En español | With COVID-19 upending almost every aspect of life, it's hardly surprising that the number of Google searches for “anxiety” and “panic attack” soared to an all-time high in the months after the pandemic began.
Robert Roca, M.D., chair of the American Psychiatric Association's Council on Geriatric Psychiatry, says it's perfectly normal and reasonable to feel anxious during these uncertain times.
In some people, however, anxiety can build and trigger a full-blown panic attack. Symptoms include heart palpitations, sweating, trembling, shortness of breath, chest pain and nausea.
Nearly 5 percent of adults experience a panic disorder at some time in their lives, according to the National Institute of Mental Health. Women are more likely to report panic attacks than men.
"It's not unusual for people who have a panic attack to end up in the ER,” says Roca, who is a psychiatrist at John Hopkins Medicine. “Typically, it comes out of the blue, so people have trouble interpreting it as an anxiety symptom.”
Since panic attacks feel different to different people, AARP asked six adults who have them to describe what their attacks feel like, and to share what helps them cope.
"It's as if a vice is squeezing me.”
Anita Lesko, 61, Pensacola, Fla.
Anita Lesko has always been a germaphobe, so her anxiety started to build when she first read about the coronavirus in early 2020.
A certified registered nurse anesthetist (CRNA), Lesko knew she was at higher risk of exposure because of her job administering anesthesia to patients before surgery. When she began hearing about the nationwide lack of personal protective equipment for health-care workers, Lesko really began to worry.
"The prospect of going to work, getting exposed and ending up on a ventilator or dead — that's what pushed me over the edge,” she says.
One morning in March, when she was between patients at the hospital, Lesko developed a deep feeling of impending doom. She began to hyperventilate, her heart started racing and she broke out in a sweat. Pressure began building in her chest.
"I got a gripping sensation in my whole chest and throat area, as if a vice was squeezing me,” she said. “Then I started shaking literally to the core of my body.”
Lesko asked to leave early and fled to her car. She collapsed into the driver's seat and burst into tears.
"I was just sitting there trying to talk myself out of it, and trying to make myself breathe normally,” she recalls.
It took about 30 minutes before she was calm enough to drive. When Lesko got home, she was so exhausted she had to sleep for a few hours before she could do anything.
Lesko has had many more attacks since that day, and has since been diagnosed with PTSD and extreme anxiety. She hasn't been able to go back to work.
How she copes: Lesko is still struggling with how to manage her panic attacks. She is reluctant to take medication, but she is seeing a therapist through telemedicine.
Lesko says the best advice she has received is not to fight the attacks, because that just makes them worse. “When one comes on, I take a deep breath and focus on just letting it happen, letting it run its course,” she says. “And that actually helps.”
"I knew something terribly wrong was happening.”
J.T. Lewis, 58, Charlottesville, Va.
One morning almost 20 years ago, J.T. Lewis hailed a cab because she was late to work. As she settled into the back seat, Lewis noticed the car seemed unusually hot, dirty and cramped. The driver's seat was so far back it seemed to be crushing her. She felt sweaty and light-headed.
"Suddenly, I couldn't breathe,” Lewis recalls. “There was this crushing chest pain. I knew something was terribly wrong. Was I dying?"
The attack subsided after a few minutes, but Lewis was so shaken she had the driver drop her at her physician's office. After a battery of tests, the doctor told her there was nothing physically wrong with her.
A few weeks later, Lewis, who frequently traveled for her job as a lawyer, had just buckled into first class on a plane when it happened again. The pressure in her chest. The feeling that she couldn't breathe. Sweaty and pallid, she asked the flight attendant for some water.
The flight attendant took one look at her and instead had the pilot return the plane to the gate, so Lewis could get off. “I was frustrated, confused and humiliated,” Lewis said. “I began avoiding business travel."
After that, the panic attacks started happening more often. In the short run, medicine quelled her symptoms: Her doctor prescribed daily beta blockers plus Xanax for the moments when she felt an attack coming on (for example, before she got on a plane).
Reluctant to rely on medicine, Lewis also began meeting with a cognitive therapist, who helped her develop strategies to get through an attack in the moment and to reduce the anxiety that triggered them. It took time, but Lewis eventually got the panic attacks under control.
Now retired from law practice, she hasn't had a full-blown panic attack in years.
How she copes: Lewis says seeing a therapist who specialized in cognitive behavior therapy was key to getting her life back.
During an attack, she focuses on breathing deeply by lengthening her exhale. She may also do something physical to interrupt the flow of the panic: a cold cloth on her face, a pinch of the arm, or a spritz of lavender water.
Lewis says it's important to acknowledge and not fight the attack: “I remind myself that I am not dying. I am safe, and this will pass. In fact, each minute of the attack is bringing me closer to the end of it.”
"It feels like my body is going at the speed of light.”
Kevin Rosko, 61, Michigan City, Ind.
Kevin Rosko was 10 years old when he had his first panic attack. It happened after he watched his uncle get smashed in the head with a baseball. Even though his uncle ended up being fine, Rosko couldn't stop thinking about what he'd seen.
That night in the bathtub, his heart started racing, his body felt numb and he told his mom he couldn't breathe.
The panic attacks continued to happen occasionally through Rosko's childhood and adult life. He saw different therapists and tried a variety of medications, but none got his anxiety totally under control.
The attacks didn't happen very often, so Rosko learned to live with them. The symptoms were always the same:
"My heart starts pumping like I'm running Mount Everest,” he says. “It feels like my body is going at the speed of light. I get pain in my arms and back, I feel dizzy, my mind is racing.”
Rosko worked as a crane operator at a steel mill before retiring in 2014. If he felt an attack coming on at work, his boss was good about giving him the rest of the day off.
