As much as it sucks, anxiety doesn’t have to be a bad thing. Without a little bit of it, you wouldn’t make sure to show up on time to that job interview or to put in effort to impress your bosses. Ideally, the right amount of anxiety commands your attention and pushes you to get shit done.
An abundance of anxiety, however, is where the trouble starts. Anxiety disorders are the most common mental illness in the U.S., affecting almost 20% of the population. Panic disorder is considered an anxiety disorder and is characterized by episodes of panic attacks.
A panic attack happens when a sudden and sharp increase in anxiety causes intense symptoms like a pounding heart rate, shaking, and shortness of breath.
Anyone who has experienced one can tell you a panic attack can be terrifying. They’re also exceedingly common — and seemingly random. For example, you can still experience one without having panic disorder. Every year in the U.S., about 1 in 4 people experience a spontaneous panic attack, according to Simon Rego, PhD, Director of Psychology Training at Montefiore Medical Center and the Albert Einstein College of Medicine.
If you’ve never had one before, you might not know what a panic attack is. The symptoms are diverse. Often, panic attacks send people to their nearest emergency room, thinking they’re having trouble breathing or having a heart attack, Dr. Rego says. Symptoms that really freak you out should always be investigated by a doctor, but it's still good to know what to expect. Ahead, we cover everything you should know about panic attacks.
What's actually happening during a panic attack?
A panic attack is really just “a sudden burst of intense anxiety with an accompanying feeling of impending doom,” Dr. Rego explains. During an attack, your body pumps out the hormone epinephrine (a.k.a. adrenaline) in response to a threat — whether it’s real or perceived — putting you into fight-or-flight mode.
Panic attacks usually reach peak intensity within moments and last up to five or 10 minutes.
Illustrated by: Tristan Offit.
What does it really feel like?
Instead of that impending doom feeling, you might feel like you're "going crazy" or that everything is out of control.
But the worst part of a panic attack is that the emotions you're feeling are so intense that your body can react with physical symptoms, according to Kenneth Abrams, PhD, associate professor of the Psychology Department at Carleton College.
These might include:
• Sweating
• Blurred vision
• Heart palpitations
• Trembling
• Shortness of breath
• The feeling of choking
• Muscle spasms
• Chest pain or discomfort
• Nausea or abdominal stress
• Dizziness or lightheadedness
• Chills or heat sensations
• Numbness or tingling
Illustrated by: Tristan Offit.
What triggers panic attacks?
Panic attacks can be caused by a variety of things, either a stressful event happening around you or an internal trigger, like a scary thought.
“Panic attacks occur in a variety of different conditions,” Dr. Abrams says. “For example, a person who has a fear of heights or spiders can have panic attacks in response to these situations. A person might have a panic attack while making a speech in front of a class.”
In short, panic attacks are usually a reaction to a conscious or even unconscious fear. They can, however, also be a response to a trigger that reminds you of something scary or traumatic that happened in the past — your body will anticipate the event happening again.
Dr. Abrams adds that if your family has a history of high anxiety, it also increases your chance of experiencing them, as there is a genetic predisposition to panic disorders
Illustrated by: Tristan Offit.
What should you do if you think you're having a panic attack?
Panic attacks are scary as it is, but if you’ve never had one before — and therefore don’t know what’s happening and haven’t had the chance to speak to a doctor — it can be doubly frightening. If you're not sure what it is, there is nothing wrong with visiting the ER or urgent care to make sure it really is a panic attack.
If you know you're having a panic attack, the National Health Service recommends a breathing exercise: take deep breaths in through your nose and out through your mouth for three to five minutes. Try to inhale for five seconds and then exhale for five, though it’s okay if you can’t get to five counts at first.
Dr. Rego also recommends reminding yourself that there are no medical side effects or complications that come from having a panic attack. As scary as they are, they will peak and then gradually subside after a few minutes.
If you have recurring panic attacks, your doctor will likely recommend talk therapy. Anxiety medications may also be helpful for managing them.
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