Types of Panic Attacks and How To Cope With Them

Panic attacks are like sudden rushes of super-intense fear with weird body stuff happening. The blog breaks down the different kinds of panic attacks, along with ways to cope with them, like focusing on what's around you and understanding what sets them off in the first place.

She halted. An intense, fearful feeling engulfed her, causing severe pain. A feeling of impending doom that mimicked a heart attack. She couldn’t move as though her feet were bogged down, her hands trembling uncontrollably. After a few minutes, an increasing feeling of anxiety reached a terrifying peak, accompanied by palpitations that made her heart pound against her chest, and a chilling tingling sensation in her hands and legs. She gasped and cried relentlessly.

This is a real life narrative of how a panic attack feels. Several stories have revolved around people trying to describe what a panic attack can feel like. So that others experiencing or someone witnessing can learn, understand and offer help. In this blog, let’s learn what panic attacks are, types and how to cope with them.

What is a panic attack?

Panic attacks are brief, sudden moments of increased and intense anxiety accompanied by physical sensations of fear. 

According to the DSM-5, a panic attack falls under anxiety disorders. It is defined as an abrupt surge of intense fear or intense discomfort. During which 4 or more of the following symptoms occur: 

• Palpitations, pounding heart, or accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath or smothering
• Feeling of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Derealization (feelings of unreality) or depersonalization (being detached from oneself)
• Fear of losing control or “going crazy”
• Fear of dying
• Paresthesias (numbness or tingling sensation)
• Chills or hot flushes

Types of panic attacks

Like anything else that’s unique to each individual, panic attacks, too, are experienced differently by people. They differ based on intensity and duration. Another key factor of differentiation is what prompted the panic attack. 

Based on different experiences, panic attacks are classified into the following categories.

Expected panic attacks

Expected panic attacks occur in anticipation of, or in response to, a known trigger or stressor. These attacks are more predictable because the individual can identify the specific stimulus that typically induces their panic. Common triggers include phobic situations (such as heights or confined spaces), social interactions, or environments associated with past trauma experiences.

For example, someone with a fear of flying might begin experiencing panic symptoms days before a scheduled flight, with symptoms intensifying as the departure time approaches. Because these attacks are linked to identifiable situations, they can sometimes be prepared for or even prevented through therapeutic techniques like exposure therapy and cognitive restructuring.

Unexpected panic attacks

Unexpected panic attacks strike without warning and seemingly without cause. They can occur during periods of calm or even during sleep, making them particularly distressing for those who experience them. These attacks often feel as though they "come out of nowhere," making an individual feel vulnerable and anxious about when the next attack might occur. This unpredictability can lead to "fear of fear" or panic disorder, where the person develops persistent worry about having future attacks and their potential consequences. Unexpected panic attacks are particularly associated with a diagnosis of panic disorder and may require comprehensive treatment approaches, including medication and psychotherapy.

Other types of panic attacks include:

Situational panic attacks

Situational panic attacks are similar to expected panic attacks but are more specifically tied to particular situations or contexts. These attacks occur almost invariably when exposed to a specific trigger, such as public speaking, driving over bridges, or being in crowded spaces.

Unlike expected panic attacks, where anticipation plays a significant role, situational panic attacks are more directly connected to the immediate presence of the triggering situation. These attacks form the basis of many specific phobias and can significantly impact an individual's quality of life if they lead to avoidance behaviours.

Anticipatory panic attacks

Anticipatory panic attacks, sharing similarities with unexpected panic attacks, occur when someone experiences panic symptoms while worrying about or expecting a future panic attack. These attacks are fueled by the fear of panic itself and can create a self-fulfilling prophecy where the fear of having an attack triggers one.

This type of panic attack is crucial to the development and maintenance of panic disorder. Disrupting this cycle often requires addressing both the physical symptoms of panic and the catastrophic thoughts surrounding these symptoms through techniques such as cognitive behavioural therapy.

