Managing a panic attack

If you have ever felt your heart racing, your chest tightening and a wave of fear that seemed to come from nowhere, you may have experienced a panic attack. It is frightening in the moment, but it is manageable, and it passes.

What it is

A panic attack is a sudden surge of intense fear or discomfort, along with physical symptoms such as a racing heart, shortness of breath, dizziness, sweating, trembling, or a feeling of unreality. It usually peaks within minutes and then eases, even though it can feel like it will last forever while it is happening. Panic attacks can happen with or without an obvious trigger, and having one does not automatically mean something is medically wrong, though a professional can assess this if you are unsure.

Signs to notice

• A racing or pounding heart, often with chest tightness.
• Shortness of breath or a feeling of choking.
• Dizziness, nausea or shakiness.
• A sense of unreality, or fear that you are losing control or about to die.
• Sudden onset, usually peaking within about ten minutes before beginning to ease.

What helps

• Remind yourself that a panic attack, however intense, will pass and is not dangerous, even though it feels alarming.
• Try slow, deep breathing, breathing in for a count of four, holding briefly, and breathing out for a count of six, since longer exhales help calm the body's stress response.
• Ground yourself using your senses, for example naming five things you can see, four you can hear, and three you can touch.
• Find a safe, quieter spot if possible, but do not force yourself to leave somewhere important if that increases distress.
• Avoid fighting the sensations. Let them happen while reminding yourself they will ease, rather than trying to suppress them.
• After it passes, rest, hydrate and be gentle with yourself rather than judging yourself for having had one.

When to reach out for help

If panic attacks are frequent, are stopping you from doing everyday activities, or you are avoiding places or situations out of fear of having one, a professional can help you understand what is happening and build coping strategies. If chest pain is severe, unfamiliar, or you are unsure whether it is a panic attack or a medical emergency, seek urgent medical care to be safe.

Getting help in South Africa

A Cleared Mind EAP counsellor can help you learn tools to manage panic over time. SADAG's Mental Health Line (011 234 4837) offers support and information, and if you ever feel unsafe or in medical danger, call an ambulance on 10177.