7 Helpful51

Sometimes my twin brother can really scare me and I feel like I can't breathe and my life is
threatened by him, but once I tell him to stop, he threatens to hurt me if I snitch. What should I
do to make him stop?

wikiHow Contributor

Tell your parents or another trusted adult and make sure they will help keep your safe. This behavior
isn't okay.

Flag as duplicate

Not Helpful3 Helpful28

What are panic attacks? What causes them?

wikiHow Contributor

Panic attacks are extreme feelings of panic, terror, anger, frustration, or any combination plus other
feelings. Most panic attacks are completely random and have no triggers, but some are caused by
being in a place in which you've had a prior panic attack, or in the same conditions in which you've
had one before. All panic attacks are different, and everybody's reactions to them and triggers are
different.


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Not Helpful8 Helpful52

I think I get these whenever traveling in a plane. Can anyone relate to this and what steps should
I take to prevent these attacks?

wikiHow Contributor

I also get these during take-off and landing - sweaty palms is the first thing I notice as the attack
begins. You could definitely try deep breathing and meditation techniques, but honestly, taking a
Xanax beforehand helps me.

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Not Helpful1 Helpful16

Can a panic attack be caused by being overweight?

wikiHow Contributor

Panic attacks aren't always caused by anything specific. They are sudden and come out of the blue.

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 Not Helpful12 Helpful63

What are the physical risks of a panic attack?

wikiHow Contributor

Physical risks are not a common symptom of a panic attack, but they can still happen. Physical risks
include: physically pushing other people away, pulling your hair or pulling it out, and scratching your
skin.

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Not Helpful12 Helpful56

Can fatigue and stress cause panic attacks?

wikiHow Contributor

Out-of-control stress/anxiety is, in fact, what usually causes panic attacks. Fatigue can increase stress
and create a lot of imbalance in your body and mind, which makes panic attacks more likely.

Flag as duplicate

Not Helpful4 Helpful23

 I have all of these symptoms and have been having panic attacks almost every other day for the
last month now. I have a doctor's appointment, but I'm really scared about what the may say,
and I'm tempted to cancel it. Should I?

wikiHow Contributor

Don't cancel your appointment! Panic disorder, if you have it, is highly treatable. Your doctor has
surely seen patients with similar problems before and can only help you.