For Claire Eastham, who lives with social anxiety and panic attacks, the adrenaline surge that accompanies a panic attack is impossible to miss. She says that it feels like liquid terror being injected into her veins and that she feels an overwhelming sense of dread but has no idea what’s behind it.

“My heart doesn't beat — it thunders against my ribs like a bird frantically trying to escape a cage,” says Eastham, a mental health blogger and author living in Manchester, England. “I can't catch my breath, and I'm certain that I'll pass out if I don't move. My mouth is dry, my vision is blurry, I'm pouring sweat, and my limbs feel numb. The symptoms are violent and relentless.”

There’s no way to predict or prevent these episodes, says Eastham, who has experienced hundreds of panic attacks and written a book about it, How I Learned to Live With Panic.

“I cannot fight off a panic attack any more than I could a tidal wave, and fighting one only prolongs the experience,” says Eastham. “Instead, I tell myself that although a panic attack might feel terrifying and uncomfortable, it cannot physically harm me nor can it make me lose my mind. My role during the attack is to accept the symptoms and make myself as comfortable as I can while it passes.”

When a panic attack strikes, Eastham focuses on breathing exercises and does her best to find a quiet space away from other people where she can ride it out. She also lets people know why she’s stepping away and what she needs at that moment.

“You wouldn't be ashamed of a headache or a sneeze, and panic attacks are no different,” Eastham says.

How Do You Know if You’re Having a Panic Attack?

Panic attacks are sudden, fleeting feelings of fear and intense physical responses to ordinary situations when no danger is present, according to the Cleveland Clinic. There’s often no trigger for them.

Panic attacks are the main symptom of panic disorder, but they can happen among people with other health conditions, such as other anxiety disorders, mood disorders, psychotic disorders, or substance use disorders, per the Cleveland Clinic.

While symptoms of a panic attack can vary from one person to the next, they tend to be very physical and can often include some of the things Eastham describes, says Lauren Cook, PsyD, a licensed clinical psychologist and the founder of Heartship Psychological Services in Pasadena, California.

Even though panic attacks often subside after about 10 minutes, it’s not uncommon for people to experience symptoms for up to an hour or so, says Dr. Cook. Several physical symptoms are common during panic attacks, according to Cook and the Cleveland Clinic:

Intense feelings of fear
Shaking
Sweating or chills
Shortness of breath
Rapid breathing
Racing heart
Nausea
Dizziness
Feeling like you’re choking or being smothered
Derealization (feeling detached from reality)
Depersonalization (feeling detached from yourself or like you’re having an out-of-body experience)

“People can feel like they are going to die during the experience, and it's not uncommon that people will go to the hospital believing they are having a heart attack,” Cook says. “It's important to note, though, no one has ever actually died from a panic attack, even though the brain can make you believe otherwise when you're actively experiencing it.”

4 Helpful Strategies for Managing Panic Attacks

If you think you’re having panic attacks, the best thing to do is reach out to your healthcare provider or a mental health professional for help.

Panic attacks are often linked to anxiety disorders or other mental health conditions, so it’s important that you see a professional to get the right diagnosis and treatment for what you’re experiencing. Your doctor can also rule out any underlying conditions that may be causing your symptoms, according to Cleveland Clinic.

If your doctor diagnoses you with panic attacks, panic disorder, or a related mental health condition, they can help you find a treatment plan that works for you. Here are four common and effective treatment options for panic attacks.

1. Psychotherapy

Psychotherapy (aka talk therapy) can be a key component of managing panic attacks, according to the Cleveland Clinic.

Exposure and response prevention therapy is often involved, Cook says. In this practice, people gradually and repeatedly get used to feeling the symptoms of their panic attacks in a safe and controlled setting (like a therapist’s office), so they can learn how to live through the uncomfortable and distressing feelings in their body.

“When we learn how to face the panic rather than fear it so vehemently, it often deflates the power of the fear of future panic attacks,” Cook says.

“We also teach various coping strategies to clients, including things like having a self-care soothing kit when in moments of intense distress,” Cook says. “Having things like gum, sour candy, peppermint essential oil, and music are all ways to down regulate the nervous system when highly activated.”

2. Medication

Medication can help many people manage panic attacks, particularly if they have underlying mental health issues, says Philip Muskin, MD, a professor of psychiatry at Columbia University Irving Medical Center in New York City.

Antidepressants are commonly prescribed for panic attacks, and several types of these drugs can be effective, Dr. Muskin says. Anti-anxiety medications are another option, per the Cleveland Clinic.

3. Exercise

Lifestyle approaches can be beneficial, Muskin adds. Exercise — especially cardiovascular activity that gets your heart racing — can be a big help. “When people exercise, they can realize, I am breathing very fast, and my heart is pounding in my chest, and I’m not having a panic attack,” Muskin says. “This can make the experience of a panic attack itself easier to get through.”

4. Deep Breathing

Breathing exercises are also a big piece of the puzzle when it comes to managing panic attacks, says Muskin. That’s because slow and deep breathing can help reduce panic symptoms like hyperventilating (trouble breathing that involves rapid and deep breaths), which increase feelings of fear during a panic attack, according to the Cleveland Clinic.

“I teach people to concentrate on their breath so they know what they’re feeling in their chest and how to control it, and how to recognize that a panic attack won’t actually stop their lungs from working,” says Muskin.

Can You Prevent Panic Attacks?

Treatment and lifestyle approaches won’t completely stop panic attacks from happening, but these interventions can make panic attacks easier to live with, Muskin says.

“They're not necessarily preventable — and that is the most important piece to accept,” Cook adds. “Problematically, many people try so hard to prevent panic or live in so much fear of having a future panic attack that they are constantly on the lookout for any and all potential triggers.”

In addition, focusing on the idea that panic attacks are uncomfortable and unavoidable, and concentrating on tools for managing them, can make life much easier for people who experience them, Cook adds. “If we can become okay with having panic attacks, they often by default lose their power over us.”