Coping with Panic Attacks: Tips and Strategies

We live in an era where our nervous systems rarely get a true pause. Constant “pings” from phones, breaking news headlines about climate change, fluctuating job markets, inflation worries, family expectations, and the endless hustle culture have created an environment where our minds are on guard more than they rest. In urban India, this pressure is compounded by long commutes, competitive workplaces, rising cost of living, and the invisible emotional toll of balancing traditional family roles with modern aspirations. In rural India, it can take a different form, lack of access to mental health services, societal stigma around seeking help, and cultural pressures that often dismiss emotional distress as “weakness.”

Globally, over 300 million people live with anxiety disorders, and the trend has been steadily increasing since the 1990s. India is no exception, in fact, the National Mental Health Survey (2015–16) estimated that nearly 3.6% of Indians live with some form of anxiety disorder at any given time, with higher rates among women, urban residents, and younger adults. Post-pandemic studies suggest these numbers may now be higher, especially among students, working professionals, and caregivers.

Anxiety vs Panic: Quick Clarity

While anxiety and panic share some symptoms, their patterns and intensity differ:

• Anxiety usually creeps in gradually. It may start as overthinking, muscle tension, irritability, or restlessness, often tied to specific stressors, deadlines, exams, relationship strains, or financial uncertainty.
• Panic attacks arrive like a sudden storm, intense surges of fear that peak within minutes, often with racing heart, shortness of breath, chest tightness, trembling, dizziness, sweating, and the overpowering thought, “I’m going to die” or “I’m losing control.”

Panic attacks can occur in isolation or as part of panic disorder, a condition where these attacks are recurrent and often lead to avoidance behaviors (avoiding crowded markets, public transport, or even stepping outside alone).

How Common is Panic Disorder?

In the United States, around 2.7% of adults live with panic disorder in a given year, and 4.7% will experience it at some point in their lifetime.

In India, exact nationwide data for panic disorder is limited, partly due to under-reporting and stigma, but smaller community studies suggest panic attacks affect between 1–3% of adults annually. Urban stress, lack of awareness, and minimal school or workplace mental health education mean many people suffer in silence, often mistaking panic symptoms for heart disease or “weak nerves.”

What’s happening in your body during a panic attack

Your threat system slams the accelerator (adrenaline, rapid breathing), your CO₂ levels drop, and light-headedness, tingling, and chest pressure can follow. People with panic disorder are often more sensitive to CO₂, even lab tests that gently raise CO₂ can trigger panic in a subset of patients. This is one reason slow breathing helps: it steadies CO₂ and downshifts the alarm.

Why it feels worse today

• Doomscrolling: Compulsively consuming negative news is linked with lower well-being and higher distress; recent summaries and studies show clear associations with anxiety. Tip: set “news windows” and avoid late-night scrolling.

• Social media overload: Meta-analyses tie problematic use to higher depression/anxiety in young people; it’s not all bad, but more isn’t always better.

• Caffeine culture: For most adults, ≤400 mg/day is the general “upper safe” limit (about 3–4 coffees), but people with anxiety or panic can be extra sensitive. At high doses (~5 cups’ worth), caffeine can provoke panic in many with panic disorder

• Sleep squeeze + hustle: Short sleep, pressure to be “always on,” and financial or climate stress keep the threat system primed. (See the breathing plan below to nudge it down.)

If you’re having a panic attack right now (save this)

1. Name it: “This is panic, not danger. It will pass.” If it’s your first episode or there’s new chest pain or fainting, seek urgent medical care to rule out other causes.
2. Breathe with a long, slow exhale: Try 4-in / 6-out belly breathing for 3–5 minutes. NHS’s calm-breathing drill is a great template.
3. Ground your senses: 5-4-3-2-1 (name 5 things you see, 4 feel, 3 hear, 2 smell, 1 taste). It yanks attention out of the fear spiral.
4. Stay (if safe): Let the wave rise and fall. Repeated safe exposure teaches your brain the sensations are tolerable.
5. Skip stimulants for the day: No caffeine/nicotine until tomorrow.

What actually helps long-term (evidence-based)

1. CBT (with exposure) is a front-line treatment.

CBT for panic uses interoceptive exposure (safely recreating body sensations like fast breathing or dizziness) so you unlearn the “fear of fear.” It’s one of the most studied, effective approaches for panic. Internet-CBT can help when access is limited.

• Medication (often SSRIs/SNRIs).

Antidepressants (especially SSRIs) are widely recommended for anxiety disorders and panic; many people do best with CBT + meds. (Benzodiazepines may be used short-term, but they’re generally not first-line for ongoing care.)

• Skills that turn the alarm down between attacks.
• Breath training (box breathing, 4-7-8, or simply longer exhales).
• Movement & sleep routines (consistency beats perfection).
• Digital hygiene: schedule news checks; keep phones out of the bedroom.

A gentle 4-week self-plan (publishable checklist)

Week 1 – Understand & track

• Panic log: trigger, body sensation, thought (“I’m dying”), action (fled/stayed), intensity 0–10.
• Daily 5 minutes of long-exhale breathing (twice/day).

Week 2 – Body confidence

• Interoceptive drills (with a professional if you can): 60s brisk stair walk (heart racing), 60s head turns (dizzy), 60s straw breathing (air hunger). Stay and let the sensations fall.
• Caffeine cap: ≤200–300 mg/day (or trial decaf week).

Week 3 – Situation exposure

• Build a ladder (e.g., short elevator ride → long ride; short queue → busy supermarket). Repeat each step until anxiety drops by half without escape behaviors.

Week 4 – Maintenance & meaning

• Sleep/wind-down plan, scheduled news windows, weekly joy activity (walks, art, prayer, time in nature).
• If attacks persist or you’re avoiding life, book CBT and discuss medications.