If you’ve ever had a panic attack, you know it can be an extremely scary experience. Characterized by shortness of breath, trembling, dizziness, sweating, and feelings of impending doom as well as derealization (when you feel like the world isn’t real) and depersonalization (when you feel like you’re not fully present in your body), the symptoms of a panic attack are no walk in the park, nor are they “just in your head.”
If you’re suffering from panic attacks, have had them in the past, or want to prevent one in the future, keep reading for some expert advice.
According to Sanna Kalika, MD , a board-certified internal medicine physician and doctor at Parsley Health in New York City, “a panic attack is just one of many manifestations of an anxiety attack or disorder.” Not everyone who experiences anxiety will get panic attacks. A panic attack occurs when the fight-or-flight response is triggered, which is quickly followed by “a complex, involuntary physiological response in which the body prepares itself to deal with an emergency situation,” she explains.
The only problem is that with panic attacks, there isn’t actually an emergency situation to be dealt with. Panic attacks can occur at any time of day, in any location, and even when we’re sitting on the couch, safe at home watching our favorite TV show. “Panic attacks are abrupt and intense, occurring at any time of the day or night and lasting from seconds to half an hour,” Dr. Kalika explains.
If you’ve ever experienced a panic attack, you may have felt like it came on unexpectedly. And you wouldn’t be the only one to feel this way. According to Dr. Kalika, panic attacks can be very unpredictable. “They may come from nowhere. They could wake a person up from sleep or be triggered by stress or various emotions—even happy ones!” She says.
That said, there are some panic attack triggers to be aware of:
According to Dr. Kalika, panic attacks can also be self-induced. As she explains it: “the fear of a panic attack is the very thing that brings one on.”
If you want to prevent a panic attack, you can start by trying to limit the triggers above as much as possible. According to Dr. Kalika, this requires a few fundamental lifestyle shifts, such as a clean diet void of common neurotoxins such as refined sugars, gluten , caffeine, and alcohol. Even if you eliminate or decrease your intake of even one or two of these triggers, it can make a difference.
Then, you can turn your attention to some of the sneakier underlying causes of panic attacks and anxiety, such as gut issues and chronic inflammation . “Increased gut permeability may cause reduced absorption of necessary nutrients and decrease the actual production of neurotransmitters necessary for inhibition of excitation that triggers panic attacks,” says Dr. Kalika. Parsley Health practitioners use advanced testing and in-depth questionnaires to uncover the root of your anxiety and are well-versed in treating these issues. (For example, here are 3 ways to reduce your anxiety through your gut .)
According to Dr. Kalika, certain foods may also help increase the production of brain chemicals that prevent panic attacks. For example:
Exercise is another great way to rebalance your nervous system and decrease stress and anxiety, says Dr. Kalika. “Any moderate or vigorous aerobic exercise such as a brisk walk, cycling, or swimming, performed regularly for a few weeks will usually bring relief in anxiety symptoms,” she explains. At Parsley Health, your doctor and health coach work with you on a personalized health plan inclusive of nutrition and exercise that will work for you.
If you follow all the prevention steps above but still find yourself in the middle of a panic attack, know that there are things you can do to ease them in the moment. These are Dr. Kalika’s top five tips for how to stop a panic attack:
Deep breathing can reduce symptoms of panic during an attack. “The simplest example is to focus on taking deep breaths in and out through your mouth, feeling the air slowly fill your chest and belly and then slowly leave them again,” says Dr. Kalika. Or, try one of these breathing exercises for anxiety .
According to Dr. Kalika, it’s important to remind yourself that panic attacks are short and will pass swiftly. “Reach out to a trusted friend or family. Talking things over and taking your mind off the sensations can diffuse anxiety,” she explains.
“Pick one object in clear sight and consciously note everything about it,” says Dr. Kalika. For example, bring your attention to the hand on the clock and notice how it moves. “Describe the patterns, color, shapes, and size of the object to yourself. Focus all of your energy on this object and your panic symptoms may subside,” she continues.
According to Dr. Kalika, focusing on physical sensations can benefit your nervous system during a panic attack. For instance, dig your feet into the grass or feel the texture of your sweater. “You can also rub ice on the skin of your arm and concentrate on the sensation. These specific sensations ground you firmly in reality and give you something objective to focus on,” she explains.
“I always ‘pack’ my mantra with me when I go on a plane ride which, with years, has become a nerve-wracking experience for me despite my being an avid traveler,” says Dr. Kailka. According to her, repeating a mantra internally can be relaxing and reassuring, and it can give you something to grasp onto during a panic attack. It could be as simple as “this too will pass.”
Finally, if you’re suffering from regular panic attacks, don’t hesitate to talk to a professional. “Parsley Health is here to help,” says Dr. Kalika.
Gretchen Lidicker is a writer, researcher, and author of the book CBD Oil Everyday Secrets: A Lifestyle Guide To Hemp-Derived Health & Wellness. She has a masters degree in physiology and complementary and alternative medicine from Georgetown University and is the former health editor at mindbodygreen. She's been featured in the New York Times, Marie Claire, Forbes, SELF, The Times, Huffington Post, and Travel + Leisure.