What To Do When Panic Attacks Happen In Public

Around six million Americans have panic disorder, an anxiety disorder characterized by panic attacks. Panic attacks are sudden fear and extreme nervousness for ten minutes or more at a time. Symptoms of a panic attack can look like strong feelings of being terrified at seemingly random times or after a triggering event. Panic attacks can occur at unexpected times,  regardless of where you are. There are some useful coping mechanisms and ways to help manage public panic attacks.

What is panic disorder?

Chronic or frequent panic attacks can point to a panic disorder. The main symptom of panic disorder is having frequent, uncontrollable panic attacks. 

Other symptoms of a panic attack could include:

• Feelings of impending danger

• Fear of not having control over a situation

• An incredibly fast heart rate

• Shaking

• Difficulty breathing

• Dizziness

• Headaches

• Chest pain

It is important to note that it is possible to experience a panic attack and not have the disorder. You may want to discuss your symptoms with a mental health professional for a possible diagnosis if panic attacks are affecting your daily life.

Panic disorder

If you have panic disorder, you may sometimes feel like panic attacks are out of your control. The fear of panic attacks can make you feel like you need to be intentional about everything you do or where you go to avoid triggering a panic attack. People may avoid certain situations, such as public places or public transportation to try to prevent future panic attacks. This fear can impact a person’s decision to go out in public to work, socialize, run errands, or participate in beloved activities.

What causes panic disorder?

The cause of panic attacks is unknown. Major stressors can play a key role in developing a panic disorder and subsequent panic attacks. Various events can put you at greater risk for panic disorder. Symptoms of other mental health conditions such as anxiety disorders or obsessive-compulsive disorder may also be comorbid with panic disorder. These could be traumatic events or built-up trauma. Also, a family history related to panic attacks can increase the likelihood of developing a panic disorder. 

We do know that more women than men experience panic disorder, though it can occur in everyone. Additionally, people who have panic disorder are more likely to experience depression, misuse drugs or alcohol, and attempt to die by suicide.*

Panic disorder should not be taken lightly. If you or a loved one has been diagnosed with panic disorder, getting professional help from an expert who can provide treatment may be valuable to maintaining a good quality of life. If left untreated, a person living with panic disorder may experience significant physical and mental health challenges.

What to do when you have a panic attack in public

Panic attacks often happen suddenly. They can happen without a trigger or in response to a small trigger. This means that panic attacks can happen in public places frequently. Someone with panic disorder could experience a panic attack during work meetings, in class, on dates, and even when spending time with family. These five tips may help you learn to spot warning signs, potential triggers, and how to soothe yourself if you experience a panic attack.

Get comfortable with your surroundings

When you feel yourself starting to have a panic attack in public, the first thing you should do is make sure you are in a safe space or quiet spot where you can stop for a minute and wait things out. You could try to learn to be comfortable letting people see you in a vulnerable way. If you’re scared about how people will look at you, it could just make your panic attack worse. For many people, the added fear of panicking in public can only add to the symptoms and length of a panic attack.

When you feel a panic attack coming on in public, try to take a moment to yourself to feel vulnerable and recognize that some people will probably see you during the attack. You can try to allow yourself to be okay with that vulnerability. If you get used to this, you could start to feel comfortable enough for other people to see you panic, and the fear of having a panic attack in public can dissipate. 

Taking a moment to familiarize yourself with the surroundings and allow yourself to be vulnerable could help the attack run its course more quickly. It is important to go through this without worrying about other people. Remember that people will see much worse in their lives than you experiencing a panic attack. 

Recognize when a panic attack may be coming on

It can be difficult to recognize the early signs of a panic attack. When you feel your heart racing, it can be hard to discern if it is a panic attack or if it is simply walking up the stairs. You may be observing yourself and evaluating your body all day to see if you need to prepare yourself for a panic attack. 

To try to recognize the early signs of your panic attacks. It can even be beneficial to take notes of the signs or symptoms that lead up to your past panic attacks. Journaling your heart rate, if you are sweating, your breathing rate and more can help you recognize your common symptoms. Learning to look for a pattern can give you a warning when you are about to have a panic attack in public. 

Additionally, in the middle of a panic attack, it might help to refer back to previous reflections or records to assure yourself that you endured the previous panic attack and will find your way back to a controlled nervous system. 

Remove yourself from the crowd

Sometimes, being in a crowd when you feel a panic attack coming on can make it significantly worse. You might feel like people will judge you or misunderstand what is happening. Try to find a secluded space or a tucked-away area. Crowds can be overwhelming and scary even when you are not having a panic attack. If you work at an office or go to school, it is a good idea to find your own place. Knowing exactly where to go when you feel a panic attack coming on can give you a moment of peace that will make your panic slightly less derailing.

Focus on your breathing

A common symptom of having a panic attack is labored or restricted breathing. Many people who live with panic attacks or panic disorder describe it as feeling like they are having a heart attack. They can’t breathe, and they can’t think about anything else. 

Focusing on deep breathing can help minimize the effects of a panic attack. You can take your time to use some methods that can help you come back from an attack. Mindfulness exercises such as deep breathing can calm your nervous system and return you to the present moment. Focusing on deep breathing is a grounding technique that lets you take your mind off the physical and emotional symptoms you may be experiencing, instead bringing attention to the feel of your lungs expanding and the sensation of air rushing through your nose or mouth. Anything that can help you distract your mind from the panic attack might be enough to relax and regain control of yourself.

Let someone you trust know when you are having a panic attack

Panic attacks can happen at the most inconvenient times. Letting someone know can help remove some of the pressure. They can cover for you when at work or take notes for you in class. If you are with someone and you can feel a panic attack starting, tell them. One of the best ways to work through a panic attack before it overwhelms you is to let the person you are with know what is about to happen. 

It could be helpful to have them talk you through something else to get your mind off things. This could include asking questions about your favorite show or activity. Distraction does not cure panic attacks but can help lessen the blow and keep you somewhat composed. Someone who knows you well may be able to provide you with other things that help you calm down, such as keeping essential oils that you find comforting or just sitting next to you and being present.

Know yourself

One of the most important things when having panic attacks in public is to know yourself. Know that it’s okay to not be okay, and if other people disagree, that is okay, too. Know your triggers and how your body feels leading up to a panic attack. Recognize the signs of your feelings and feel them through completely. 

Once everything has passed, don’t try to block out what happened. When you feel comfortable enough, revisit what happened so you can learn about yourself and how to get through things better than the last time. Even though it doesn’t feel okay at the moment, the moment will pass.

Online help from a counselor

Getting help from a professional can help you figure out the best ways to manage your panic attacks. A counselor can explain why you have panic attacks and what the root of them may be. If seeking traditional therapy isn’t available to you, you might consider online therapy. Online therapy through platforms like BetterHelp allows you to meet with a therapist where you’re comfortable. For people with panic disorder, online therapy means that they can manage a panic disorder wherever they have internet, versus a new or unfamiliar setting in an in-person therapist’s office.

Online therapy has proven effective in treating panic disorder and its symptoms. While there may be different approaches, a common treatment for panic disorders or disorders that may include panic attacks is cognitive behavioral therapy. A literature review of 14 relevant studies discovered that online cognitive behavioral therapy (CBT) resulted in a 50% improvement in symptoms of panic disorder, social anxiety disorder, depression, compulsive gambling disorder, generalized anxiety disorder, and obsessive-compulsive disorder (OCD).