There’s never a good time to have a panic attack. For many, anxiety is an overwhelming emotional and physical experience. Yet, you can’t pick and choose when you experience your anxiety. So what happens when you have a panic attack in a public place?
You can’t schedule your panic attacks, but you can prepare yourself for them. By knowing what to do when you experience a panic attack in public and being ready in case it happens, you can mitigate the severity of that panic attack. Below are five tips for managing a panic attack in public so you can leave home knowing what to do to stop panic in its tracks.
What is a panic attack?
Panic attacks describe an intense physical and mental reaction to perceived danger. They often occur out of nowhere — they can happen even when you’re feeling calm or relaxed. Somehow, your mind and body jumps into an extreme episode of fear that creates a wide range of distressing symptoms.
Panic attacks differ from anxiety attacks, though they can feel similar to each other in the moment. Panic attacks generally begin and end relatively quickly, sometimes lasting only minutes (though it often doesn’t feel like it’s very quick when you’re in the middle of it!). Anxiety attacks, on the other hand, typically have a lead up — individuals who have anxiety may feel their anxiety for days before it reaches a crescendo, which might only subside after several more days.
The signs of a panic attack look different person-to-person. They include physical symptoms that can be confused for a medical emergency, including:
- Shortness of breath
- Excessive sweating
- Flushed or hot skin
- Increased heart rate
- Pain in the chest
- Intense stomach ache or headache
- Hot flashes or chills
- Nausea
- Shaking or shivering
While sometimes there are solely physical symptoms for panic attacks, they are more commonly paired with intense cognitive or emotional symptoms. A few examples of these symptoms are:
- Intense fear, especially of getting hurt or of dying
- Thought spiraling
- Sense of dread or doom, like a disaster is about to happen
- Feeling detached or disconnected from reality, like you’re watching a movie of your life
- Feeling out of control
- Being confused or disoriented
- Extreme distress
Some people start crying without the ability to stop. Others feel like they can’t speak or are scared to move. People have panic attacks in all sorts of places — that’s one of the most salient features of panic attacks, they seemingly happen whenever they want, no matter how good you might feel at the time.
You might be on the bus on your way to work. You might be at work — and your office has an open floor plan, so you’re surrounded by your colleagues. Or you could be out shopping, doing something as routine as getting your weekly groceries.
Wherever you are, it’s not at all convenient to have a panic attack. And when you’re in public, it’s especially inconvenient because you can’t retreat to your bedroom or another safe space.
How to stop a panic attack in public
What’s the best way to calm your panic attack when you’re not home? These five steps can help.
1. Identify the signs of an oncoming panic attack
The first step to managing your panic attack when you’re out in public is to recognize that you’re having a panic attack. Because panic attack symptoms are diverse and can often be mistaken for a physical emergency, it can be difficult to pinpoint the reason why you feel so terrible.
If you start to feel different, ask yourself to identify your symptoms. Is there another reason why your heart rate is elevated, perhaps because you just walked up three flights of stairs? Are you feeling disoriented because you’re in a new place and unsure where you’re supposed to go? If you can’t determine the reason behind the signs, you may be experiencing a panic attack.
Especially if you’ve had a panic attack in the past, you might be able to name what’s happening to your mind and body. Recognizing that you’re having a panic attack — and that it will cease in a matter of minutes — means that you don’t have to feel confused about what’s happening to you, which further exacerbates the distress.
Iva Svancarova, LCP, LMHC shares, “When you know that a panic attack is coming, start describing the feeling to yourself without judging it. Observe the sensations of your body, your thoughts. Try to rate your panic on the scale of 1-10, and ask yourself if you can tolerate this level of discomfort without going into a full blown panic attack.” By recognizing your feelings in a nonjudgmental way, you can avoid the full impact of a panic attack.
2. Get yourself to a safe spot
Next, it’s important to get yourself to a location where you feel safe. Because panic attacks trigger your body’s physiological processes related to fear, finding a place where you can feel safe can help your body calm down.
If you’re in a public space, look for a spot where there are less people. This could be a bathroom — even better if it’s a single stall bathroom — a vacant meeting room, or even a quiet corner. If you feel more safe with others around you, then find a spot that hits the mark so that you can focus on grounding yourself.
3. Ground yourself
The concept of “grounding” means centering yourself in the moment and within your current physical state. Once you establish that you’re safe, try to find a way to ground yourself. Grounding comes from mindfulness practices and can be extremely helpful when you’re feeling distressed, as it moves your attention away from your symptoms so you can begin to process through what’s happening.
