How to Recognize and Manage Panic Attacks
Feeling like your heart is racing out of control, your chest is tightening, or you can’t quite catch your breath can be terrifying. Many people who experience these sensations for the first time think they might be having a heart attack. In reality, they may be having a panic attack, a sudden surge of intense fear or discomfort that peaks within minutes.
Therapy for anxiety can help. We offer anxiety therapy both virtually and in-person at our office in Raleigh, North Carolina.
Panic attacks are more common than you might think. According to the Anxiety & Depression Association of America, millions of adults in the U.S. experience panic attacks every year. While they are not life-threatening, they can feel overwhelming and leave lasting fears about when the next one will strike.
In this article, we’ll cover:
What a panic attack feels like
Common signs and symptoms to recognize
Why panic attacks happen
How to stop a panic attack in the moment
Long-term strategies to manage and prevent them
How therapy can help you find relief
If you’ve been struggling with panic attacks, know that you’re not alone, and with the right tools and support, it’s possible to break the cycle.
What Is a Panic Attack?
A panic attack is a sudden, intense episode of fear or discomfort that comes on quickly and typically lasts between 5 to 20 minutes. The hallmark of a panic attack is that the fear is disproportionate to any actual danger in the situation. Many people describe panic attacks as feeling like they are losing control, suffocating, or even dying. Even though panic attacks are not physically dangerous, the fear of the experience itself often leads people to avoid situations where they think a panic attack might occur. Over time, this avoidance can greatly impact daily life.
Recognizing the Signs: Symptoms of a Panic Attack
Panic attacks involve both physical and emotional symptoms. While they may look different from person to person, some of the most common signs include:
Physical Symptoms
Rapid heartbeat or palpitations
Shortness of breath or a feeling of choking
Sweating
Shaking or trembling
Chest pain or tightness
Nausea or stomach discomfort
Dizziness, lightheadedness, or feeling faint
Chills or hot flashes
Numbness or tingling in hands, feet, or face
Emotional Symptoms
A sudden sense of overwhelming fear or doom
Feeling detached from reality or yourself (depersonalization or derealization)
Fear of losing control
Fear of dying
If you’ve experienced several of these symptoms all at once, especially in situations where there was no clear danger, you may have had a panic attack.
Why Do Panic Attacks Happen?
Panic attacks occur when your body’s “fight-or-flight” response is triggered, even when there is no real danger. Stress hormones like adrenaline flood your system, leading to physical changes such as a racing heart, rapid breathing, and tense muscles.
Some common triggers and risk factors include:
Chronic stress
Major life changes (moving, starting a new job, relationship stress)
Genetics or family history of anxiety disorders
Health concerns or medical conditions
Certain substances (caffeine, stimulants, alcohol withdrawal)
Sometimes panic attacks seem to come “out of the blue” without any clear cause, which can make them feel even more frightening.
How to Stop a Panic Attack in the Moment
When you’re in the middle of a panic attack, it may feel like there’s nothing you can do to stop it. But there are proven techniques that can help calm your body and mind. Here’s a few ways to guide you out of a panic attack:
Ground Yourself with Breathing
Try slow, deep breathing to signal to your body that you are safe. Inhale for 4 counts, hold for 2 counts, and exhale for 6 counts. Repeat until you notice your heartbeat slowing down.
Use the 5-4-3-2-1 Technique
This grounding exercise pulls your attention away from fear and back into the present:
5 things you can see
4 things you can touch
3 things you can hear
2 things you can smell
1 thing you can taste
Relax Your Muscles
Tense and release each muscle group in your body, starting with your toes and moving upward. This progressive relaxation helps undo the tension panic creates.
Repeat a Calming Phrase
Tell yourself: “This will pass. I am safe. I’ve gotten through this before.” Positive affirmations can counter the spiral of catastrophic thoughts.
Visualize a Safe Place
Close your eyes and picture a place where you feel calm and safe, perhaps the beach, a cozy room, or a favorite hiking trail. Engage your senses to make the visualization as real as possible.
Long-Term Strategies to Prevent Panic Attacks
While knowing what to do in the moment is important, addressing panic attacks at the root is key to long-term relief. Here are some ways to reduce the likelihood of future episodes:
Practice Regular Relaxation
Incorporating activities like yoga, meditation, or mindfulness into your daily routine helps lower baseline stress levels.
Improve Sleep and Nutrition
Lack of sleep and high caffeine intake can make panic attacks more likely. Aim for consistent sleep and a balanced diet.
Exercise Consistently
Physical activity helps regulate stress hormones and improves overall mood. Even a daily walk can make a difference.
Challenge Anxious Thoughts
Cognitive-behavioral strategies teach you to question whether the catastrophic thoughts fueling panic are actually true.
Consider Professional Therapy
Therapists trained in anxiety can teach evidence-based skills to manage panic. Some common approaches include:
Cognitive Behavioral Therapy (CBT): Helps reframe unhelpful thought patterns.
Exposure Therapy: Gradual, supportive exposure to feared sensations reduces fear of panic itself.
Mindfulness-Based Therapy: Encourages acceptance of bodily sensations without judgment.
Panic Attacks vs. Anxiety Attacks: What’s the Difference?
The terms are often used interchangeably, but they are not exactly the same.
Panic attacks are sudden, intense bursts of fear with physical symptoms that peak quickly.
Anxiety attacks are more gradual, tied to specific worries or stressors, and often last longer.
Understanding the difference can help you better describe your experience to a healthcare provider.
When to Seek Professional Help
While one panic attack doesn’t necessarily mean you have a panic disorder, frequent attacks or ongoing fear of them may indicate a more chronic issue.
Seek professional support if:
You experience panic attacks repeatedly
You avoid places or situations out of fear of an attack
Your daily life, work, or relationships are being affected
You have persistent worry about your health because of panic symptoms
Therapy can provide not only coping skills but also reassurance that you are not alone in this.
How Therapy Can Help with Panic Attacks
Working with a therapist allows you to:
Learn how to recognize and interrupt panic patterns
Practice grounding techniques in a safe environment
Understand the connection between thoughts, feelings, and bodily sensations
Reduce the fear of panic itself through gradual exposure
Build confidence in managing anxiety day-to-day
Many clients find that after therapy, even if panic attacks occasionally happen, they no longer control their life.
Finding Help for Panic Attacks in Raleigh, NC
If you’re experiencing panic attacks and looking for support, our team of licensed therapists in Raleigh, NC specializes in anxiety and panic disorders. We use evidence-based treatments tailored to your unique needs, helping you regain control and peace of mind.