Nocturnal panic attacks

Nocturnal panic attacks occur during sleep, causing individuals to wake up with intense fear and physical symptoms typical of panic attacks. These attacks can be particularly frightening because they interrupt sleep and occur without any apparent trigger.

Research suggests that nocturnal panic attacks may be related to sleep transitions between different sleep stages and might be associated with breathing irregularities during sleep. These attacks can contribute to insomnia and sleep avoidance as individuals become fearful of experiencing panic while asleep.

How to cope with panic attacks?

When a panic attack occurs, it can feel like the moment is happening in a blur. You might struggle to understand what’s going on, and finding the right techniques to manage it can be hard. If you’ve faced this before, having some handy first-aid tips or go-to strategies can help you through the experience.

Go to a quiet place

If you’re in a public place, it’s better to go somewhere quiet to help yourself feel safe. Try carrying something that feels safe to see, hold or smell (a locket, fragrance).

Affirm yourself and give yourself reassurance

It may feel challenging or even a bit off, but taking a moment to centre yourself and recognise that you’re safe can make a big difference. You might experience overwhelming fear as if you’re in real danger, but remember, that’s not the case. Gently reminding yourself that you’re physically safe and holding onto this thought can help reassure you that this feeling is just temporary.

Try to distract your mind

The next step is to change your perspective and distract your mind. During a panic attack, you might also feel disconnected from yourself, or fear losing control and may feel shortness of breath. To gain control, pinch yourself and engage in deep, belly-breathing exercises to help activate the parasympathetic nervous system. These are a few easy to remember techniques.

54321 technique

• 5: Acknowledge five things you can see around you. Look for details.   
• 4: Acknowledge four things you can touch. Notice the texture, temperature, or weight.
• 3: Acknowledge three things you can hear. Listen closely for distinct sounds.   
• 2: Acknowledge two things you can smell. Identify any scents, pleasant or unpleasant.   
• 1: Acknowledge one thing you can taste. Notice the current taste in your mouth, or if safe, have a small sip of water or a piece of candy.   

This technique engages your senses, helping to shift your focus away from the distressing thoughts and physical sensations of a panic attack and ground you in your current surroundings.

The 5 finger rule 

The 5-finger rule is a mindfulness breathing technique. Trace each finger on one hand, focusing on your breath as you go up and down each finger. It engages the senses and promotes awareness.

Understand your triggers

This is one of the most crucial points that can help you cope with panic attacks in the long term. If you have a history of panic attacks, study and understand what triggers you. Notice patterns, places, and surroundings that make you anxious often. Try to work towards making a safe environment around those things. For example, if public or crowded places make you feel anxious, try finding alternatives or using tools and ways to build resistance to go there.

FAQs

1. How do you cope with panic attacks?

Coping involves both immediate strategies during an attack and long-term approaches. During an attack, focus on grounding techniques like deep breathing or the 3-3-3 rule. Long-term, therapy (especially CBT), lifestyle changes (like reducing caffeine), and building a strong support system are crucial. 

2. What are 3 types of panic attacks?

While the core experience is similar, panic attacks can be categorised by triggers:

Unexpected (Uncued): Occur seemingly out of the blue, without an obvious trigger.   

Situationally Bound (Cued): Predictably triggered by specific situations (e.g., public speaking, driving).   

Situationally Predisposed: More likely to occur in certain situations, but not inevitable every time.

3. What is the 3-3-3 rule for panic attacks?

The 3-3-3 rule is a grounding technique: Name 3 things you see, and 3 things you hear, and move 3 parts of your body. It helps shift focus from internal anxiety to external reality.

4. How to get rid of panic attacks permanently?

While "permanently" can be a strong word, the goal is to significantly reduce their frequency and intensity, and develop effective coping mechanisms. This is often achieved through consistent therapy, lifestyle adjustments, and learning to manage underlying anxiety. It's about management and resilience, not necessarily complete eradication.

5. What is the 5 finger rule for panic attacks?

The 5 finger rule is a mindfulness technique: Trace each finger on one hand, focusing on your breath as you go up and down each finger. It engages the senses and promotes present moment awareness.