It generally takes people trial and error to find the grounding technique that works best for them, as personal preference and neurodiversity impact how effective certain techniques can be. Here are a few grounding techniques to try when you’re feeling overwhelmed:
- Deep breathing: Breathwork is one of the most popular types of grounding techniques or mindfulness exercises. There are many different ways to benefit from deep breathing. Try square breathing: inhale for four seconds, hold your breath for four seconds, exhale for four seconds, and then hold once more for four seconds. You can also vary the lengths of your breath, inhaling for six seconds and exhaling as slowly as you can. By focusing on your breath, including feeling the sensation of air going into your lungs, you’re centering yourself on something other than your panic attack. Deep breathing also helps your body regulate its physiological functions, helping to decrease your physical symptoms.
- Tactile grounder: A tactile grounder is an object that you can focus on through your fingertips. The best tactile grounders have interesting textures: soft, fuzzy, bumpy, coarse, and more. When you need to center yourself, run your fingers over this object and pay attention to how it feels against your skin. You can even use objects that have different temperatures, such as an ice cube. This is a way to keep your thoughts in the present.
- Visualization: If you feel comfortable, close your eyes and visualize yourself in a safe or comforting situation. You might conjure the image of the waves of the ocean crashing against the shore, a candle flickering, or a tennis ball going from one side of the court to the other. Whatever image brings a sense of control to your mind could be a way to decrease the impact of your panic attack.
All of these grounding techniques can be done in public — you can even do them without other people noticing, making them handy tools to have at hand when you’re surrounded by others.
4. Focus on a distraction
If grounding isn’t working for you, finding a distraction is another way to shift your attention away from your panic attack and help you establish homeostasis once more. Because panic attacks usually last only a matter of minutes, distracting yourself for a few minutes might lessen the impact that your panic attack has on your wellbeing.
To distract yourself, activate all five of your senses.
- Touch: A tactile grounder can be an especially helpful tool to use.
- Smell: You can also focus on your favorite scent, perhaps from an essential oil.
- Sight: To engage your sight, look around you and count how many red objects you can see. Once you run out of red objects, now look for orange objects — all the way through the rainbow.
- Sound: If you enjoy listening to music, find a song that helps you relax.
- Taste: If you have something nearby that you can eat, try paying attention to the taste and texture of your snack.
5. Call a friend or loved one
Whether for support or for a distraction, calling a friend of a loved one is another avenue you might go down if you’re having a panic attack in public. If you feel comfortable, you can disclose that you’re experiencing a panic attack so that they can help you by talking you through how you feel. Hearing the voice of someone that cares about you can also be an effective way to break out of the grip of your panic attack.
Speaking with someone else about what you’re experiencing also ensures that you’re safe — if you’re in a public place, calling a friend or loved one means that they know where you are in case you need additional help.
How to prepare for panic attacks in public
You can prepare for a panic attack by carrying with you what you need to feel grounded or to distract yourself. Hopefully you won’t have a panic attack in public, but if you do, being prepared with what you need to cope means that you’re one step ahead.
Bring your essential oil with you, something with an interesting texture to touch, or a sour candy that will make you pucker. You can have a playlist ready of all of the most relaxing songs you know, or have your friend on speed dial in case you need to reach them. If you take medication for your panic attacks, be sure that it’s in your bag wherever you go.
You can also prepare mentally for a panic attack. If you know what tends to trigger your panic attacks, anticipate if you’ll encounter that trigger if you’re in a certain setting. For example, if flashing lights generally cause you to feel upset, then avoiding nightclubs is a good idea. Being aware of when you’re at risk of a panic attack can give you the heads-up you need to lessen its impact — or to avoid it altogether.
How to help a loved one who is having a panic attack
If you want to help a loved one who is having a panic attack, help them find a quiet or calm space where they can feel safe. It might be helpful to remind them that they’re safe, whether that’s saying, “Hey, I’ve got you, you’re safe with me” or “It’s okay, you’re going to be alright, I’m here with you right now.” If you know of a good coping skill — deep breathing, for example — you can try to talk them through it.
Wanting to help your friend, partner, or loved one experience a panic attack can be scary — it can be quite distressing to see someone that you care about in physical and emotional pain. If none of your techniques help, however, remember that it isn’t a reflection on your friendship. Your loved one might be too distressed to react to your support or even process that it’s there — though they likely appreciate it nonetheless.
Seek support from a therapist
If you suffer from panic attacks, a therapist can help you navigate their impact and give you more tips to manage a panic attack in public. A therapist can also help you identify and avoid your triggers. They can also support you as you process through the underlying cause of your panic attacks so you can prevent them altogether.
Svancarova shares that, “Therapy can aid with recognizing the red flags before panic attack and teach coping skills to prevent, slow down or tolerate the attack. It can also process some mental health issues, possibly trauma, that lead to these attacks, which can decrease the severity and frequency of them.”
To find a therapist who can help you or a loved one with panic attacks, filter the Zencare therapist directory for what you’re looking for. Each therapist profile features information about the therapist and their background, as well as personal statements, a video, and a welcoming message. To see if a therapist is the right one for you, schedule a consultation call — and don’t hesitate to ask them how they can help you with panic attacks.