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How Long Do Panic Attacks Last?

My pen dragged diligently across my notebook in my undergraduate classes some years ago. “A panic attack usually lasts about fifteen minutes, the body can’t sustain that activation for long.” Still, this did not match my personal experiences of the beast. I wondered, how long can a panic attack truly last?

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How long can a panic attack last?

The majority of panic attacks indeed last less than fifteen minutes. During a panic attack, we leap into hyper-activation with physical, cognitive, and emotional symptoms. Still, what distinguishes panic from other anxiety disorders is the marked bodily symptoms. A study that assigned 114 people with panic disorder to wear devices measuring activity/sleep in addition to responding to questions on an app found that chest tightness, heart palpitations, breathlessness, and dizziness were among the most common panic symptoms most often marked panic attacks ( Tsai et al., 2024). Symptoms can match that of a heart attack and typically reside quickly.

Still, many report ongoing panic symptoms that last much longer. It is possible to have a panic attack for several hours or longer. Yet, this is relatively uncommon.

In addition, most individuals with panic disorder also have other conditions such as anxiety and depression. The study (Tsai et al., 2024) found that, not surprisingly, anxiety and depressive symptoms predicted panic. For many, panic attacks are bordered by ongoing anxiety making it difficult to note when the panic truly stops or begins. In addition, it is possible to have panic attacks one after another, which can feel like one long panic attack.

Could it be something else?

Mindstorms (Meltdowns)

Several experiences mimic panic. For example, autistic individuals often experience mindstorms (meltdowns), which can be intense. Mindstorms represent total overwhelm and are often triggered by overwhelming demands or sensory information. These features are similar to a panic attack yet can last much longer.

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Generalized Anxiety

While panic attack is one kind of anxiety disorder, generalized anxiety also can be exceptionally distressing. Unlike panic attacks, in generalized anxiety, there is typically a significant anxious feeling or worry, but not the level of physical symptoms of a panic attack.

Obsessive Compulsive Disorder

In obsessive-compulsive disorder, when an obsession is triggered the response can be loud. Anxiety about the fear lands front and center making it hard to think about much else. It is common to have some physical symptoms. Still, the main focus is on a single worry that follows a theme such as fear of germs, doing something immoral, or having a health problem. That worry presents in different forms repeatedly. For example, someone might become anxious about having a stroke, then having a heart attack, and later having cancer.

How can I handle anxiety that has lasted more than some minutes?

Anxiety or panic that lasts any amount of time can be incredibly difficult. Still, a panic attack that lasts more than a few minutes is particularly infernal. These are three strategies for making it through.

1. Ground

Do what you can to refocus on the moment. This could be focusing on one thing in the moment such as a picture on the wall or the feel of a neckless. These sensations can be your anchor to the present.

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2. Remember that all you have to deal with is Right Now

Panic has a way of making everything feel imminent. Still, the reality is that all we have is this one present moment. Remembering that this is all you have to deal with at the moment can be helpful.

3. Try to Activate the Mammalian Dive Reflex

When mammals submerge in cool water, we slow down. In dialectical behavioral therapy, a skill known as TIPP (Linehan, 2015) is taught to help people tolerate distress. The T stands for temperature. This part of the skill encourages us to take advantage of this mammalian dive response to help us relax. Diving into a pool is not necessary. A shower, walk in the cool air, or ice can do the trick. While some might find a mask activating, for me, a cool aloe vera-based face mask will help me chill.

In Closing

Most panic attacks last less than twenty minutes. Still, a panic attack can last longer. In addition, other conditions such as mindstorms (meltdowns), generalized anxiety, and OCD can sometimes look like panic attacks.

If panic or anxiety is taking a toll on you, know that you are not alone. There is help. Psychotherapy such as Cognitive Behavioral Therapy and Acceptance Commitment Therapy can give you new strategies for facing your panic and getting back to what matters most to you.

References

Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). Guilford Press.

Tsai, C. H., Christian, M., Kuo, Y. Y., Lu, C. C., Lai, F., & Huang, W. L. (2024). Sleep, physical activity and panic attacks: A two-year prospective cohort study using smartwatches, deep learning and an explainable artificial intelligence model. Sleep Medicine, 11455-63.