Wellness Tips from Josef Schenker, MD | Panic Attack Treatment and Management

Wellness Tips from Josef Schenker, MD

Welcome to our Wellness Tips blog series, brought to you by Dr. Josef Schenker, the Medical Director at Centers Urgent Care. In this series, Dr. Schenker shares his extensive knowledge and experience in internal medicine and emergency medical services, including panic attack treatment and management, to help you lead a healthier life.

Dr. Schenker will cover a range of crucial health topics, offering expert advice on how to avoid common ailments. With a focus on prevention and practical tips, each blog post is designed to empower you with the information you need to make informed decisions about your health and well-being.

Panic Attack Treatment and Management

Panic attack treatment and management start with recognizing how sudden surges of intense fear can affect both body and daily life. About 2.7% of U.S. adults have panic disorder in any given year, and nearly 4.7% experience it at some point in their lives. These episodes often bring chest pain, shortness of breath, and a strong sense that something is very wrong, even when tests later look normal.

In this guide, Dr. Josef Schenker explains how panic attacks occur, how long they usually last, what helps in the moment, and when to seek medical care so symptoms are taken seriously and evaluated safely.

Dr. Josef Schenker Explains the Symptoms of a Panic Attack

Panic attack symptoms usually begin without warning. A person may feel fine one moment, then suddenly experience a rapid surge of intense fear or discomfort that peaks within minutes.

Josef Schenker, MD notes that symptoms often feel “out of the blue,” even when stress has been building quietly in the background. Being able to identify these patterns allows individuals to understand that what they’re going through is a panic attack rather than a serious medical emergency. Common symptoms include:

Racing or pounding heartbeat: Many patients describe feeling their heart “thudding” in their chest or neck.
Chest pain or tightness: Discomfort can range from pressure to sharp pain, which is why many people fear a heart attack.
Shortness of breath or feeling smothered: Breathing may feel shallow, rapid, or blocked, even when oxygen levels are normal.
Sweating, shaking, or chills: The body’s fight-or-flight response can cause visible tremors, sweating, or sudden temperature shifts.
Dizziness or feeling unsteady: Lightheadedness, tingling, or a sense of being about to faint is common.
Stomach upset or nausea: Some people feel a “knot” in their stomach or feel the need to run to the bathroom.
Feelings of unreality or detachment: The surroundings may seem strange, or a person may feel separate from their body.
Fear of losing control or dying: A powerful sense that something terrible is about to happen often sits at the center of the episode.

Not everyone has every symptom. Some only notice chest tightness and fast breathing. Others experience more cognitive symptoms, such as feeling detached or terrified without understanding why. Patterns can also change over time, which is why careful evaluation helps.

What Is a Panic Attack?

A panic attack is a sudden, overwhelming wave of fear or distress that intensifies rapidly within minutes, triggering a range of physical and emotional symptoms, often with no clear or real threat in sight.

According to Dr. Josef Schenker, panic attacks often feel like a body alarm firing at full volume when the system is safe. The heart races, breathing changes, and muscles tense as if a threat were near, even though no medical emergency may be found on exam. Key features of a panic attack include:

Sudden onset: Symptoms build rapidly, often going from mild unease to intense fear within a few minutes.
Cluster of symptoms: At least four signs such as palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, chills or heat sensations, numbness, or fear of losing control.
No clear trigger at times: Some episodes follow stress or specific situations, while others come “out of the blue.”
Short duration: Most attacks are time-limited, even if they feel much longer in the moment.

Panic attacks may happen in isolation or as a symptom of panic disorder, a condition marked by recurring episodes and a persistent dread of future attacks that can interfere with everyday life, including work, academics, and personal relationships.

Can You Stop a Panic Attack?

Panic attack treatment and management during an active episode focuses on reducing distress and helping the body’s alarm system reset. A person cannot usually “will” the attack to stop instantly, but practical steps often shorten its course and make symptoms less intense. Simple measures help the nervous system calm down:

Slow breathing: Inhaling through the nose for about 4 seconds, holding briefly, then exhaling for 6 to 8 seconds can reduce dizziness and chest tightness for many people.
Grounding techniques: Identifying five visible things, four you can physically feel, three audible sounds, two distinct scents, and one taste helps redirect the mind away from spiraling thoughts and grounds you in the here and now.
Reframing thoughts: Reminding yourself that panic attacks are frightening but typically not dangerous, and that many episodes resolve within 5 to 30 minutes, can lower fear of the symptoms themselves.

Some people benefit from prescribed fast-acting medication that targets panic symptoms. Health care teams sometimes use short courses of anti-anxiety medicine, such as benzodiazepines, while long-term approaches like therapy and antidepressants address the underlying tendency toward panic.

