What should you know about avoiding panic attacks?

Trying to eliminate every anxious sensation can strengthen fear of those sensations. A more useful plan is to understand the panic cycle, practise a calm response and gradually return to situations you have been avoiding with appropriate support.

A panic attack is a sudden surge of intense fear or discomfort. Panic disorder commonly presents with repeated unexpected attacks, worry about another attack and changes in behaviour intended to avoid one. Symptoms may include a racing heartbeat, chest tightness, shaking, breathlessness, dizziness, nausea, tingling or a sense of losing control.

Fast, shallow breathing can lower carbon dioxide and contribute to light-headedness or tingling. Interpreting normal body changes as dangerous can then amplify adrenaline and create a self-reinforcing cycle. Similar symptoms can also come from physical illness or substances, so a first or unusual episode deserves careful assessment.

Track when episodes occur, what you noticed in your body, caffeine or nicotine use, sleep and situations you avoided. Patterns can help a clinician distinguish triggers from the habits that keep the fear cycle going. Keep meals and sleep reasonably regular, reduce stimulants if they worsen symptoms, and avoid using alcohol or sedatives to suppress anxiety.

During an episode, plant both feet, loosen tense muscles and breathe gently rather than taking repeated deep breaths. Name what is happening, remind yourself that the surge will pass, and focus on details in the room. Cognitive behavioural therapy can teach these skills and supported exposure; prescribed medicine may also be considered according to symptoms and health history.

Seek urgent medical care for new or severe chest pain, fainting, marked breathing difficulty, weakness on one side, an irregular heartbeat that does not settle, or symptoms that feel different from previous assessed attacks. Do not assume a new physical symptom is panic. Immediate help is also needed if you might harm yourself, cannot stay safe or feel unable to cope.

Book a routine assessment when attacks recur, lead you to avoid work, travel or social situations, disturb sleep, or cause ongoing fear between episodes.

Ask whether your symptoms or medicines suggest a physical cause, which therapy approach fits your avoidance patterns, and what to do during the next episode. If medication is offered, discuss expected effects, side effects, interactions and how it would be reviewed. Mention energy drinks, nicotine, decongestants and other substances that may raise heart rate.