How to Diagnose—and Deal with—a Panic Attack

panic attack1 How to Diagnose—and Deal with—a Panic Attack


I spent the better part of 2014 completely avoiding all seafood after experiencing what I later learned was a panic attack and not an allergic reaction to shrimp, like I’d thought. The initial episode came out of nowhere—I was sitting on the beach eating lunch with my family when I started freaking out, my heart began racing, I couldn’t breathe, and I found myself in an ambulance convinced I was having an anaphylactic reaction. Within 15 minutes, the paramedic ruled out any problems with my lungs, throat, or heart, and suggested I needed a therapist rather than an allergist.

Bizarrely, I didn’t even realize I was stressed until the anxiety manifested in the full-blown attack that felt far more physical than mental, a reaction clinical psychologist and New York Times bestselling author Dr. Susan Albers recently told me is actually very common. “Sometimes [a panic attack] feels like a heart attack, and often a person’s first hypothesis is that it’s an allergic reaction, because the symptoms are so physical it makes perfect sense for this to be your first assumption,” she said, adding that people often don’t realize they’re anxious until they’re hit with that first attack. 

I’m definitely not alone in this experience either—anxiety disorders affect more than 40 million adults in the U.S., which is roughly 18 percent of the population. Often panic attacks send sufferers straight to the emergency room, but Dr. Albers says there are ways to diagnose—and deal with—an anxiety attack that may be helpful before calling 911.

A panic attack is your body going into fight-or-flight mode.

A panic attack’s essentially your body’s flight-or-fight system going into overdrive after perceiving a threat, even though you’re usually not in any real danger. Dr. Albers calls it an “emotional tsunami”—a response that was crucial to the survival of our specials many, many years ago, but can be set off by non-life-threatening triggers in modern life, such as stress at work, financial problems, or relationship breakdowns. “It’s setting off stress hormone cortisol that gears your body to fight some sort of stress. If you had a real stress, you need to be prepared to charge, which is why your heart beats faster and your lungs breathe faster, as if there’s a real threat,” she explained.

Symptoms can feel like a heart attack, allergic reaction, or food poisoning.

Panic attacks might involve difficulty breathing; chest pains; sweating; a pounding heart; dizziness, or feeling faint, trembling, nausea, or tingling. Dr. Albers explained it’s common to confuse a panic attack with a heart attack, food poisoning, dehydration, or even a food allergy as you might feel as though you can’t breathe. “In extreme circumstances, people go to the emergency room,” she said. If you do end up in the ER, a doctor will come to the conclusion that you’re having an anxiety attack after completing a full physical exam and determining that there’s nothing wrong with your lungs or heart and after ruling out allergies. 

The good news is that the feeling will eventually pass. “They can be very scary, truly terrifying and sometimes embarrassing, but it’s important to remind yourself that the attack will end,” Dr. Albers said.

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Anything can trigger an attack.

Anything from receiving a huge bill in the mail to seeing someone you don’t get along with could trigger a panic response. Some things are repeated and tangible triggers, but others are less obvious, like a thought or a feeling or being stressed in general. Also, some people just seem to be more susceptible to attacks than others. “You are more likely to experience panic if you have a family member who also experiences anxiety. It’s often just the way a person is wired; whereas one person may experience nervousness or fear in a situation, the anxious person’s system kicks off a fight-or-flight response as if this is a real emergency,” Dr. Albers explained. 

Breathing exercises and simple meditation can help.

Trying to talk someone out of a panic attack with rational thoughts rarely works; instead, Dr. Albers says breathing exercises are “critical” to calm your body down if you feel an attack coming on. “Slowing down your breathing signals to your brain to calm down and move back into a relaxed state,” she said, recommending breathing apps like Relax Lite and Breath2Relax. Full-body scans are another good way to bring yourself out of an episode: “Anxiety is often about thinking about the past or future that you can’t control, so bringing your mind to the present with a body scan can help. Start at the top of your head and work your way down by tensing and releasing your muscles; it makes you feel empowered and in control your body,” Dr. Albers suggested.  

One of the biggest fears associated with panic attacks is that after the first episode, people can develop anxiety about the possibility of experiencing another one. So, you can literally have anxiety about your anxiety. After getting a physical to rule out any other illnesses, practicing breathing techniques and using relaxation apps regularly can help negate some of that stress and help you feel armed to deal with a panic attack where and when it is triggered. “Feeling confident that if you have a panic attack you have tools to cope with them can be really helpful,” she said. “The one thing you can control is whether you’re ready to deal with the anxiety.” 

Therapy and medication are also tools available to help deal with anxiety, something Dr. Albers recommends with lifestyle and dietary changes. “Eating more vitamins and minerals, particularly magnesium, and those found in pumpkin seeds and green leafy vegetables help keep your nervous system running well.” 

At the end of the day, Dr. Albers says it’s all about recognizing the symptoms and knowing that the panic attack will pass. “That helps people through it, knowing it isn’t forever and it’s a period of time that you just need to ride out, almost like riding a wave,” she said. 

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