Anxiety is a common and natural response to stress, but when anxiety becomes overwhelming and uncontrollable, it can lead to an anxiety attack. Anxiety attacks can be a frightening and debilitating experience, but recognizing the signs early on can help you manage your anxiety and prevent an attack from escalating. In this article, we will explore the signs of an anxiety attack and provide tips for recognizing and managing them.

What Is an Anxiety Attack?

Anxiety attacks, also known as panic attacks, are sudden episodes of intense fear or panic. Panic attacks are defined as an "abrupt surge of intense fear" that peaks within minutes. Attacks typically peak within 10 minutes and last for 20 to 30 minutes, though they can occasionally persist longer.

They can be triggered by a variety of factors, including stress, trauma, or even genetics. While anxiety attacks are not life-threatening, they can be very distressing and can affect your ability to function in everyday life.

Recognizing the Signs: What Does an Anxiety Attack Feel Like?

We asked Dr. Michael Grandner, Sleep Expert and Professor of Neuroscience and Physiological Sciences, what his research shows about anxiety awareness. He says: “Recognizing early physiological signs like rapid heartbeat or shortness of breath helps stop anxiety before it peaks.” In other words, awareness gives you time to intervene and regain control.

Anxiety attacks manifest differently for everyone, but there are common physical and emotional symptoms to watch for:

Physical symptoms:

• Shortness of breath or hyperventilation
• Rapid heartbeat or palpitations
• Chest pain or tightness
• Sweating or chills
• Nausea or dizziness
• Tingling or numbness in the hands or feet

Emotional and cognitive symptoms:

• Feeling of impending doom or death
• Fear of losing control or "going crazy"
• Feeling detached from yourself or your surroundings

If you experience any of these symptoms, it is important to seek help. While anxiety attacks are not life-threatening, they can be very distressing and can affect your ability to function in everyday life.

Immediate Strategies: What to Do During an Anxiety Attack

When you feel an attack coming on or you're in the middle of one, these evidence-based techniques can help you regain control:

Ground yourself with breathing

Your breathing pattern changes dramatically during an anxiety attack, often becoming rapid and shallow. Deep breathing exercises activate the parasympathetic nervous system, which counterbalances the high sympathetic activity intrinsic to stress and anxiety. Just 5 minutes of deep breathing significantly increased parasympathetic activity and reduced anxiety levels in both young and older adults.

Try this simple technique: Breathe in slowly through your nose for a count of four, hold for four counts, then exhale through your mouth for a count of six. Controlled breathing can reduce stress and anxiety while improving heart rate variability.

Use the 5-4-3-2-1 grounding technique

This mindfulness exercise brings you back to the present moment. Identify five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. Grounding techniques provide immediate physiological benefits such as regulation of heart and respiratory rates, reduction of muscle tension, and calmer brain wave patterns.

Remind yourself: "This will pass"

Anxiety attacks are temporary. Most peak within 10 minutes and subside within 20-30 minutes. Reminding yourself that this is a time-limited experience can provide comfort during the most intense moments.

Move your body gently

If possible, try gentle movement like walking or stretching. Physical activity helps discharge the stress hormones flooding your system during an attack.

Long-Term Management: Building Your Anxiety Toolkit

While managing anxiety attacks in the moment is crucial, addressing the underlying anxiety is equally important. Here are evidence-based strategies that can help:

Practice regular mindfulness and meditation

Mindfulness-Based Stress Reduction significantly reduced anxiety symptoms in individuals with Generalized Anxiety Disorder. Mindfulness-based therapy shows moderate effectiveness for anxiety, with results similar to well-established therapies. Even five minutes of daily meditation can help you recognize anxiety triggers earlier and respond to them more calmly. Learn more about using meditation for better sleep.

Maintain consistent lifestyle habits

Your daily habits have a profound impact on your anxiety levels. Sleep deprivation leads to significant increases in anxiety. Partial sleep deprivation can cause higher next-day anxious arousal, particularly for individuals with higher overall anxiety levels.

Prioritize seven to nine hours of quality sleep each night. If you're struggling with sleep, explore natural sleep remedies or discover how to improve sleep quality with evidence-based strategies. Poor sleep can significantly worsen anxiety symptoms, creating a vicious cycle. Learn to break the cycle of sleep anxiety.

Exercise regularly

A 12-week group exercise program proved effective for anxiety in primary care settings, with both low-intensity and moderate/high-intensity training showing significant improvements. Exercise programs are viable anxiety treatment options, with high-intensity exercise showing greater effectiveness than low-intensity regimens.

Nourish your body

What you eat affects how you feel. Omega-3 supplementation led to 20% reduction in anxiety among medical students. Omega-3 polyunsaturated fatty acids reduce clinical anxiety symptoms, with the greatest improvements at 2 grams per day.

A diet rich in whole foods, omega-3 fatty acids, and complex carbohydrates supports brain health and mood regulation. Stay hydrated and avoid skipping meals, as low blood sugar can mimic anxiety symptoms. Discover how nutrition affects your sleep and overall mental health. Consider incorporating magnesium-rich foods into your diet, as magnesium deficiency has been linked to both anxiety and sleep disturbances.

