PanicAttack

Twitter 2014-08 health active
Also known as: PanicDisorderAnxietyAttackPanicMode

Overview

#PanicAttack describes sudden episodes of intense fear/physical symptoms (racing heart, shortness of breath, feeling of impending doom) that peak within minutes. The hashtag became a space for sharing experiences, coping strategies, and reducing stigma (2014-2023).

Symptoms

Physical:

  • Rapid heartbeat, palpitations
  • Sweating, trembling
  • Shortness of breath, feeling of choking
  • Chest pain, nausea
  • Dizziness, lightheadedness
  • Tingling, numbness
  • Chills or hot flashes

Psychological:

  • Fear of dying
  • Fear of losing control / “going crazy”
  • Derealization (feeling detached from reality)
  • Depersonalization (feeling detached from self)

Duration:

  • Peaks in 10 minutes
  • Usually subsides within 20-30 minutes
  • Physical exhaustion afterward

Panic Attack vs. Anxiety Attack

Panic Attack:

  • Sudden onset (0 to 100 in minutes)
  • Specific DSM-5 criteria
  • Often no clear trigger
  • Intense physical symptoms

”Anxiety Attack” (colloquial):

  • Gradual build-up
  • Not official diagnosis
  • Usually has identifiable trigger
  • More mental than physical

Panic Disorder

DSM-5 diagnosis:

  • Recurrent unexpected panic attacks
  • Persistent worry about future attacks (anticipatory anxiety)
  • Behavioral changes to avoid triggers

Agoraphobia often develops: Fear of places where panic attacks occurred or escape would be difficult.

Social Media Impact

Twitter Threads (2015-2020)

Real-time documentation:

  • “Having a panic attack right now, trying to breathe”
  • Responses: grounding techniques, reassurance
  • Community support in crisis

Instagram Education (2017-2023)

Mental health accounts posted:

  • Grounding techniques (5-4-3-2-1)
  • Breathing exercises (box breathing, 4-7-8)
  • “What to do during a panic attack”
  • “What NOT to say” (‘Just calm down’ makes it worse)
  • POV: having a panic attack vs. how people think it looks
  • Grounding technique demonstrations
  • Post-panic attack exhaustion relatability
  • Partners learning how to help

Triggers

Common:

  • Stressful life events
  • Caffeine overload
  • Sleep deprivation
  • Certain medications
  • Substance use/withdrawal
  • Specific situations (crowds, driving, flying)

Paradox:

Sometimes no trigger (spontaneous panic attacks are part of panic disorder).

Grounding Techniques

5-4-3-2-1:

  • 5 things you see
  • 4 things you touch
  • 3 things you hear
  • 2 things you smell
  • 1 thing you taste

Box Breathing:

  • Inhale 4 counts
  • Hold 4 counts
  • Exhale 4 counts
  • Hold 4 counts

Cold Water:

  • Splash face
  • Hold ice cube
  • Activates dive reflex, slows heart rate

Movement:

  • Walk, pace
  • Shake out limbs
  • Release adrenaline

Treatment

Therapy:

  • CBT: Challenge catastrophic thoughts
  • Exposure therapy: Gradual facing of triggers
  • Interoceptive exposure: Safely trigger symptoms to reduce fear

Medication:

  • SSRIs/SNRIs: Long-term (prevent attacks)
  • Benzodiazepines: Short-term rescue (addictive, use cautiously)
  • Beta-blockers: Physical symptom relief

Lifestyle:

  • Limit caffeine, alcohol
  • Regular exercise
  • Sleep hygiene
  • Stress management

The “Am I Dying?” Experience

Common Fear:

First panic attack often leads to ER visit:

  • Convinced it’s a heart attack
  • All tests come back normal
  • “It’s just anxiety” (frustrating but true)

The Relief-Frustration Cycle:

  • Relief: Not dying
  • Frustration: “Just anxiety” minimizes how terrifying it felt

Nocturnal Panic Attacks

Wake up in panic (not from a nightmare):

  • Happens during non-REM sleep
  • No dream trigger
  • Particularly frightening (disoriented + panicked)

Helping Someone Having a Panic Attack

DO:

  • Stay calm
  • Reassure (“You’re safe, this will pass”)
  • Ask: “What do you need?” (some want touch, some don’t)
  • Guide breathing if helpful
  • Offer grounding techniques

DON’T:

  • Say “just calm down” (impossible)
  • Minimize (“it’s not that bad”)
  • Get frustrated
  • Make them feel weak

Sources

  • DSM-5: Panic Disorder diagnostic criteria
  • Anxiety and Depression Association of America (ADAA)
  • National Institute of Mental Health (NIMH)
  • Hope and Help for Your Nerves by Dr. Claire Weekes (1962, classic resource)

Explore #PanicAttack

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