Panic attacks: what happens and what to do

A panic attack is a sudden surge of intense fear or discomfort that peaks within a few minutes and then slowly eases. The first time, many people think they are having a heart attack or dying. That very fear makes the panic worse.

Signs of a panic attack

• A pounding or racing heart
• Shortness of breath or a feeling of choking
• Chest tightness or pain
• Sweating, trembling, sudden chills or heat
• Dizziness, nausea
• Tingling or numbness in hands and feet
• Feeling that the surroundings are unreal
• Fear of losing control, “going crazy” or dying

What to do during a panic attack

1. Remind yourself. “This is panic. It is uncomfortable, but it will pass in a few minutes.” Once physical causes have been ruled out, this works very well.
2. Slow your breathing. Breathe in through your nose for a count of 4 and out slowly through your mouth for a count of 6. A longer out-breath helps the body calm down.
3. Come back to the present. Notice 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell and 1 you can taste.
4. Don’t run away, if the place is safe. Leaving out of fear teaches the brain that the place is dangerous, and the fear grows next time.

When is it called panic disorder

One panic attack does not mean an illness. But when sudden attacks happen repeatedly, and for at least a month there is worry about another attack or life changes because of the fear (for example, no longer going out), professionals call it panic disorder. It responds well to treatment. Cognitive behavioural therapy (CBT) is very effective for panic, and a psychiatrist can prescribe medication if needed.

If someone near you has a panic attack

• Stay calm yourself and speak slowly and gently.
• Don’t snap “calm down”. Instead say, “I’m here with you, this will pass.”
• Breathe slowly with them so they can follow.
• Ask what helps them at such moments.