How to relieve chest pain felt during panic attacks
When someone has a panic attack, chest pain is a common and frightening symptom. It can be so severe, and accompanied by palpitations, difficulty breathing and other physical symptoms, that it makes a person feel as though they are having a heart attack where they worry that they are going to die.
What causes chest pain during panic attacks?
Your body’s stress responses are activated during a panic attack. These are also known as your ‘fight or flight’ responses.
Contraction of your muscles is one of these stress responses. Your body does this to protect you from danger, as the tension makes you more resilient. This stiffness in your chest wall muscles and nearby areas can cause chest pain both during and after panic attacks.
Another stress response that can be activated during a panic attack is hyperventilation, where you ‘over-breathe’ as your body believes it is going to have to move fast. This can cause you to use your chest muscles to expand your rib cage, causing chest pain when your muscles become tired. This hyperventilation can then cause carbon dioxide levels in your blood to decrease, another factor that can lead to chest pain as well as tingling, dizziness, numbness and a dry mouth.
Stomach and digestive functions also alter during a “fight or flight” response and it is possible for problems with these functions to be experienced as chest pain or tightness.
How long does the chest pain last?
A panic attack will usually last a few minutes but can come in waves and feel more continuous. As people can experience severe chest pain during a panic attack, it is possible to feel soreness afterwards.
Relief for chest pain caused by a panic attack
During a panic attack, the following strategies can help you to manage the symptoms:
- Focus on controlling your breathing – breathe in slowly and deeply through your nose for three seconds, hold for two seconds and breathe out for three seconds. You may want to close your eyes to help you focus. By concentrating on your body and your breathing, you can break the panic cycle, calm your hyperventilation and reduce your chest pain
- Remind yourself that this moment will pass – panic attacks can be incredibly frightening to experience. When you are having a panic attack, try to repeat a positive phrase such as: “I know this is a panic attack and I know it will pass”. This can serve as a reminder that the moment will disappear just as it appeared. Recognising the transience of a panic attack can help to lessen the worry caused by the symptoms, helping the panic attack to subside
- Refocus – when you feel a panic attack start to pass, begin to focus on your surroundings rather than on the experience. Think carefully about what you can see, hear, taste, smell and touch. You may also want to hone in on a particular object, and think carefully about its shape, colour and size
There are also preventative measures you can take to avoid panic attacks, which include the following:
- Limit your caffeine, alcohol and nicotine intake
- Exercise regularly to relieve tension and boost your mood
- Eating healthy regular meals to keep your blood sugar levels stable
- Get good quality sleep – try to achieve eight hours a night and stick to the same bedtime routine all week
Getting support and treatment for panic attacks
Panic attacks can be incredibly frightening and cause you to worry about if and when another will happen again, causing a ‘vicious cycle’.
At Priory, we can help you to learn strategies so that you are able to better manage your panic attacks and reduce the likelihood of them happening in the future.
Cognitive behavioural therapy (CBT) is an evidence based treatment available at Priory, where you learn how to identify and reframe your panic attack triggers and anxiety-inducing thought patterns.
Mindfulness sessions are also useful for learning how to identify and move past unpleasant thoughts and sensations without allowing panic to take over. During sessions at Priory, you can also receive relaxation training to understand deep breathing techniques and progressive muscle relaxation.
Exposure treatment may also be used after sessions in relaxation, cognitive reframing and mindfulness. During this time, you have the opportunity to practise the strategies you have learnt, and recognise that you can cope in challenging scenarios.
Certain medications, including selective serotonin reuptake inhibitors (SSRIs), or other medications, may be recommended or prescribed if necessary to further support in the management of your panic attacks.
If you think you are having a medical emergency, please seek immediate support.
Reviewed by Dr Ed Burns (MBChB, MRCPsych, MSc , Consultant Psychiatrist at Priory Hospital Roehampton