You were fine a minute ago. Now your heart is racing, your hands and feet have gone numb and you feel like you can’t get enough air.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Clearly, you’re freaking out. But why? Are you having a panic attack? An anxiety attack? Are they the same thing? Are you going crazy? (Why can’t you stop the flood of questions?!)
Deep breaths. Clinical psychologist Regina Josell, PsyD, explains what’s going on when your body goes haywire — and how to get back to a place of calm.
Anxiety and panic attacks
A lot of people use the terms “anxiety attack” and “panic attack” interchangeably, but anxiety and panic attacks are slightly different beasts, Dr. Josell says. What’s the difference?
Here’s a basic breakdown:
- Anxiety is a typical human emotion. Big nerves before a big test, feeling super-stressed before a work presentation, fear before a medical exam — anxiety is unpleasant in the moment, but can also motivate us and protect us from threats, Dr. Josell says. “Everybody experiences anxiety.”
- Anxiety disorders occur when anxiety starts to interfere with everyday life. They can come in many forms, like social anxiety, a phobia of spiders or planes, or generally feeling worried and on alert at all times. What anxiety disorders have in common: People respond to non-threatening things with outsized fear and dread.
- Anxiety attacks aren’t technically a thing, at least not according to medical terminology. It’s a layperson’s term for a panic attack.
- Panic attacks are intense attacks of fear and anxiety that may occur without warning. They often occur in response to a stressful event. But sometimes they strike for no apparent reason. “The body’s fight-or-flight response gets triggered when it shouldn’t. The body thinks it’s in danger, but it’s not,” Dr. Josell says. Panic attacks are scary, but not dangerous and usually last just 15 or 20 minutes. (Though that feels like a loooong time when you’re in the middle of one.)
- Panic disorder is a type of anxiety disorder. It occurs when a person has repeated panic attacks. (Because one isn’t awful enough?)
Panic attack symptoms
It’s one thing to get nervous. A panic attack is different. To qualify as a panic attack, you have to experience four or more of these symptoms:
- Increased heart rate.
- Chest pain or discomfort.
- Trembling or shaking.
- Feeling that you might be choking.
- Chills or overheating.
- Fear that you’re dying or going crazy.
- A feeling that what’s happening around you isn’t real.
Unfortunately, if you have one panic attack, it’s common to have another. People often become so worried about it happening again that it becomes a self-fulfilling prophecy, says Dr. Josell. “People sometimes start to avoid certain situations or places where they had a panic attack before. They might even avoid leaving home,” she adds.
But you don’t have to become a hermit, reassures Dr. Josell. “Panic attacks are so treatable.”
Dealing with panic attacks
1. Label it
When someone has a panic attack, they often think they’re having a heart attack or losing their mind, Dr. Josell says. “It can be pretty intense and often happens out of the blue.”
Learning about panic attacks and recognizing the symptoms helps people keep it together if they have another. “It helps if you can say to yourself, ‘This is a panic attack, it’s not going to kill me, it will be uncomfortable — but it will end,’” she says.
2. Keep track
Keep a log of your panic attacks, including when and where they happened, how long they lasted and anything that might have triggered it. If you can identify a particular trigger, you can find specific ways to manage that trigger.
Tracking also helps you see if your current strategy for dealing with panic attacks is working. “When people see their panic attacks are happening less often, or lasting for a shorter time, it gives them confidence — and that helps them get better,” Dr. Josell says.
Deep breathing exercises can help turn down your body’s panic response, helping your breath and heart rate return to normal. You can find breathing exercises online and in the app store.
4. Distract yourself
“The more you focus on your panic, the worse it gets,” Dr. Josell says. “Wash your face, brush your teeth, pet the dog, smell something pleasant — using your other senses, like smell and touch, can be helpful.”
5. Ask for help
Mental health professionals can help you find ways to manage anxiety as well as treat panic attacks and panic disorder. To tackle panic attacks, they often use a Jedi mind trick known as cognitive restructuring. You learn to identify and change the thoughts that go hand-in-hand with panic triggers.
“Once you learn to manage those thoughts instead of dreading them, it tends to reduce both the intensity and frequency of the panic attacks,” Dr. Josell says.
If you feel like panic attacks are controlling you, flip the script and start controlling them instead. “If panic attacks are interfering with your daily life, it’s a good time to get help,” she says.