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This post is not intended to substitute medical information from a doctor.
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Imagine you are walking to the grocery store parking lot. You just parked your car, and are running through the list of items you need. As you are crossing the lot, a giant, ferocious dinosaur appears. Not a cartoon Barney dinosaur, more like Jurassic Park. You freeze. You feel your heart start to race as adrenaline pumps through your body. Your mind goes blank as to what to do or how to stop this creature from eating you whole.
No imagine that there was no dinosaur. Your body goes through those same reactions. It can be triggered by a stressful event, too much caffeine, or sometimes by nothing at all. Imagining that feeling of terror gives you a glimpse into what some people experience as a panic attack. It is the fight, flight or freeze response to something that others might see as nonthreatening. Those who experience these attacks often may find that they avoid certain areas or situations that may trigger their attacks. While they can look different for each person, one thing is certain, panic attacks can be a terrifying experience.
How can I tell if I am having a panic attack?
Panic attacks have similar symptoms to other medical conditions, such as heart attacks. Often times the signs of a panic attack are mistaken for signs of a heart attack. In fact, in general, more and more people are going to the emergency room as a result of physical reactions to their mental health1. So when in doubt, get medical attention. But for those circumstances where a medical issue has been ruled out, here are some signs that what you have experienced might just be a panic attack. Please note that while panic attack symptoms can feel intense and frightening in the moment, they are not usually dangerous unless you have a preexisting medical condition that can be affected by your symptoms.
12 Signs of a panic attack:
Sign #1 Rapid Heart Rate You may feel your heart racing in your chest. Some people describe it as a “fluttering sensation”, while others say it feels like they just sprinted up a flight of stairs.
Sign #2 Shallow Breathing, Choking You may find yourself taking shallow breaths, or going through periods where you aren’t breathing in at all. (This is why deep breathing is a good tool!) Hyperventilation is often experienced with quick inhales and exhales. This contributes to the dizziness that often accompanies panic attacks. (See sign #3!)
Sign #3 Dizziness This includes feeling faint, like you are going to pass out. Since this is common when your body is short on oxygen, it is likely due to the shallow breathing that accompanies a panic attack.
Sign #4 Chills and/or Hot flashes Think of having the flu. You may just experience intense heat, or chills, or both. This would be an improper reaction to the air temperature around you. For example, if you are in air conditioning, an intense hot flash may be a notable reaction.
Sign #5 Sweating You may feel your forehead break out into a sweat, or your underarms. If your heart is beating quickly, you may sweat as a result of the overuse of your muscles. This is often a result of hot flashes that can be associated with panic attacks.
Sign #6 Shakiness, Trembling Those who experience panic attacks often describe feeling shaky or trembling sensations, even when they aren’t visibly shaking. You may experience unsteadiness and feel the need to sit or lay down.
Sign #7 Weakness Muscle weakness or feeling like your muscles don’t work right can be a symptom of a panic attack. You may feel “weak in the knees” or notice that your arms or fingers aren’t moving in a way you’d expect them to. “Wobbly” or “Rubbery” are words often used to describe this feeling2.
Sign #8 Chest Pains Pains in your chest during a panic attack is common due to increased heart rate and rapid breathing patterns. This may also be due to general muscle tightness.
Sign #9 Nausea/Digestive Issues Having an upset stomach is common to panic attacks because of the fear you are experiencing. In that fight, flight or freeze reaction, your body may be preparing to run. There are multiple ways that running (fleeing) can trigger your body to feel nauseous or even throw up3.
Sign #10 Panicked thoughts These panicked thoughts are often geared towards a certain trigger in the moment, but can also be a generalized feeling of panic. They are often more intense and dire thoughts than everyday anxiety.
Sign #11 Increased agitation Just like other situations where your body isn’t feeling well, many people experience increased agitation and irritability. This may also happen as a result of someone around not being supportive or helpful during or after a panic attack.
Sign #12 Exhaustion afterwards Increased muscle usage, adrenaline response and panic can often leave you feeling drained and exhausted after a panic attack. This may be a good time to take a sip of water, lay down, and try to promote relaxation.
The important thing to remember is that while there are similar symptoms of panic attacks, they are often specific to each person experiencing them. You may experience panic attacks differently than someone else.
What do I do about it?
In the moment…
- Take a breath Trying to regulate your breathing can help send your body the message to calm down. Focus on taking in as much air as you can. As your breathing slows, you can take deeper, belly breaths. You can visualize this as if you are blowing up your belly like a balloon. Some people find that breathing out for longer than they breathe in can help calm them, such as breathing in for a count of 5 and breathing out for a count of 7. Others find that putting their head between their legs and taking deep breath can help.
- Focus Moving your attention to something or someone else can help. Can you focus on a piece of furniture near you? A pet? A friend or family member? Try to describe everything you can about that person or object.
- Use Reassurance This can be hard in the moment, but using reassuring language can be helpful when you are having a panic attack. For example, thinking “this will pass” or “panic attacks ALWAYS end” can reassure you that you won’t feel this way forever. “You’ll be alright” or “Just take a breath” can be ways to talk yourself down from your reaction.
Looking long term…
- Learn the signs that you are about to panic. Triggers to anxiety can be both internal and external. We can start worrying about something and our thoughts can spiral out of control, heightening our feeling of anxiety. It can also be a result of physical sensations, such as worrying about being sick or experiencing muscle tension. In her book “The 10 Best-Ever Anxiety Management Techniques Workbook“, Margaret Wehrenberg creates this chart as an example.
This shows how an increase in worry can lead to an increase in physical tension, which can result in panic. The sooner you can detect you are feeling anxious, the sooner you can use skills to try to reduce anxiety and cope with the situations or thoughts triggering your anxiety.
- Practice coping skills Deep breathing, progressive muscle relaxation (PMR), reassurance, and self-soothing can all be effective tools to use when attempting to combat feelings of anxiety. However, when anxiety gets intense, it is difficult to remember all of the tools you know to calm down. First, writer down all of your go-to strategies for dealing with feelings of anxiety or anxious thoughts. This could be journaling, listening to music, going for a walk, or others. Then, be sure and practice these techniques when you are calm. The more you practice your skills while you are calm, the better you can recall them and use them when you are panicking.
- Find support Seek support from family, friends, church members or even co-workers around you. Having someone to provide reassurance, support, and to coach you through dealing with your panic can help you overcome it in the moment. It can also help to find support in the long term. Having supportive people around you can help you reduce your anxiety levels overall.
If you are struggling to use skills, identify triggers to anxiety, or to reduce your anxiety, find a therapist you trust. Check out our article on finding a therapist.
Have you ever experienced a panic attack? What did you do that helped? Please leave your answer in the comments below.
Erica K. Cieri, LCSW is a therapist and trainer at Made to Thrive in Williamsville, NY. She specializes in working with kids, teens and college students dealing with anxiety, behavior problems, tough relationships and difficulty managing their emotions. She collaborates with her clients to develop strategies to manage their current issues, but also to discover long term how to find peace. Erica can be reached at firstname.lastname@example.org.