Our therapists get asked a lot “what can I do to get out of a panic attack?” or “how can I stop an anxiety attack from happening?”  For starters, let’s talk about terminology.  Anxiety and panic are related and overlapping terms. Typically, when someone is describing an “attack,” they are referring to a panic attack.  

 

What Does Anxiety Feel Like?

Anxiety can feel like a lot of things. Cognitively, it tends to feed into scary “what ifs,” predicting worst-case scenarios faster than you can shut it down. Physically, anxiety can feel like butterflies in the stomach, sweaty palms, a racing heart, muscle tension, tightness in your chest, etc. Essentially, your body is gearing up for a “fight or flight” response, even if the “threat” is just an awkward social interaction or an overwhelming to-do list.

Anxiety is largely fueled by your brain’s amygdala (a part of your brain responsible for processing emotions), which sends signals to get your body ready for action. It’s a helpful system when there’s actual danger, but it tends to go a bit haywire when the threat is something more abstract—like worrying about giving a presentation at work. Research shows that generalized anxiety can create an almost constant state of heightened arousal, where your nervous system is stuck in a loop of overreacting to potential dangers.

 

Anxiety vs. Panic Attacks: What’s the Difference?

If anxiety is the everyday grind of worrying about the little things, what’s a panic attack? While anxiety can be a slow build—a simmer of worry—panic attacks are more like a boiling pot that overflows without warning. Better yet, the pot that went from luke-warm to boiling instantly.  A panic attack can feel like a tidal wave of intense fear without a clear cause. Your heart races, your breathing becomes shallow, and you might even feel detached from reality.

In contrast to anxiety, which can last for hours or days, panic attacks come on suddenly, peak within about 10 minutes, and then subside. However, the lingering effects of a panic attack can last much longer, leaving people feeling exhausted and on edge.

Both anxiety and panic are triggered by similar brain mechanisms.  While anxiety is more of a long-term, low-grade stress response, panic attacks are acute episodes where your body goes into full “fight or flight” mode. Panic attacks can be largely driven by misinterpretations of bodily sensations (i.e., you feel your heart race and assume something is seriously wrong), which fuels the panic and reinforces the fear cycle. In CBT, we call this a “catastrophic misinterpretation,” and helping clients reframe these thoughts is a big part of treatment.

 

How Can I Stop Panic Attacks Immediately? 

Unfortunately, we don’t have an on-off switch for panic attacks.  There is also research that indicates trying to control panic can actually make it worse (more on this in a future blog).  However, here are some ways to reduce the intensity of your experience of a panic attack, or at least ride them out with more ease.

  1. Cold Exposure: Ever had a rush of cold water snap you back to reality? Splashing cold water on your face can activate the body’s parasympathetic system (the one responsible for calming you down). It’s called the “dive reflex,” and it can help slow your heart rate and curb that spiraling feeling. You can try placing an ice pack on your chest over your heart, on your inner wrists, or on your neck where you would take your pulse.  Others options are holding onto ice cubes until they melt, or going straight for dunking your face in ice cold water.
  2. Paced Breathing: Our bodies are built with a strong connection between our breathing rate and our heart rate, which, in turn, greatly affects our overall arousal level. During a panic attack, your breathing may become shallow and fast, which can make you feel more panicked. Focusing on elongating your exhale can slow your heart rate and ease symptoms. Try breathing in for 4, then out for 6, for example.
  3. Move!: Shaking your arms, walking, push ups, or jumping up and down can help dispel the pent-up energy that comes with a panic attack. Physical movement helps signal to your body that it’s not in danger and doesn’t need to be in fight-or-flight mode.

 

Final Thoughts

Overcoming panic largely has to do with increasing acceptance and tolerance for these extremely uncomfortable feelings as a way of pulling power away from the discomfort.  There are helpful strategies in Cognitive Behavioral Therapy and Exposure Therapy that can help you practice building up a resilience for anxiety and panic, which in turn decreases anxiety and panic.