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Depression and Anxiety Special Report

Coping With Panic Attacks

Johns Hopkins shares four strategies for managing panic attacks so they frighten you less, are less intense, and occur less frequently.

It comes on suddenly, without warning. Your heart races and pounds in your chest, you sweat, you feel short of breath, dizzy, sick to your stomach, faint even. You fear you’re having a heart attack or maybe losing your mind. You have a distinct feeling of unreality and, perhaps, a desire to run away and hide. You fear you may do something crazy or uncontrollable. Being in the throes of these feelings and sensations is terrifying and profoundly uncomfortable. But within minutes, the symptoms are gone (one way to know you’re not having a heart attack).

You’ve just had a panic attack. And now you live with the fear of having another panic attack, the dread of which can be worse than the attack itself. You may also be blaming yourself for allowing your emotions to run away from you. But the truth is that once a panic attack begins, your body is being held hostage by a cascade of physiological events -- starting with the release of stress hormones such as cortisol -- that are difficult to reign in. This doesn’t mean all hope is lost.

Why do we panic? Ironically, panic attacks most often occur during non-threatening, normal activities. They can hit when you’re walking down the street, sitting at your desk at work, or visiting with friends. The catch is that for some reason the brain misinterprets the situation as threatening.

Although the setting of a panic attack is usually benign, panic attacks commonly occur during stressful periods of life, such as when someone is getting a divorce, grieving a death, or moving to a new town. Stress, it’s believed, may create a physiological imbalance or allow an underlying genetic predisposition to panic attacks to emerge.

Strategies for Coping With Panic Attacks
If you experience a panic attack, keep these facts and tips in mind, courtesy of Edmund J. Bourne, Ph.D., author of The Anxiety & Phobia Workbook, and Denise F. Beckfield, Ph.D., author of Master Your Panic and Take Back Your Life! Twelve Treatment Sessions to Conquer Panic, Anxiety, and Agoraphobia, to help get you through the episode:

  • Remember that a panic attack poses no physical danger. You won’t faint, have a heart attack, lose your balance, fall, suffocate, or go crazy. You will not lose control of your body.
  • Recognize and accept your symptoms rather than fight them. Intellectualize the situation by telling yourself that you recognize the symptoms and know they are signs of a panic attack. Though disquieting, tell yourself that the attack will run its course and resolve within a few minutes.
  • Learn the early signs of a panic attack. Sometimes you can stop a full-blown panic attack from developing by intervening at the first sign of an episode and focusing on something else besides your body and feelings.
  • If a panic attack is under way, interrupt the cascade of panicky thoughts by repeating the words “Stop it!” aloud or silently to yourself. Then shift your focus to deep abdominal breathing to slow your respiration rate and relax your muscles so you can “flow through” the attack.

Seeking Professional Help
An occasional panic attack can usually be managed with the strategies discussed above. However, if you have four or more panic attacks in a month and/or your fear of another attack is disrupting your everyday life, it’s time to consult a mental health professional who specializes in panic and anxiety disorders. Both therapy and medication are effective in managing panic disorder and preventing future episodes.

Could It Be a Heart Attack?
The symptoms of a heart attack are quite similar to those of a panic attack. In both cases, the symptoms appear without warning and can include chest discomfort, dizziness or lightheadedness, shortness of breath, stomach upset, and sweating. But there are a few differences. In a heart attack, chest pain often spreads to the arms (particularly the left arm) or to the jaw, and the symptoms continue for longer than 10 minutes. If in doubt whether it’s a heart attack, it’s best to err on the side of caution: Dial 911 immediately for an ambulance.


Posted in Depression and Anxiety on April 23, 2008
Reviewed July 2009

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