1. Chest pain
2. Heart palpitations
3. Difficulty breathing or a choking sensation
4. Dizziness
5. Sweating, hot flashes, or chills
6. Tingling sensation
7. Trembling
8. Upset stomach or nausea
9. Feeling separated from your body (“depersonalization”)
10. Fear of dying, going crazy or just “losing it”

If a friend or relative is beginning to experience a panic attack, you can help bring her out of it with the following actions:

• Establish eye contact: Get her back into the moment; assure her that she’s not alone.
• Help her calm her breathing/heart rate: Breathe with her, gently slowing her a little more with each subsequent breath.
• Hold them up: Take her hand or shoulder if she’s dizzy and help her find a wall or something solid to stand against, or a chair to sit down on.
• Cool her down or warm her up: If she’s experiencing hot flashes, have her loosen her clothing and get her to fresh air. If she’s experiencing chills, give her a jacket or cover.

These sensations should pass quickly, but if they don’t, call 911 for help.

• Be prepared to step back: Sometimes a panic attack is accompanied by claustrophobia; step away, but don’t leave her.
• Watch the clock: Call 911 if symptoms are getting worse and you fear a bigger health issue is emerging; otherwise, keep an eye on the time, knowing that most attacks last for only 10 minutes or so.
• Acknowledge your care for her: Help relieve any embarrassment or frustration your friend may have after an attack by assuring her of how glad you were to be there to help her through what must have been a terrifying time; tell her you’re glad she’s feeling better now.

Reduce stress: It’s a common panic attack trigger; learn to say “no” or “I’d love to but I can’t …” and keep your life at a manageable pace.

Take control: When you’re in a trigger situation or feel like an attack is imminent, stop and take control. Remind yourself that panic attacks pass and aren’t life-threatening. Affirm that you know what to do when they strike.

Slow your breathing: Breathing drives your heart rate, which speeds up in response to anxiety; practice slow breathing exercises, and never hold your breath during an attack.

Practice good self-care: You’re much less susceptible to stress and its effects when you take care of yourself each day, which means eating right, exercising regularly, keeping a network of friends and relatives around you and getting enough rest.

About the Author: Jan Demasters, PhD, RN, CSP, is a well-known expert on managing stress and is founder of Total Health Concepts in St. Louis. She emphasizes that panic attacks usually peak in about 10 minutes. “If your symptoms are severe, or last longer than a few minutes, play it safe and call for help to make sure it truly is PA and not some other health problem,” she advises.