Stopping a panic attack fully often depends on treating the overall pattern. Cognitive behavioral therapy (CBT) has strong research support in reducing panic attacks by changing how people respond to body sensations and anxious thoughts. Many trials show that structured CBT programs lead to significant improvement for a large share of patients.

Any new or intense chest pain, trouble breathing, or collapse still needs urgent evaluation to rule out heart, lung, or other serious problems. This is why understanding urgent care versus emergency room options helps people choose the right setting. Panic and medical conditions can look similar from the outside.

How Long Does a Panic Attack Last?

Most panic attacks are brief, even though they feel much longer in the moment. Typical attacks last about 5 to 20 minutes, with symptoms usually peaking within the first 10 minutes.

Josef Schenker, MD points out that people often remember the emotional shock more than the clock time. Residual fatigue, anxiety, or muscle soreness can linger for hours, which makes the episode seem as though it never ended. Here is a general guide:

Single, short attack: Many episodes rise and fall within 5–20 minutes.
Cluster of attacks: Repeated attacks over several hours can feel continuous, even though there are brief breaks in between.
After-effects: Shakiness, tiredness, and worry about “the next one” can last the rest of the day.
Ongoing pattern: When attacks keep returning and cause persistent fear of new episodes, clinicians consider the possibility of panic disorder.

Any episode that lasts longer than usual, brings new neurologic symptoms, or feels different from prior attacks deserves medical review, especially if there is chest pain, shortness of breath, or fainting. Recognizing signs that urgent care is the best option can prevent dangerous delays.

Josef Schenker, MD, Explains Panic Attack Treatment and Management

Ongoing panic attack treatment and management usually involves a mix of education, therapy, lifestyle changes, and sometimes medication. Josef Schenker emphasizes that the best plan addresses both the body and the thought patterns that keep the cycle going. Common approaches include:

Cognitive behavioral therapy (CBT). CBT helps people understand how thoughts, body sensations, and behaviors link together. Structured programs teach skills such as breathing exercises, gradual exposure to feared sensations, and ways to challenge catastrophic thinking.
Antidepressant medication. SSRIs and SNRIs are commonly prescribed medications that help lessen how often panic attacks occur and how severe they feel when they do. These medicines may take several weeks to show full benefit and are usually taken daily under a health care provider’s guidance.
Short-term anti-anxiety medication. In some cases, benzodiazepines are prescribed for brief periods to manage severe or frequent attacks. Because of dependence risks and possible interference with therapy gains, guidelines suggest careful, time-limited use.
Lifestyle and medical review. Treatment often includes checking for thyroid problems, heart rhythm issues, or stimulant use, sometimes using urgent care lab work services to support testing. Reducing caffeine intake, improving sleep, and building a regular physical activity routine can lower overall anxiety for many people.
Care coordination. Urgent care visits may address acute episodes and rule out heart or lung emergencies. Follow-up with primary care and mental health professionals supports long-term panic attack treatment and management, so the focus shifts from crisis to prevention.

How to Avoid Panic Attacks

Many people find that practical habits reduce the chance of future attacks, even when a full cure is not realistic. Small, consistent steps can make the nervous system less reactive over time. Useful strategies include:

Build regular sleep patterns. Going to bed and waking up at similar times supports brain systems that regulate stress and emotion. Poor sleep can make sudden surges of fear more likely.
Limit stimulants and heavy alcohol use. Caffeine, nicotine, and certain energy drinks can mimic panic symptoms, such as a racing heart or jitteriness. Alcohol may briefly calm nerves, but it can worsen anxiety the next day.
Practice daily breathing or relaxation exercises. Short, twice-daily sessions of paced breathing or muscle relaxation help train the body to shift out of “alarm mode” more quickly.
Stay active. Regular movement, such as brisk walking, cycling, or swimming, supports mood regulation and reduces general anxiety levels for many people.
Learn the early warning signs. Some people notice subtle signals before a full attack, such as a tight jaw, shallow breathing, or urgent worries. Responding at this stage with coping strategies can stop escalation.
Talk with a professional about therapy or medication. People with frequent panic episodes or constant fear of them benefit from a structured evaluation, including annual physicals in urgent care when appropriate. Early treatment lowers the chance that panic will interfere with work, driving, or leaving the house.

Avoiding panic attacks is not about eliminating all stress. Instead, it focuses on building skills and supports so ordinary stress does not trigger a full alarm response as often.

