How to manage panic attacks

Find out how to manage panic attacks

Knowing how to manage panic attacks helps
Knowing how to manage panic attacks helps

This was initially a guest post on Happiness between tails and I’m now sharing it with you. As someone who’s experienced and had to manage severe panic attacks, I understand just how frightening and debilitating they are.

I never want to experience another one and if this is you too, let’s look at how to prevent them.

First tho’, in order to overcome panic attacks, you’ll need to understand what they are. We’ve all had feelings of anxiety – it’s our body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come.

For example, you may feel anxious about a job interview. During times like this, feeling anxious can be perfectly normal, but some people find it harder to control their anxieties.The most severe form of anxiety can trigger panic attacks.

What is a panic attack or panic disorder?

Panic attacks might follow stressful life events
Panic attacks might follow stressful life events – Image Pixabay

We have panic attacks and panic disorder; one episode is a panic attack, which might occur following a stressful life event i.e death of someone close.

Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear. You experience regular and subsequent attacks. It’s a common yet very misunderstood illness and lots of people with this disorder won’t ever seek help due to fear and stigma.

The attacks can occur often and at any time, seemingly for no apparent reason. It feels like a sudden, unexpected rush of intense fear and anxiety along with a flood of frightening thoughts and physical sensations – so, panic attacks are not merely psychological.

What you should know about panic disorder

Panic attack symptoms are similar to some physical illnesses
Panic attack symptoms are similar to some physical illnesses
  • Many of the symptoms of panic attack are similar to some physical illnesses i.e. heart attack or over-active thyroid. See your GP to rule these out.
  • It’s a chronic condition and can lead to changes in behaviour, like avoiding situations or events.
  • People dread the onset of another attack, and the fear of having one is just as debilitating as the attacks themselves.
  • Panic disorder knows no boundaries as it affects people of all socio-economic groups and races. It’s more common in women than men. It can also affect children and the elderly.
  • Although the exact causes are unclear, panic disorders can run in families.
  • While many attacks are be triggered by stressful life events, they can also occur ‘out of the blue’.
  • Be aware – anti- malaria medication, cold and flu medications, appetite suppressants and even too much caffeine can trigger panic attacks in some people.

If you experience panic attacks, you might then begin to avoid events or situations because you’re afraid of another attack. However, avoidance can create a cycle of living in “fear of the fear”, which only adds to your sense of panic. This can cause you to have more panic attacks, leading to diagnosis of panic disorder

What are the symptoms of panic attacks?

Panic attack can feel like a heart attack
Panic attack can feel like a heart attack – see your GP

If we encounter a situation that threatens our safety, we’ll experience a series of reactions known as the ‘fight or flight’ response – triggered by the release of chemicals that prepare your body to either stay and deal with a threat or to flee to safety.

During a panic attack, we’ll experience similar symptoms, even when there’s no real threat involved. A panic attack might happen in response to situations that others find harmless. Symptoms include physical and physiological symptoms:

  • Racing heartbeat, palpitations
  • Dizziness, light-headedness, or nausea
  • Difficulty breathing, like you can’t get enough air
  • Dry mouth and unable to swallow – if you do need fluids, just take smalls sips to avoid choking
  • Shaking, trembling
  • Sweating and hot flushes or sudden chills
  • Sudden need to go to the toilet, the body needs to lighten to fight or flee
  • Numbness or tingling sensations, initially in your fingers and toes
  • Your face, feet and hands might go white (as with the tingling, this is the blood leaving your extremities to rush to where it’s needed most i.e. heart and muscles)
  • Chest pains – you might think you’re having a heart attack – one way to tell is – if your fingers and toes are tingling, you’re more likely to be having a panic attack. However, if you’re afraid call the emergency services to check

You might experience negative thoughts

tender redhead woman with finger on lips
Embarrassed by panic attack — Image by Pexels
  • I’m so embarrassed, everyone can see me panicking
  • I feel like I’m dying or I’m having a heart attack.
  • I can’t cope with this!
  • I’m so stupid, I’m never going to get rid of this feeling.

and feelings of:

  • You’re going mad or crazy.
  • Being out of physical or emotional control.
  • Unreality/detachment from yourself or your surroundings.
  • Heightened sound and visual awareness, and hypervigilance (for flight or flee you need to hear and see clearly and be vigilant).

