It always starts the same way. I sense my heartbeat speeding up, as if it’s going to burst out of my chest. At the same time, my chest feels tight but also huge; it’s like my ribs and lungs have expanded to capacity and are being forced to stay there—and the tension hurts.

Next come the thoughts. The uncomfortable physical sensations start a quick succession of questions and worries: What’s happening? Why am I feeling this way? What if I can’t calm down? What is my boss/boyfriend/this random stranger on the train going to think? Am I always going to feel like this? Am I going to die?

It has teeth and claws, and it pins you down and waits for you to just stop struggling.

Then my stomach joins the party. It’s doing Olympics-level backflips, and I have that gagging feeling in the back of my throat, except I’m not actually gagging so I get no relief. My thoughts latch onto this new symptom and race ahead of me: Oh f*ck, now I’m nauseated. Where are my ginger pills? What do I do if they don’t help? What if I can’t get this under control and I have to cancel my plans? When is this going to end?

All of this happens in less than a minute. If I’m lucky and can get somewhere where I can take a few minutes for myself, I can practice belly breathing and gradually slow my heartbeat and my thoughts. But if I can’t do that or if I feel I need to hide what’s going on, then Houston, forget a problem—we have a freaking disaster on our hands.

During a panic attack, it becomes incredibly difficult to distinguish where physical symptoms like nausea and hyperventilating end and racing thoughts and fears begin. This is because a panic attack is precisely that: You’re terrified and panicking, and that fear is very real. It has teeth and claws, and it pins you down and waits for you to just stop struggling.

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If I’m unlucky, the belly breathing doesn’t work and I get hit with the following symptoms all at once and with startling intensity: dry heaves, diarrhea, crying so hard I give myself a headache, being so on edge that all of my muscles are clenched. At the same time, my thoughts are rushing at me so quickly that I barely finish one before another has started.

Underneath the what if's and this sucks is the sense that I am quickly losing control, losing my mind, losing all grasp of who I am. During my most intense panic attack to date, in the bathroom at my boyfriend’s parents' house, it seemed like there was no way this was happening to me—it had to be happening to someone else. It was like I didn’t know who I was anymore, and it was absolutely terrifying.

In reality, panic attacks don’t last long. But when you’re experiencing one, every second feels like years, and you start to think that this is inescapable, that you will feel this way for the rest of your life. Panic attacks take over your brain; they hijack your thoughts and convince you that, without a doubt, the worst-case scenario will happen, and there is nothing you can do about it.

You know you can’t will yourself to feel better. Distracting yourself won’t help, and neither will anything else. It’s futile. You’re trapped.

Anxiety Attack Image

Eventually, your brain and body start to calm down on their own, usually because you’re exhausted and your brain starts to shut down, or because you’ve given up and just stopped fighting what’s happening to you.

Ironically, giving up is the thing that’s most helpful: When you surrender to what’s happening, you give up the idea that you can control it, and you stop fighting it. You stop adding to the tension that you’ve been creating with your thoughts, which are in opposition to what your brain and body are doing.

Ask anyone who has panic attacks, and they will tell you that a lot of what they fear is losing control: of their minds, of their bodies, in public, in front of loved ones. Your brain tells you that you will faint/look like an idiot/go crazy, and people will judge you for it.

There are a host of other symptoms too: dizziness, inability to concentrate, insomnia, chills, hot flashes, dry mouth, irritability, excessive sweating. A panic attack is comprehensive; it’s not just racing thoughts or just stomach cramps. It is everything all at once in a deluge. A panic attack is like an orgasm—you may not know what it was at the time, but it is not an ambiguous experience.

It’s not just racing thoughts or just stomach cramps. It is everything all at once in a deluge.

Even when the panic attack itself is over, you’re still not “better.” You’re still highly sensitized, and you’re also afraid of having another attack. This creates more anxiety and uncomfortable physical sensations, and you’re right back to where you started. This is called the panic loop, and it is very, very easy to get trapped in.

Remember: There is nothing wrong with having a panic attack. It doesn’t mean you’re weak or broken or flawed. Panic attacks are your brain telling you that there is danger. Your anxious brain is wrong 99 percent of the time, but it’s trying to keep you alive. Your brain is wired differently than other people's, and there is nothing wrong with that. You’re not a bad person, and you haven’t done anything to deserve it. This is something really sh*tty that’s happening to you.

Some good news? While I'm not a certified mental health expert, I've found some tips that really work for me.

If You're Experiencing a Panic Attack:

1. Speak to a therapist.

This doesn’t mean that you’re locked into therapy for the rest of your life; it may only take you a few sessions to get to the root of your panic attacks. (Here's why everyone—even happy people—can seriously benefit from therapy.)

2. Pick up calming habits.

Try preventative and stress-relief strategies like yoga, regular exercise, and/or meditation. They can teach you breathing techniques and other habits that you can use in the middle of a panic attack to help your body to calm down more quickly.

You’re not a bad person, and you haven’t done anything to deserve it.

3. Write it down.

Panic attack workbooks, like this one, are also great, because they help you break down the fears and symptoms, and tailor your treatment to your specific fears.

4. Reach out to a friend or family member.

It’s really helpful to have someone that you can text, call, or go see when you feel an attack coming on. This person can remind you of the things you can do to help yourself calm down, and they can also help you keep perspective. I usually call my sister, and every time she reminds me that it’s not an indication of who I am—it’s just a thing that is happening to me.

If Someone Else Is Experiencing a Panic Attack:

1. Ask how you can help.

But just that. Don’t overwhelm them with a bunch of decisions and options; people having a panic attack usually can’t focus beyond their immediate experience for more than a few seconds at a time.

2. Don’t take it personally if they don’t want help or are irritable.

Again, they’re going through something really uncomfortable and scary, and it’s unreasonable to expect them to be polite or to act like their normal selves. If they don’t want help, respect that. Let them know you’re there if they need you, and then leave them alone.

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3. Don’t tell them to “calm down.”

Or “relax,” “stop worrying,” or that “it’s going to be OK.” There is no nice way to say this: That’s not helpful, and it makes us want to strangle you.

4. Try to be as compassionate as you can.

They’re not doing this for attention or sympathy. They’re going through something really difficult, and judging or treating them like something is wrong with them isn’t going to help. Even something as small as getting them a glass of water can be much appreciated. Just make sure you ask before you touch them—some people really don’t like that in the midst of an attack.

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