What to Do if Someone Is Having a Panic Attack

Panic attack treatment and management in the moment centers on safety, calm support, and clear decisions about when medical evaluation is needed. Josef Schenker advises families and friends to stay present, avoid arguments over whether symptoms are “real,” and watch for red-flag signs that could point to a heart, lung, or neurologic emergency.

Check for emergency signs. If the person has crushing chest pain, pain spreading to the jaw or arm, severe shortness of breath, confusion, or collapse, treat it as a medical emergency and call emergency services right away. Do not assume it is “just anxiety.”
Stay calm and speak clearly. Use a steady voice. Remind the person that you are staying with them and that the episode will pass.
Guide slow breathing. Encourage slow, even breaths. You can model the pace by breathing in through the nose and exhaling longer through the mouth.
Help them sit or stand in a comfortable position. Some feel better sitting upright; others prefer standing and gently moving their arms or legs. Avoid forcing them to lie flat if that increases fear.
Use simple grounding. Ask them to name things in the room, feel their feet on the floor, or hold an object. This shifts attention from “What if I die?” to concrete sensations.
Stay until symptoms ease. Most panic attacks ease within 5 to 30 minutes, although fatigue may last longer. Stay nearby until the person feels stable enough to move or call a ride.

If episodes are frequent, severe, or difficult to distinguish from heart or lung problems, an in-person evaluation is important. Centers Urgent Care offers timely assessments for chest discomfort, shortness of breath, dizziness, and related symptoms, and can coordinate referrals when longer-term mental health support is needed.

Josef Schenker, MD, Answers Frequently Asked Questions:

What is the difference between a panic attack and an anxiety attack?

The main difference between a panic attack and an anxiety attack is that a panic attack is a defined medical event with sudden onset and intense physical symptoms, while an anxiety attack is an informal term for escalating worry. Panic attacks peak within 10–20 minutes, whereas anxiety builds gradually and lasts longer.

Can a panic attack cause a heart attack?

No, a panic attack does not cause a heart attack in most otherwise healthy adults. Panic attacks create intense symptoms such as rapid heart rate and chest pain, but they do not damage the heart muscle. Chest pain with risk factors like high blood pressure, diabetes, or heart disease requires immediate medical evaluation and may involve urgent care blood testing options.

Can you have a panic attack in your sleep?

Yes, you can have a panic attack in your sleep. Nocturnal panic attacks wake a person suddenly with a racing heart, sweating, shortness of breath, and intense fear. These episodes often occur during non-REM sleep and follow the same pattern as daytime attacks.

Do repeated panic attacks mean I have panic disorder?

Yes, repeated panic attacks can mean panic disorder when ongoing fear of future attacks and avoidance behavior persist for at least 1 month. Panic disorder requires recurrent unexpected attacks plus lasting concern or behavior change. A licensed clinician confirms the diagnosis after ruling out medical causes and substance effects.

When should I go to urgent care for a panic attack?

You should go to urgent care for a panic attack when intense chest pain, shortness of breath, dizziness, or faintness make it unclear whether symptoms are anxiety or a medical emergency. Urgent care can check heart rate, blood pressure, oxygen levels, and perform cardiac screening.

Prioritize Panic Attack Treatment and Management Early

Panic attack treatment and management work best when symptoms are taken seriously and checked early. This guide has reviewed how panic attacks feel, how long they usually last, what helps in the moment, and which treatment options lower the chance of future episodes.

An urgent care facility in New York can play an important role when new or intense symptoms appear, and you need timely tests to rule out heart, lung, or other medical emergencies. Dr. Josef Schenker and the team at Centers Urgent Care combine experience in internal medicine and emergency care to sort urgent symptoms, give immediate support, and guide you toward follow-up for long-term anxiety care when needed.

Centers Urgent Care operates 12 accredited locations across New York City, making same-day evaluation accessible when panic symptoms raise questions about safety. If you or a loved one is unsure about chest pain, dizziness, or sudden fear, locate a Centers Urgent Care near you and get timely care today.

About Josef Schenker, MD:

Dr. Josef Schenker, a board-certified expert in internal medicine and emergency medical services, brings extensive experience and compassion to his role as Medical Director and Partner at Centers Urgent Care. With leadership in SeniorCare Emergency Medical Services and as an Attending Physician at New York-Presbyterian Brooklyn Methodist Hospital, Dr. Schenker oversees critical care and treatment protocols across varied medical needs. His dedication extends to chairing NYC REMAC, ensuring adherence to state standards in emergency medical procedures. At Centers Urgent Care, Dr. Schenker's expertise ensures prompt, high-quality emergency care for patients of all ages, supported by state-of-the-art facilities including a dedicated pediatric suite.