SAMAR HAFEEZ, BANGALORE
Have you ever suddenly felt an overwhelming wave of fear, your heart racing, your chest tightening, and a sense that something terrible is about to happen—even when nothing dangerous is around? If so, you may have experienced a panic attack. Panic attacks are sudden, intense episodes of fear or discomfort that can be completely debilitating. To manage them effectively, it’s crucial to understand what they truly are.
A panic attack is a sudden onset of intense fear without any real or apparent threat. It is often accompanied by severe physical reactions like palpitations, rapid heart rate, sweating, feelings of impending doom, thoughts about losing control, or even fears of having a heart attack or dying. Panic attacks typically last between 5 and 30 minutes.
While many people recover naturally after experiencing a few panic attacks in their lifetime, recurrent attacks without explanation—combined with constant fear of future episodes—may indicate a panic disorder.
What does a panic attack look like?
Panic attacks can strike anywhere, at any time—during a meeting, while travelling, sleeping, eating, or shopping. Symptoms often peak within minutes and can leave a person feeling helpless. Recognising these signs is the first step to effectively managing or even preventing a full-blown attack.
Some of the common symptoms of a panic attack include a rapid heart rate (tachycardia), shallow breathing or shortness of breath, sweating, dizziness, lightheadedness, or feeling off balance, and tightness in the chest. People may also experience trembling or shaking, tense muscles, nausea or stomach discomfort, a choking or smothering sensation, dry mouth, and tingling or numbness in the fingers or toes. Hot flushes or cold chills, a sense of impending harm or doom, thoughts of losing control or dying, and feeling disconnected from the whole or parts of the body are also frequently reported.
Risk factors
Panic attacks can occur at any stage of life. But they are found to be more common in teenagers and young adults and tend to affect women more than men. Certain factors can increase the likelihood of experiencing panic attacks:
Family history of panic attacks: Having relatives who experience panic attacks may increase susceptibility.
History of childhood abuse (sexual or emotional): Early trauma can heighten vulnerability to anxiety and panic.
Major life stress or chronic stress: Events like serious illness, death in the family, or financial strain can trigger attacks.
Major life changes: Divorce, postpartum complications, changes in work status, or unemployment can increase stress levels.
Traumatic events: Sexual or domestic abuse, or serious accidents, can contribute to panic attacks.
Excessive caffeine consumption: High intake of caffeinated beverages can exacerbate anxiety.
Smoking or alcohol use: These substances can heighten stress responses and anxiety.
How to manage or prevent a panic attack
Being aware: Recognising the symptoms of panic attacks allows you to remind yourself that the situation is temporary and manageable. Knowing that fear of dying or of impending doom is a symptom, not reality, can help you reaffirm your capacity to control, manage, or even quickly reverse such thoughts.
Diaphragmatic (belly) breathing: This exercise involves taking deep and long breaths using your diaphragm (a muscle above the abdomen that helps in breathing). This can increase oxygen in the brain, counteract hyperventilation, reduce stress, and alleviate other cognitive symptoms of panic attacks.
Grounding exercise (5-4-3-2-1 technique): True to its name, a grounding exercise helps a person anchor themselves in reality and redirect focus to the present moment during a panic attack. It is highly effective in helping a person focus on safe and real surroundings, which promotes a sense of calm. This technique engages all five senses to direct the brain’s attention to the environment. For example, one can notice five things they see, touch a blanket or any nearby object, observe smells or aromas, and listen to sounds like cars passing by or people talking. These sensory checks help disconnect from distressing or negative thoughts and emotions in the moment. Therefore, it is a crucial step in successfully managing panic attack symptoms.
Progressive muscle relaxation (PMR): This technique is useful when a panic attack is approaching or already in progress. PMR involves two stages: first, consciously tensing muscles, and second, intentionally relaxing them. Tensing and relaxing different muscle groups—such as the chest, arms, legs, and glutes—relieves tension, promotes overall relaxation, reduces heart rate and blood pressure, and can improve sleep quality. This exercise can be performed while sitting on a chair or lying down on a sofa or bed.
Focus on positive imagery: Guided imagery helps a racing mind, filled with anxious thoughts, refocus on a calm and peaceful mental space. Positive visualisation reduces hyperfocus on threatening thoughts and replaces distressing thoughts with calming ones, thereby increasing a sense of control over negative or catastrophic thinking patterns.
Reassuring, realistic statements and positive affirmations: Remind yourself that a panic attack is not a real threat; it is a temporary physical experience that will pass and does not pose any actual danger to life or sanity.
Prevention
Practising yoga, Pilates, and mindfulness meditation daily can help reduce the likelihood of panic attacks. Reading self-help books on anxiety management, particularly those based on cognitive-behavioural therapy (CBT), is also beneficial. Engaging in regular physical activity, such as walking, swimming, or a preferred sport, helps regulate stress. Avoiding caffeinated drinks, smoking, sugary foods, and gambling can also reduce triggers. It is important not to overschedule your day; planning 2–3 achievable tasks per day helps prevent overexertion, which is a risk factor for panic attacks.
Interestingly, the digestive system acts as a modulator of anxiety through the gut-brain axis. Maintaining a balanced diet and getting at least seven hours of uninterrupted sleep daily are vital for overall well-being. Additionally, regular habits such as praying and participating in community service can serve as effective protective measures against panic attacks.
Conclusion
In the journey of managing panic attacks, patience and self-compassion are key. Progress may be gradual, but every step you take—whether learning to breathe deeply, practising relaxation techniques, or simply acknowledging your feelings—is a meaningful move toward greater emotional resilience. Remember that understanding your mind and body, and responding with care rather than fear, builds a foundation for long-term well-being and a stronger sense of inner calm.
Seek professional help if needed: If you find managing panic attacks alone or even with support from family and friends challenging, consider joining a support group, calling a 24/7 helpline, or consulting a therapist or psychologist. Professional assistance can help address deeper causes of frequent panic attacks, laying the foundation for healthier mental, emotional, and physical well-being.
Samar Hafeez is a consultant psychologist and a certified holistic health coach currently pursuing her PhD in psychology. She is a regular contributor for Light of Islam.
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