What to do when you have a panic attack

What is a panic attack?

It's intense. It's out of the blue. It comes with uncontrollable physical and psychological symptoms. Given the onset and intensity of the physical and psychological symptoms, many people think they're having a medical emergency.*

How to stop panic in its tracks

Panic attacks are extremely distressing. However, if you can understand the physiological response, you can find ways to get through them, reduce the intensity and even prevent them from happening. We spoke with Mindy Wise, LICSW, MSW, who sees patients at Gundersen St. Elizabeth's Hospital and Clinics in Wabasha, Minn., about what to do when you experience a panic attack.

Reassure yourself that you're safe

Remind yourself that you're not in real danger. Panic attacks can feel so intense that you may feel as though you're dying. But, Mindy says anxiety and panic are just misplaced fear.

"When we're not verbalizing our thoughts and expressions, that anxiety manifests itself through our bodies, sometimes in the form of a panic attack. That's all it is," Mindy says. "When we don't allow space for anxiety and verbalize our feelings and emotions, they get stuck."

Integrate wellness, practice gratitude

Mindy says one of the best methods to prevent panic attacks is to integrate wellness patterns, based on basic needs, into our lives. Things like meditation, mindfulness, breathing techniques and exercise. In fact, Mindy preaches this so often that she created a mnemonic device to better equip her patients.

N: Nutrition. As often as you can, only feed your body with nutritious, high-protein foods.
E: Exercise. Research continues to show that exercise is one of the best ways to reduce pain and improve mental health. Mindy's not necessarily pushing an hour on the treadmill. Go-to ideas like creating a standing workstation, taking the stairs at work and stepping out for a short walk during your lunch break are simple ways to incorporate exercise into your day.
E: Entertainment. Add positive experiences, such as meditation and yoga, to your day and week.
D: Don't drink or smoke.
S: Sleep. Establish healthy sleep habits, like avoiding that late-day latte, limiting afternoon naps and skipping late-night screen time.

Mindy also suggests practicing gratitude daily. Hop out of bed and mentally note three things for which you feel grateful.

"Negative, toxic feelings can't coexist with positive thoughts," Mindy says. "By flooding your brain with gratitude, you're flushing out toxins."

Go someplace quiet, if possible, in nature

If you're feeling anxious or panicky, instead of hitting WebMD or Google, step outside.

"Looking outside for 10 minutes is equivalent to 30 minutes of meditation," Mindy says. Researchers agree. Spending time walking near trees—or just looking at trees—lowers blood pressure and reduces cortisol and adrenaline.

Even the sounds of nature can be recuperative. One study found that people who listened to nature sounds like crickets chirping and waves crashing performed better on cognitive tests than those who listened to sounds of traffic or a busy café.

Breathe deeply

Try box breathing. Sit in a comfortable chair with your feet flat on the floor. Slowly inhale to the count of four. Hold that breath for four seconds (again, counting slowly). Exhale through your mouth to the same slow count of four. Box breathing can help calm and regulate the nervous system.

Make time for laughter

Lastly, add laughter into your life. Laughter produces the same effects that exercise does. Laughter enhances your intake of oxygen, stimulates your heart, lungs and muscles, and increases endorphins released by your brain.

*If symptoms persist, please consult with your primary care provider.