When you’re having a panic attack, it might feel like you’re drowning. You feel like you can’t breathe and your chest is constricted. You might feel detached from your body, from your surroundings, as though you’re floating in a dream. You might become overheated with clammy hands, a flushed face and sweat trickling down your spine. You also might be shaking.

Of course, panic attacks are different for every person. Maybe you don’t feel any of the above. But you hear or feel your heartbeat. Your vision is blurry. You’re dizzy. And your ears are ringing. According to Washington DC-based psychologist Alicia H. Clark, PsyD, these also are common symptoms.

Experiencing a panic attack at home or in public is bad enough. Experiencing one at work can be extra stressful. You might feel incredibly alone. You might feel a profound sense of shame. You might berate yourself for being the only person who clearly can’t control themselves.

And that’s a powerful part of the stress: In addition to a job’s demands, we have the added pressure of having to hold it together, Clark said. “It’s not just that we’re asked to do more things or make uncomfortable phone calls or respond to a nasty email. It’s also that we’re supposed to be professional, which means we’re not supposed to show our feelings.” Or at the very least, we’re not supposed to feel anxious.

But you’re far from alone. About six million American adults or 2.7 percent of the population have panic disorder, according to the Anxiety and Depression Association of America. Clark believes that number might be even higher. After all, people rarely talk about their panic attacks because of the shame and stigma. You also might not know that someone is struggling just by looking at them. 

The good news is that you can learn to manage panic attacks. Here are tips to help.

Find privacy. “It’s awfully difficult once you start to feel panic to pull yourself out of it when you’re in public,” Clark said. You might be around people you don’t feel comfortable with. You might feel judged. People who struggle with recurrent panic tend to struggle with other anxieties, such as social anxiety, she said. At its core, social anxiety is a fear of other’s judgment. This is why it’s helpful to “excuse yourself to whatever place you can that allows you some space,” such as a bathroom.

Don’t ignore it. Sometimes people will try to stop a panic attack by ignoring it and trying to perform their responsibilities. But “ignoring your symptoms will only make them worse” and compromise your work performance, said Cohen, LCSW, who specializes in working with adolescents, families and young adults. Instead, it’s more helpful to acknowledge what’s happening.

Don’t fight it. It’s hard not to fight the symptoms of a panic attack. Because they’re so uncomfortable, your natural reaction might be to make it stop. Just make it stop. But this only fuels your symptoms. Instead, Clark suggested trying to embrace the physical sensations. “[L]et it wash over you, and know you can handle it even if it’s horribly uncomfortable.” Like a storm, she said, your panic attack will pass. It’s important to note that many people, particularly when they experience their first panic attack, have no idea what’s going on—and start thinking the worst. They assume they’re dying. But you are safe. As Clark noted, “Nobody has ever died from a panic attack.”

Observe your sensations. Similarly, observe your symptoms without trying to control or change them. For instance, notice that your palms are flushed and filled with blood. Notice that you’re alive and breathing. Notice as your body is calming down, which is different from telling your body to calm down, calm down, calm down, Clark said. In other words, step back and try to notice what’s happening.

Refocus on your environment. What also drives anxiety is thinking about the future or thinking too many things at once, Clark said. Essentially one anxious thought leads to another anxious thought and so on. This is why staying in the present, or grounding yourself in the moment, is important. One way to do this is to focus on your surroundings, Clark said. What’s in the room with you? What color and shape is the desk? What are the knobs made of? What color is the tile? What is immediately in front of you?

Take productive action. “Anxiety—and panic at the ultimate extremes—is…a signal that something you care about is at risk,” Clark said. And the most powerful [antidote] to anxiety is taking control and taking action.” Try to pinpoint what triggered your anxiety. For instance, maybe you have no idea how you’ll make a project deadline. Instead of being angry about the deadline and wishing it away, think about what you can control. You can control how you spend your time and how you create the project. You can control asking your boss for an extension. Instead of expending energy on resisting and avoiding anxiety, channel that energy into what you can control.

Reach out. It might be helpful to call a loved one who’s supportive, Cohen said. You might ask a colleague to cover your desk or tell your boss you’re taking a brief break, she said. Panic attacks are “horribly uncomfortable, but [they don’t] have to be debilitating,” Clark said. Just like you’ve learned to have them, you can unlearn, she said. It takes practice (like anything). And you might find it more helpful to work with a therapist who specializes in treating panic. Remember you are not alone—not at all—and you can get through this.

From Margarita Tartakovsky, MS, Associate Editor, PsychCentral.com