What is happening? Am I going crazy? Am I having a heart attack? What do I do now?

These are just a few of the many terror-inducing questions that might race through your mind if you find yourself in the midst of having a panic attack.

How do I know if I have had a panic attack?

The best way I can explain a panic attack is as a rush of fear or anxiety. That may come over you from seemingly out of nowhere, especially if it is the first time you are having one. Along with the feeling of fear, you might physically have a racing heart, heavy breathing, shaking, tense muscles, and more. The ordeal can sometimes be so scary and out of the ordinary that you could start to wonder whether you are dying or having a serious medical emergency. The thing is, although during a panic attack your body is essentially responding to a perceived danger or threat. You are most likely perfectly safe.

Imagine you are camping in the woods and you see a bear. You understandably become amped up, your mind is racing, and you have to decide whether to run away or to combat the bear. Now, imagine you’re in the grocery store shopping for some essentials when you are riddled with extreme fear. That same fight-or-flight sensation comes over you…except there is no bear. That is what it is like to have a panic attack. Sounds pretty daunting, right?

Okay, so I have had my first panic attack. I’m worried it will happen again. What do I do now?

It is pretty common after having a panic attack, especially if it was somewhere in public, to start to associate that place with danger, as well as to worry about having another panic attack. Understandably, that can lead to avoiding the place the attack occurred, lessening the likelihood you will return there. Thus increasing your level of anxiety around that place and, in some instances, around public places in general. To mitigate that concern, one of the best things you can do is put yourself, not the panic, in the position of power. By that, I mean permit yourself to continue going where you first experienced the panic attack, even if it is scary. If that feels uncomfortable or unrealistic at first, ask a friend, family member, or other “safe person” to accompany you until you feel empowered to go solo again.

How can I manage my panic attacks?

Panic attacks are sneaky. They can shrink your world as they become more and more powerful. You are worthy of a vibrant, rich, and fulfilled life, and you deserve to get where you need or want to go with confidence and comfort. With that in mind, here is where I will arm you with some strategies, tools, and techniques. That you can tap into as a way to increase the power you have over your panic attacks. You can use these when you feel a panic attack coming on, when you are faced with a situation. Where you believe you could experience a panic attack, or as a way to gently pull yourself out of one.

  1. Grounding Techniques – my favorite grounding technique is the “5-4-3-2-1 Technique” because it engages all 5 of your senses, and it brings your focus into the here and now. It helps to ground you or bring you “back down to Earth”. Here is what you do: notice and identify 5 things you can see. It could be a woman walking her dog on the sidewalk, or perhaps the pattern on your shirt. Then, identify 4 things you can touch. Notice how they feel. Maybe the chair you are seated in is smooth leather, or the texture of your skin feels rough and dry. Next, notice 3 things you can hear, and identify them. A song playing on the radio, or a man whistling down the street, for some examples. Lastly, do your best to identify 2 smells, and then 1 thing you can taste. These can be trickier depending on the situation—that is okay. If you have a drink or a piece of gum nearby, take a sip or a piece, and notice how that tastes and smells.
  2. Breathing Techniques – have you ever been really nervous, worried, or scared, and then you realize your breathing has become quite shallow? Or, perhaps, you are barely breathing at all? What happens to your muscles? If you are anything like me, intense stress or worry can lead to such bodily tension that your shoulders are practically up to the earlobes! That is why I love to teach my clients to do “square breathing”. Focusing on your breathing is a simple, subtle, and surefire way to create a sense of greater calm in both the body and the mind. So it is especially helpful in times of heightened anxiety or panic. Here is what square breathing looks like: inhale through your nose for 4 seconds. Then, hold it there for 4 seconds. Exhale through your mouth for 4 seconds. Hold for another 4 seconds. Repeat as needed.
  3. Seek out professional help – if you are experiencing panic attacks often, seeking professional guidance from a counselor or therapist can be incredibly beneficial. As a therapist who sees clients who deal with anxiety and panic attacks. I know firsthand some of the ways that a mental health provider can assist. That may include helping you identify triggers for your panic attacks, along with ways to cope with them, manage them, and lessen their power. Moreover, because panic attacks can sometimes result in negative experiences and emotions like stigma, shame, and isolation. A therapist can help with processing those feelings, as well as normalizing and validating them in an empathetic and non-judgmental way.

If there is anything I would most hope that you take away from the information above. It is this: first, if you do not struggle with panic attacks, know that they are a real and scary thing. You can share these tips and tricks as a way to provide support. Second, if you are struggling with panic attacks, they do not have to dictate your life forever. There are ways to overcome them. You are capable, and there is hope!


Perspectives Therapy Services is a multi-site mental and relationship health practice with clinic locations in Brighton, Lansing, Highland, Fenton and New Hudson, Michigan. Our clinical teams include experienced, compassionate and creative therapists with backgrounds in psychology, marriage and family therapy, professional counseling, and social work. Our practice prides itself on providing extraordinary care. We offer a customized matching process to prospective clients whereby an intake specialist carefully assesses which of our providers would be the very best fit for the incoming client. We treat a wide range of concerns that impact a person's mental health including depression, anxiety, relationship problems, grief, low self-worth, life transitions, and childhood and adolescent difficulties.