A panic attack generally lasts between 4 – 20 minutes, although it often feels a lot longer. However, they have been known to last an hour. I had them one after another, and all night for around three months and it felt like torture. It’s no wonder I became psychotic!

How to manage panic attacks

Practice breathing through your panic attack
Practice breathing through your panic attack — Photo by Pexels
  • Breathe as slowly and deeply as possible, exhaling firstly through your mouth – slowly for a count of 8-10 seconds, then in through your nose slowly and so on.
  • Some people use a paper bag to cover their nose and mouth, and breathe in an out. This is known to work but it’s not something I’d teach because you’re not always going to have access to a paper bag.
  • Recognise that this is a panic attack and tell yourself that it will pass, because it will.
  • Use muscle relaxation techniques – try slumping your shoulders, letting them drop down from your ears, give your jaw a little wiggle then let it relax, uncross your legs, unclench your fists and lay the palms of your hands lightly on your thighs (remind yourself that your body cannot be relaxed and tense at the same time).
  • Try to get to a quiet space and sit down if necessary and continue with the breathing.
  • If you’re at work or outside, ask for help, I know this might feel a little embarrassing, but do ask if you need to.
  • Count backwards slowly from 100 or
  • Look around for 5 things that you can see and name them out loud i.e. “I can see a red truck,” etc. You can go onto things you can hear, smell, taste, or touch in the same way – until the panic subsides. This technique will help you stay in the present and grounded by using your five senses.
  • Put a few drops of lavender (known to ease anxiety) on a tissue, exhale then breathe it in slowly.
  • Call emergency services if the symptoms continue or get worse, or if you’re afraid it might be something else i.e. heart attack.

How to manage someone else’s panic attacks

How to manage someone else's panic attacks
How to manage someone else’s panic attacks — Photo by Pixabay on Pexels
  • Ask the person if they’ve had a panic attack before, and what they think might help or has helped them in the past.
  • Encourage them (or tell them quite firmly if they’re confused and unable to follow directions) to breathe (as above). Do this with them if necessary, as often they think they can’t breathe and won’t be able to do this alone.
  • Follow the above steps and call emergency services if necessary.

Self-help to combat panic attacks

Notice the tension in your body
Notice the tension in your body — Photo by Pexels
  • Listen (regularly) to free mental wellbeing audio guides online. These will help prepare you so that you can manage your panic attacks as you need to.
  • Search and download relaxation and mindfulness apps or online community apps.
  • Learn other skills like visualisation to help you relax and practice them often.
  • Notice when your body is tense i.e. when your shoulders are up round your ears or your fists are clenched and let them relax. When your body is constantly tensed up, it’s effectively telling your brain you’re on alert, tensed and ready to fight or flee.
  • Ask your close friends or family members to support you by gently pointing out when you’re all hunched up and tense. Even better, perhaps they’ll give you a light head massage, or lightly rub your arms and hands in a soothing way.
  • Practice the breathing exercises often so that you’ll be able to use them easily when needed. Honestly, practice this all day, every day — it’s a great feeling and you’ll have it ready to use when you need it.
  • Try mixing lavender oil with other aromatherapy oils like geranium or camomille to produce your own stress reliever.

I really can’t stress enough the need to practice the coping techniques. You know you wouldn’t be able to drive say on a motorway after having just one lesson. It takes practice!

Treatment for Panic attacks

Talking therapy for panic attacks
Talking therapy for panic attacks — Photo by Pexels

Treatment aims to reduce the number of panic attacks you have and ease your symptoms:

  • Psychological (talking) therapies and medicine are the main treatments for panic disorder
  • Depending on your symptoms, you may need either of these treatments, or a combination of both

When to get help

See your GP to rule out other causes
See your GP to rule out other causes — Photo by Pexels
  • If you’re having suicidal thoughts, please seek professional help. Or talk to someone close.
  • See a GP if you’ve been experiencing symptoms of panic disorder. Regardless of how long you’ve had the symptoms, if panic attacks are interfering with your life, work, or relationships you should seek professional help.
  • Although panic disorder is a medical condition in its own right, there can sometimes be a physical reason for your symptoms – and treating it can bring the anxious feelings to an end. See your GP to rule out any other causes and don’t self-diagnose.