Create structure and boundaries

Anxiety often thrives in chaos. Establishing routines, setting realistic boundaries at work and in relationships, and making time for activities you genuinely enjoy can create a sense of control and reduce overall stress. Good sleep hygiene practices are essential for managing anxiety—maintain a consistent sleep schedule, create a calming bedtime routine, and optimize your sleep environment.

Build your support network

Connection is powerful medicine for anxiety. Stay in touch with friends and family who understand what you're going through. Sometimes just talking about your fears can make them feel less overwhelming.

When Sleep Anxiety Takes Over

Many people with anxiety disorders also struggle with sleep-related anxiety—worrying about whether they'll be able to fall asleep or stay asleep. This type of anticipatory anxiety can become a self-fulfilling prophecy, making it even harder to rest. If you experience anxiety rushes when falling asleep or jolts of anxiety as you drift off, you're not alone. These sensations are common among people with anxiety disorders.

If you find yourself waking at 3am nightly with anxious thoughts or experiencing fight-or-flight while sleeping, this may indicate that your anxiety is significantly impacting your sleep quality. Learn more about conquering sleep anxiety with expert-backed strategies.

For those dealing with persistent sleep issues related to anxiety, CBT-I for insomnia has been proven highly effective. CBT-I addresses both the behavioral and cognitive factors that contribute to insomnia and can be particularly helpful for anxiety-related sleep problems. Discover how CBT-I works and whether CBT-I might work for you.

When to Seek Professional Help

If you're experiencing anxiety attacks regularly, or if anxiety is interfering with your work, relationships, or daily activities, it's time to reach out for professional support. Therapy isn't a sign of weakness—it's a proactive step toward better mental health.

At Dawn Health, we understand that waiting weeks or months for mental health care isn't acceptable when you're struggling. That's why we've eliminated wait lists entirely. Our licensed therapists are available to work with you quickly, and we accept insurance coverage to make care accessible.

We specialize in evidence-based approaches that have been proven effective for anxiety disorders:

Cognitive-Behavioral Therapy (CBT)
CBT shows moderate efficacy for anxiety, with large effect sizes for OCD, GAD, and acute stress disorder. CBT demonstrates efficacy in clinical trials and effectiveness in naturalistic settings for treating adult anxiety disorders. CBT for anxiety disorders improves outcomes for 12 months compared with control conditions after treatment completion.

CBT helps you identify and change the thought patterns that fuel your anxiety. You'll learn to recognize cognitive distortions—like catastrophizing or all-or-nothing thinking—and replace them with more balanced, realistic thoughts. Learn more about mind-body connection in CBT and how it effectively treats both insomnia and anxiety.

Acceptance and Commitment Therapy (ACT)
ACT is more efficacious than usual treatment, with largely equivalent effects relative to traditional cognitive behavioral therapy. ACT versus CBT showed similar overall improvement, indicating that ACT is a highly viable treatment for anxiety disorders. ACT shows small to moderate effects on depression and anxiety symptoms across different populations.

ACT teaches you to accept uncomfortable feelings rather than fighting them, while taking action aligned with your values. This approach can be especially helpful if you've been avoiding situations or experiences because of anxiety.

Your therapist will work with you to develop a personalized treatment plan that addresses your specific triggers, symptoms, and goals. Therapy provides a safe space to explore the root causes of your anxiety while building practical skills you can use immediately.

Alternatives to Medication for Sleep and Anxiety

While some people benefit from medication for anxiety management, many are seeking natural alternatives to sleep medication and anxiety relief. If you're considering sleep aids, it's important to understand that medications like Ambien, Lunesta, and benzodiazepines come with significant risks and side effects.

Instead of relying on sleeping pills, consider exploring home remedies for insomnia or learning how to sleep without aids. Many people find success with sleep coaching, which provides personalized guidance without medication.

For those experiencing nighttime anxiety or adrenaline rushes, understanding why adrenaline rushes occur nightly can help you address the root causes rather than masking symptoms with medication.

Check Your Mental Health

Take a moment to reflect on these questions:

You might benefit from exploring Sleep Reset's comprehensive approach to improving both sleep and anxiety symptoms.

Moving Forward: You Don't Have to Face This Alone

Anxiety attacks can feel isolating and overwhelming, but they don't have to control your life. By learning to recognize the early warning signs, practicing effective coping strategies, and seeking support when you need it, you can reduce the frequency and intensity of these episodes.

Remember: experiencing anxiety or having anxiety attacks doesn't mean you're broken or weak. It means you're human, and like millions of others, you're navigating a challenging mental health condition that responds well to treatment.

Whether you're dealing with generalized anxiety, panic disorder, or sleep-related anxiety, there are proven strategies that can help. Consider exploring 5 ways to improve sleep, as better sleep often leads to reduced anxiety symptoms. Many people find that addressing their sleep anxiety leads to rest.

At Sleep Reset, we're here to support you every step of the way—no wait lists, no judgment, just compassionate, evidence-based care designed to help you feel like yourself again. Your mental health matters, and seeking help is one of the bravest and most important things you can do for yourself.

Ready to take the next step? Connect with a Sleep Reset clinician today and start your journey toward managing anxiety and your sleep with confidence.