You were in the grocery store aisle, or driving on the highway, or almost asleep, and your heart took off. You could not get a full breath. Your hands went numb. You thought you were dying, and you meant it.

A few minutes later your body settled on its own. But you were left shaking, with a question that will not leave: what was that, and what happens if it comes back?

What happened has a name, an explanation, and a treatment. Below: what a panic attack is, how it differs from an anxiety attack, what to do in the first minutes, when to go to the emergency room, and what to do afterward.

What a panic attack actually is

MedlinePlus describes panic attacks as "sudden periods of intense fear, discomfort, or a sense of losing control," and adds that "these attacks happen even though there is no real danger." That second half is the whole thing: your body fires the full survival alarm — the same one that goes off when a car swerves into your lane — with no car anywhere.

That is why the symptoms are so physical. The same source lists a pounding or racing heart, sweating or chills, trembling or shaking, trouble breathing, the feeling of choking, weakness or dizziness, chest pain, and stomach pain or nausea. The National Institute of Mental Health describes the experience as "a sudden wave of fear or discomfort or a sense of losing control even when there is no clear danger or trigger."

Two facts almost nobody hears the first time: an attack peaks and then the body comes down on its own, and "panic disorder is not life-threatening," even though every signal your body is sending says the opposite.

Panic attack vs anxiety attack: the difference that matters

People use the two phrases interchangeably. They are not the same experience, and the difference is more useful than it sounds.

An anxiety attack — a common phrase, not a clinical diagnosis — builds. It climbs over hours or days around something specific: the debt, the test result, the court date. It feels like tension and circling thoughts, and it eases when the situation resolves; MedlinePlus keeps a plain-language overview of anxiety.

A panic attack drops. It peaks within minutes, often with no subject you can name, and it is overwhelmingly physical. The National Alliance on Mental Illness notes that a panic attack is "often mistaken for a heart attack" because it "causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath, nausea, vomiting and diarrhea."

The difference matters practically: slow-building anxiety responds to solving the problem; panic responds to stopping the fight with your own body.

What to do in the first few minutes

None of this shuts an attack off on command — nothing does — but it shortens the climb and heads off the fear of the fear.

Stop fighting the symptoms. "I have to make this stop right now" pours adrenaline into a body that already has too much. Change the instruction: this is a panic attack, it will peak, and then it will come down.

Make the exhale longer than the inhale. Do not breathe deep and fast; that worsens the dizziness. Breathe in for four, then out through your mouth for six or eight, like blowing out a candle slowly.

Put both feet on the floor and name what is around you. Five things you can see, four you can hear, three you can touch.

If you are driving, pull off. If it starts on I-77 toward Akron or on I-4 leaving Orlando, take the nearest exit and wait it out. Nobody has to be anywhere on time.

And stay where you are, if you can. Walking out of the grocery store brings relief today and teaches your brain that the aisle was dangerous. That is how avoidance starts, and it costs the most later.

When you should go to the emergency room

Plainly: if this is the first time and there is chest pain, go. Panic and cardiac problems share symptoms, and only an exam separates them. MedlinePlus notes that a provider evaluating panic disorder may check whether an unrelated physical problem is causing the symptoms, using a physical exam, blood tests for thyroid problems and other conditions, and heart health tests.

Call 911 if chest pain spreads into your arm or jaw, if shortness of breath does not ease, if you faint or feel weakness on one side, or if you are not sure. Being told "your tests came back fine" does not mean somebody thinks you imagined it. It means your heart is fine and the thing to treat is the anxiety.

The hours and days after

Write it down, briefly. Time, place, what you were doing, how much you slept, how much coffee. Three or four entries show a pattern memory alone will not. Tell one person, too — not everyone, just one; silence is what turns an episode into a secret.

Look at sleep and caffeine before anything else. MedlinePlus lists getting enough sleep, reducing caffeine, eating regular meals, avoiding alcohol, and getting regular exercise among the lifestyle changes that help with panic disorder. If you work night shifts through a Northeast Ohio November, or rotating hospitality schedules in Orlando and Kissimmee, sleep is the first thing to go and the last thing anyone mentions.