Over to you


Have you ever had panic attacks, or do you know someone who has? Do you have other coping techniques that might help readers? Do you think you’d be able to support someone having a panic attack now? I look forward to your comments as always and I’m happy to answer any questions.


Mum to two amazing sons. Following recovery from a lengthy psychotic episode, depression, anxiety and anorexia, I decided to train as a Mental Health Nurse and worked successfully in various settings before becoming a Ward Manager. I am a Mental Health First Aid Instructor and a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor. Just started my mental health from the other side blog.

22 thoughts on “How to manage panic attacks”

  1. Interesting!! I doubt I’d be able to help someone with a panic attack, but I’d sure try! It sounds terrifying! I’ve never had one, but my mom used to have them, although I don’t think I was ever around when she did. It’s just something she told me about that I was never aware of. She got some meds from her doctor, took them for a while, and the problem went away. YAY for that!! I did know that many people go to the hospital convinced they’re having a heart attack or something, when the reality is that it’s a panic attack. I think aromatherapy is a brilliant idea that I’d definitely look into if I suffered from panic attacks!! But breathing exercises have never helped me with anything. I’m not sure if it’s me–it’s probably me. The idea about feeling tension in your body is really smart! I have constant tension, and I’ve just learned to live with it. Nothing can enable me to relax physically!

    1. I’m sure it must have been awful for your mum as they can be terrifying, especially when you can’t catch your breath and your heart is hammering. I’m glad she got meds that stopped them. Like you said, breathing exercises never helped you with anything, but you’d try the oils if you had panic attacks. That’s the thing, not every coping techniques suits every individual, you just have to keep trying various techniques to find something that does work.

      I tried practically everything and my favourite was acupuncture as, for me, it was an immediate relief. But lots of other techniques worked too. That’s a shame you don’t have anything to help you relax 🙁 x

  2. Yes, I have had panic attacks in the past.
    And now, with Coronavirus and not wanting to shop when a huge crowd and finding that I can’t avoid busy times, I notice how I tense and breathing changing, but this time in control with my attacks mostly.
    I only had one ocassion last week where I thought I was going to have an attack, but not be able to stop it. But thankfully, it didn’t get that far.

    1. Hey Liz, nice to hear from you. Yes, no doubt lots of people feel the same way during this damn virus thingy. But I’m really happy to read that you were able to stop it in time.

      Fortunately, I haven’t had a full blown panic attack for a while now – it’s so comforting knowing I can stop them in their tracks lol. xx

      1. Yes, it’s been comforting knowing I have some control over mine too.
        My last attacks were a few years ago, when at my last old job that caused a lot of them in the end, at one point.

  3. This is really great info! As someone who has panic attacks and panic episodes quite often, learning how they affect me physically has been a big help. I also appreciate that you listed so many ways to manage these situations. In the moment, you hope there’s a magic solution, but you might have to try a few different things to get back to a calmer state. Thanks for sharing!

    1. I’m glad you’ve found something that helps. Being able to ‘head panic attacks off at the pass’ makes them much easier to cope with.

      And yes you’re right, it’s good to have a few techniques practised to be able to use them quickly when needed.

  4. This was – is – a fantastic post, and I’m glad you shared it on da-AL’s site as well as here to allow more folks to see it. Panic attacks are horrid and overwhelming, not to mention scary if you don’t really understand what they are, why they’re happening or how to better manage the anxiety and future instances of a panic attack. Bravo, Caz !!

    1. Thanks Caz and I agree, panic attacks feel worse when you don’t know what they are! I’d seen a friend having a panic attack years before I had them. I read about them so I could support her. Thankfully I haven’t had a full blown panic attack for a while now 🙂

  5. Panic Attacks are horrible to experience. After losing both my Dad and Brother to Heart Attacks I was terrified it was my heart each time I had a Panic Attack. Eventually I learnt ways in dealing with them.

    This post is very helpful

  6. That’s interesting that over-active thyroid can mimic a panic attack. I had some issues with that not too long ago and I did notice a spike in my anxiety. Later, though, it just turned into crushing fatigue.

    A very good point about paper bags. Anxiety is an unpredictable thing, so any tools for handling it need to be portable or internal.

    1. With an over-active thyroid, your heart palpitates, you become jittery and get thirsty so you might think you’re having a panic attack,

      The paper bag does work, it’s just you might not always have one so yes, breathing is the most natural and effective coping technique. And it’s scientifically proven to work.

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