If you suffer from anxiety or panic disorder, just the thought of having a panic attack can keep you from venturing out at all. However, there are things you can do if you have a panic attack in public, and no matter what happens, it's helpful to keep in mind that while you might feel like you're dying, you're going to be OK. "People are often so traumatized by a panic attack that they shape their behaviors and lifestyles in order to ‘avoid’ one from happening again, the website The Panic Room explained. "Unfortunately, this means sacrificing doing many ‘normal’ things that they once did or that most people do every day. Going outside, for example, becomes an arduous task due to being fearful of a panic attack striking at any moment."
I have major social anxiety, which means that I spend a lot of time anticipating what could go wrong, especially if I'm someplace where I don't know anyone. If I do start to have a panic attack in public, I get tunnel vision, I suddenly get very hot, and I feel like I'm going to both throw up and pass out. Panic attacks most often happen to me in airports and supermarkets, but can also occur at social events where I know very few people. The dread I experience before some events is so debilitating that I convince myself that it's just easier to stay home. This type of anxiety is known as agoraphobia, and often goes hand in hand with panic attacks.
"The anxiety is caused by fear that there's no easy way to escape or get help if the anxiety intensifies," the Mayo Clinic reported. "Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again." Take it from me, this is no way to live. But there are some practices I have adopted in order to make my life a little more livable.
If you're not sure if you've ever had a panic attack, the Mayo Clinic lists symptoms as "rapid heart rate, trouble breathing or a feeling of choking, chest pain or pressure, lightheadedness or dizziness, feeling shaky, numb or tingling, excessive sweating, sudden flushing or chills, upset stomach or diarrhea, feeling a loss of control, and fear of dying." Because loss of control is one of the worst parts about having a panic attack, doing some simple things to regain control can help.
PsychCentral reported that things like deep breathing and focusing on fixed objects — like your toes, for example — can help you stabilize yourself. Additionally, Healthline advised that one of the most important steps is to recognize that you are having a panic attack. "You can remind yourself that this is temporary, it will pass, and that you’re OK," Healthline noted. "Take away the fear that you may be dying or that impending doom is looming, both symptoms of panic attacks. This can allow you to focus on other techniques to reduce your symptoms."
You can also close your eyes. One thing that works for me is repeating a mantra in my head to remind myself that the panic attack is what's happening, but it's not who I am. I also try to focus on a task, especially if my panic attack happens somewhere like the airport. I remind myself that I'm just waiting for my coffee, and that's literally all I have to do in that moment. While I'm waiting I sit down, close my eyes, and repeat my mantra. If I have water on hand I sip it slowly.
When I do open my eyes, I try to focus on seeing what's around me. "Let your field of vision broaden until you can see from the outside corners of your eyes," Steve Bressert, PhD, explained on PsychCentral. "Breathe deeply and let your jaw muscles relax. This exercise activates the parasympathetic nervous system, which calms your body." What's more, I try to remember that while this feeling is utterly awful, I'm not the only one this happens to.
Another terrible thing about panic attacks is that the fear of having one in public often prevents you from doing things you love, not just things you're afraid of, and this actually pretty common. "When I have those moments, I have to keep in perspective that I'm freaking out about music, which is essentially a fun thing, show business which is essentially a fun thing, and if I'm freaking out about life and things that are important like friends being sick and so on, like that I just try to say there's other people in the world that deal with the same issues as me, and I'm not alone," Lady Gaga told Elvis Duran on Z100. "It just helps to calm me down."
While you're in the throes of a panic attack, I know firsthand that it feels like it will never end. The University of Michigan provided some tips from the National Institute of Health on its University Health Service page for surviving a panic attack. "Realize that although your symptoms are frightening, they are an exaggeration of normal stress reactions and aren't dangerous or harmful; face the feelings rather than fighting them, and they will become less intense; don't add to the panic by asking 'What if?' Tell yourself 'So what!'; stay in the present," the tips suggested.
"Notice what is actually happening rather than what you think might happen; rate your fear level on a scale of 1 to 10 and watch it change. Notice that it doesn't stay at a high level for more than a few seconds; distract yourself with a simple task like counting backwards or lightly snapping a rubber band around your wrist; and when the fear comes, expect it and accept it. Wait and give it time to pass without running away."
This sounds all well and good right? But in the moment it can be hard to remember what to do. If there are certain things that you know help you calm down, set yourself up for success before you go out. Being prepared can make you feel safe and in turn reduce your chances of having a panic attack in the first place.
The most important thing is to find something that works for you because everyone is different. "I seek refuge in public restrooms. Not the cleanest place, but to me, it’s my safe place," Nicole Campbell wrote for The Mighty. "I told everyone that I just needed to go to the bathroom and was able to calm myself in a few minutes thanks to years of therapy and knowing how to talk myself through a panic attack." Personally, having a regular meditation practice has also helped reduce my anxiety because meditation actually creates a space in your brain between stimulus and response.
If you feel like you've tried everything and you need more help, talking to a counselor, certain medications, or starting cognitive behavioral therapy also helps reduce feelings of panic and can remind you that this is a medical issue and not a personality defect. Remember, having a panic attack in public is nothing to be ashamed of. "It’s not abnormal to feel bad at first when these situations occur because we should all care about how our actions impact others," Campbell noted on The Mighty. "But I hope one day that no one feels guilty for situations out of their control that result from health conditions." While I know it doesn't feel like it in the moment, everything is going to be OK. You're not in this alone — I'm right there with you.