Flushing, sweating, tight chest, pounding heart rate: You might think you’re having a heart attack, but it could very well be a panic attack.
Los Angeles entrepreneur Neal Sideman was in the middle of an intense workout at the gym when he felt lightheaded and realized his heart was pounding. Alarmed, he immediately worried about his heart — never thinking that he might be having a panic attack instead.
But a visit to the doctor the next day and an EKG reassured him his heart was fine. His doctor told him that what he’d experienced were, in fact, the symptoms of anxiety.
How Do You Know You’re Having a Panic Attack?
An anxiety or panic attack often comes on suddenly, with symptoms peaking within 10 minutes. For doctors to diagnose a panic attack, they look for at least four of the following signs: sweating, trembling, shortness of breath, a choking sensation, chest pain, nausea, dizziness, fear of losing your mind, fear of dying, feeling hot or cold, numbness or tingling, a racing heart (heart palpitations), and feeling unusually detached from yourself.
Stress, Anxiety, and Then Panic: Neal’s Story
As Sideman says, his attack occurred in the early 1990s, and few people seriously considered the possibility of a panic attack in a 39-year-old man. So he went home thinking all would be fine, only to have another, more severe attack one week later.
Now, looking back, the situation seems clearer.
“I was under a lot of stress — starting a new business, working 16-hour days, a close friend was ill and dying, and on top of all that, I was doing a super heavy workout regimen at the gym with a trainer,” Sideman says. “So it was a lot of physical stress, emotional stress, and a lot of financial stresses.” He says he also can see roots of anxiety in his childhood and teen years as well as in other family members.
In the moment, he didn’t know what to think because it can be tough to know what a panic attack is like until you have one. His second panic attack “was really a full-blown panic attack, where I thought I was going to die,” Sideman says. “I thought I was going to pass out, not wake up, go crazy, have a heart attack.”
He recalled being terrified, and the response he chose was one that can actually make panic disorder worse: He started to avoid the situations where he had attacks.
“I thought I would be smart, take care of myself, and not go out as much,” Sideman says. He managed to find ways to build his business without leaving his home office. After he had a panic attack on a freeway, he decided to avoid driving on the freeway — a tough stand to take in Los Angeles. He kept withdrawing from activities to try to avoid panic attacks, but that never solved the problem, he says, and after two and a half years, he realized the attacks were getting worse.
How to Cope When You Have Panic Attacks
Desperate for help, he reached out to the Anxiety and Depression Association of America, which sent him a list of therapists experienced in treating panic attacks and anxiety. “This is how I got better,” Sideman says. “I found a therapist who understood what panic disorder was, understood agoraphobia, and knew cognitive behavioral therapy, which I had not known about.” He also started practicing meditation.
Cognitive behavioral therapy has been shown to help with treating panic disorder and agoraphobia. According to a study published in December 2013 in the journal Behaviour Research and Therapy, its effects lasted as long as two years after the initial treatment. And a study published in August 2017 in the Journal of Consulting and Clinical Psychology suggested that it may be superior to traditional psychotherapy in the treatment of this condition.
People generally can overcome panic attacks faster if they seek help after the first one or two, says psychologist Cheryl Carmin, PhD, director of clinical psychology training at the Wexner Medical Center and a professor at Ohio State University in Columbus. When you do seek help, your doctor or therapist will ask about your symptoms and the situations in which they arise, and might also recommend additional medical testing to rule out other health concerns.
Don’t wait too long to seek help, or it might mean you’ll also have to do extra work to undo the habits you may have developed to try to protect yourself — like avoiding triggering situations, which Sideman had tried to do.
“If it’s beginning to interfere with your life, if you’re more fearful, or you’re avoiding doing things that provoke the symptoms, that’s when you need to seek help,” Dr. Carmin says. “At its worst, people with panic disorder become housebound. Or they stop doing things they really like.”
There’s Definitely Life After Panic Attacks
Sideman says that his recovery has also made him a better friend. While he was struggling with anxiety, he would call friends for help. As he recovered, he realized that he could cope on his own and would then call them to share his success.
“I changed the way I talked about my condition,” he says. “Now, I focus on my recovery, not my suffering.”
By Madeline R. Vann, MPH
Medically Reviewed by Allison Young, MD