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Panic Attacks: What They Are and How to Manage Them

According to the Cleveland Clinic, up to 11% of Americans experience a panic attack every year with approximately 2-3% going on to develop panic disorder. Unfortunately, the term “panic attack” commonly gets used out of context in day to day conversation and panic attacks are often portrayed inaccurately in the media. These exaggerated and false portrayals can create increased confusion and fear. To set the record straight–let’s take a closer look at what it really means to experience a panic attack…

The DSM-5 defines a panic attack as “an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes” and includes four or more of the following symptoms:


• Heart palpitations

• Sweating

• Trembling or shaking

• Shortness of breath sensations

• Feelings of choking

• Chest pain or discomfort

• Nausea or stomach distress

• Feeling dizzy, lightheaded or faint

• Chills or heat sensations

• Numbness or tingling sensations

• Derealization or depersonalization

• Fear or losing control or going crazy

• Fear of dying


Notice the word “fear” in the list of symptoms above? A panic attack can morph into “the fear of the fear” or the fear of the uncomfortable sensations involved. The truth is… as uncomfortable as panic attacks can be–they do not need to be feared. It is important to know that a panic attack is the body’s natural response to stress. I once had a college professor who taught us that the heart rate associated with panic is equivalent to running up six flights of stairs. Six flights of stairs–uncomfortable, absolutely. Dangerous, no.


Did you also happen to catch that the definition of a panic attack involves reaching a peak “within minutes?” This is SO important for folks who fear that a panic attack will cause them to die, lose control, or go crazy. Panic attacks resolve within minutes–it is biologically impossible for them to last longer than this.


If you or someone you know is prone to experiencing panic, here are some tips to help weather the intense emotional and physical storms that they can create:


-Know your Triggers: Distressing thoughts (ex. “I’m not good enough”) or reminders of distressing events can prompt symptoms of panic. Knowing your triggers can help you feel more prepared to respond when panic symptoms appear.


-Practice Self-Talk: Develop a set of helpful statements or mantras that can help you manage through the panic. Some examples might be “I’m safe; This will pass.”


-Practice Deep Breathing: Slowing and/or deepening your breath can decrease the intensity of panic symptoms. Square Breathing is my personal favorite technique.


To Practice Square Breathing:


Focus on taking deep breaths in and out through your mouth, feeling the air slowly fill your chest and belly and then slowly leave them again. As you trace the shape of a square in front of you, (1) breathe in for a count of four along one side of the square, (2) then hold for the count of four along the top side of the square, (3) breathe out for a count of four down the other side of the square, (4) and hold for the count of four along the bottom of the square.

-Create a Calm/Safe Place for Your Mind to Visit: Guided Imagery can be a powerful tool. Creating a go-to calm or safe place to visit in your mind during times of distress can help the body relax. The trick is to practice visiting this place in your mind during times of regulation first so that it is easier to practice when you need it.


-Utilize Mental Distractions: Try counting backwards from 100; pick a letter and think of emotionally positive or neutral words that begin with that letter; think of the words to your favorite song or poem


If panic symptoms are interfering with your daily life or causing you to miss out on things that you typically enjoy, consider seeking out the support of a therapist. The good news is that there are several therapeutic options available that can help. Lastly, know that you are not alone–many people experience panic attacks. Having accurate information and a few coping strategies can make a big difference in preventing or alleviating the intensity of panic attacks.


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Written by: Jenna Butzow, MSW, LICSW

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