Do not reorganize your life around the attack. NIMH warns that many people with panic disorder "may significantly change their lives to avoid having another attack." Each small avoidance calms you today and shrinks your world tomorrow: one highway, then one store, then one invitation.

One attack is also not a disorder. NIMH is direct — "not everyone who experiences a panic attack will develop panic disorder" — and MedlinePlus notes that "many people only have one or two panic attacks in their lifetime and get better without treatment." Panic disorder is different: repeated attacks, steady worry about the next one, and behavior organized around preventing it. Untreated, MedlinePlus notes, it "can sometimes lead to other health conditions, including depression and substance use disorders."

In a lot of families this never gets called a panic attack at all. It gets called nerves, or a bad scare, or being run down — language that describes something real but leaves the person without the information that would help. And if English is your second language, describing a choking sensation and numb hands through a phone interpreter is close to impossible; most people say only that they felt bad, and the conversation stops there.

What treatment actually looks like

MedlinePlus notes that treatment for panic disorder usually includes "talk therapy, also called psychotherapy or counseling," and that it "may include cognitive behavioral therapy (CBT), a type of talk therapy that helps you change your negative thoughts and how you react to things that cause you to feel anxiety." The same overview mentions medicines as well, a decision for a physician and not for an article. The American Psychological Association agrees that anxiety disorders respond well to treatment.

In practice the work has three parts. You learn what your body is doing, so the symptoms stop reading as a death sentence. You practice a different response until it stops being instinct to fight. And you take back, step by step, whatever you had started to avoid: the highway, the mall, sleeping with the light off. That last part returns your life to its normal size, and it is the substance of individual therapy — in person in Stow, or by teletherapy anywhere in Ohio or anywhere in Florida.

Frequently asked questions

Can a panic attack kill me? No. MedlinePlus states that "panic disorder is not life-threatening, but it can be upsetting and affect your quality of life." The symptoms peak and then subside on their own. Still, if this is your first attack and there is chest pain, get your heart checked.

How long does a panic attack last? MedlinePlus notes that an attack can last "anywhere from a few minutes to over an hour." The most intense stretch is usually the first ten minutes, though the exhaustion afterward can last the rest of the day.

Why do they wake me up at night? NIMH confirms that panic attacks "can occur at any time, sometimes even during sleep." A nighttime attack is not more serious than a daytime one; it only means the alarm went off without a visible trigger. Irregular sleep and afternoon caffeine are often underneath it.

Does teletherapy work for panic attacks? Yes, and it has one real advantage: you practice the tools in the rooms where the attacks happen. You only need to be physically in Ohio or in Florida during the session. If you would rather start in person, the office is in Stow; there is more detail for Cleveland and for Orlando.

When to seek professional support

If you have had more than one attack, if you spend your days braced for the next one, or if you have started avoiding places, talking with a licensed therapist is a reasonable step, not an overreaction. Joselyn Vasquez, LISW-S, has practiced since 2003, and at Quez Therapeutic Solutions in Stow, Ohio, she offers individual, couples, family, and teen therapy (ages 7 and up) in Spanish and English — in person in Stow, serving Akron, Hudson, Cuyahoga Falls, Summit County, and the Cleveland area, and by teletherapy anywhere in Ohio and anywhere in Florida. Panic work usually draws on cognitive behavioral therapy, a solution-focused approach, and trauma-informed care. The practice is in network with many major plans, including Aetna, Cigna, Medical Mutual, and UnitedHealthcare, and accepts Medicare and Medicaid in Ohio; if you are in Florida, verify your plan. Self-pay is $145 for the first session and $135 for each session after, with a superbill provided for out-of-network reimbursement. Hours are Monday through Saturday, 9:00am to 9:00pm Eastern. You can book an appointment or contact us.

A final note

A panic attack is your body pulling an alarm that did not need pulling. It is not weakness, not a lack of faith, and not you losing your mind. It is one of the most treatable things there is, and almost nobody knows that the first time it happens.

This article is educational and is not a substitute for an evaluation by a licensed mental health professional. If you or someone close to you is in crisis, call or text 988 (press 2 for Spanish), available 24 hours a day, or call 911 if there is immediate danger.