Rosko also helped to care for his sister, who had Down syndrome and came to live with him when he was in his 40s. After being diagnosed with Alzheimer's disease five years ago, she became more difficult to care for. That's when Rosko's panic attacks ramped up. He began having one about every 10 days, severely impacting his quality of life.
Fortunately, a nurse practitioner suggested a medication called Lexapro. Rosko was skeptical because he had tried so many others, but it worked.
"It relaxes me,” he says. “It helps me feel less antsy.”
In combination with guided subliminal meditation and other techniques, Rosko said he's now able to stop most panic attacks before they escalate.
How he copes: Rosko meditates regularly, limits his caffeine intake and gets emotional support from a Facebook group for panic attack sufferers. If he feels an attack coming on, he gives his body a physical jolt by running his wrists under cold water, and then lays down, focusing on rhythmic breathing.
He also gets periodically checked by a cardiologist. “It's incredibly reassuring in the moment to know that it's not a heart issue, that your heart is OK,” he says.
"You're frozen. You can't move. You think the end is coming."
Corky Klein, 63, Laguna Beach, Calif.
Corky Klein knows she's about to have an anxiety attack when her whole body breaks out in a sweat.
"I even get sweaty on the balls of my feet,” she says.
She gets light-headed, and a little dizzy. Then the headache and the panic hit.
"You forget about everything around you,” Klein says. “Your heart is beating horribly, and that brings on more panic. You get this scared feeling and you want to run. But you're frozen. You can't move. You think the end is coming."
Klein began having panic attacks after her mom died when she was 16. Over the years, she says her anxiety led her into dark bouts of alcoholism and addiction, into long periods of isolation, and on many trips to the emergency room.
Ten years ago, at age 53, she was still having frequent panic attacks, even though she had kicked her addictions. Concerned, her doctor persuaded her to try therapy, and she began seeing a cognitive behavior therapist who specialized in anxiety.
The therapist helped her process the trauma in her past and taught her how to cope with her anxiety before it escalated.
"I learned that I had never dealt with the stuff that had happened to me,” Klein says.
Her panic attacks became less frequent, and she focused on exercising, enjoying her retirement and spending time with her son and other family members.
When her dad passed away, in January, Klein was worried that she would relapse, but she found healthy ways to mourn instead. “I didn't suffer even one panic attack after his death,” she says.
Although she rarely has panic attacks now, Klein is still a member of support groups online, and she often provides encouragement to others who are struggling. “It's a wonderful feeling to be able to help,” she says.
How she copes: She exercises every day ("It makes a difference."), and she uses an app called Calm for meditation and deep-breathing exercises.
If she feels an attack coming on, she either takes a walk or sits in a chair with her feet up, and focuses on her breathing. “I have to talk myself out of it,” she says. “Even after all these years, it's still very hard. But I've had a handle on it for almost three years now."
"I thought I was having a heart attack."
Nicholas Ruggiero, 42, Dumfries, Va.
Police Sgt. Nicholas Ruggiero was packing his lunch for work one morning in October 2018 when his heart started dancing in his chest.
He felt hot and sweaty, and he couldn't catch his breath. Then the room began to spin. As he fell to the floor, his wife called 911.
"I actually thought I was having a heart attack,” Ruggiero remembers.
An ambulance rushed him to the hospital, where we underwent a full workup. Afterward, the doctor gave Ruggiero an unexpected diagnosis: He was having a panic attack.
"At first, I just started laughing,” Ruggiero says. “As a police officer, I'd been in a lot of stressful situations — shooting scenes, homicides — and I had never panicked. How could I be having a panic attack?”
It turned out that the stress of his job had built up over time and triggered the attack. In the two years since, Ruggiero estimates he has had another 100 panic attacks, but medication and lifestyle changes have helped make them less frequent.
Ruggiero thought his attacks would further subside when he retired from police work last spring, but the arrival of coronavirus and trying to switch careers during a pandemic created a new kind of anxiety.
How he copes: Ruggiero sees a therapist twice a month, takes long walks and spends a lot of time writing and drawing, which help relieve his anxiety. He also takes an anti-anxiety medication and avoids crowded places, because they can be a trigger.
When he feels an attack coming on, he finds the nearest quiet area, closes his eyes and focuses on deep breathing. “I'll put my AirPods in and play very relaxing music, and that snaps me out of it.”
"You feel like you're dying and going crazy at the same time."
Cheryl Poldrugach, 53, of Dallas
For 30 years, Cheryl Poldrugach hid her panic attacks from her family and friends.
When her anxiety hit, she would tell them she was sick or had the “stomach flu.” She sometimes missed important events like graduations and holiday celebrations, cancelling at the last minute when an attack left her curled on the bathroom floor.
Poldrugach says her secrecy contributed to her divorce 10 years ago and to rifts with friends and family.
"It was very crippling,” she says. “You get this cold sweat, yet feel like you're on fire, and you're shaking. Your heart is racing out of your chest. You feel like you're dying and going crazy at the same time, and you're not sure you can make it through.”
It wasn't until Poldrugach's teenage daughter had a panic attack at school last year that she finally realized she had to get help and talk to her family about what she was going through.
She started taking anti-anxiety medication, which helped a lot. She also sees a counselor who has helped her learn about healthy ways to cope and get through an attack.
These days, she has turned her focus outward, helping her daughter, her son and others who suffer from anxiety. She adopted the Twitter handle @CherylPanics, and advocates for mental health awareness and education on social media.
How she copes: Travel makes Poldrugach especially anxious, but it helps her cope to learn as many details as possible in advance. “I'll watch videos showing where we are going,” she says.
To get through a panic attack, she repeats the following mantras to herself: “'You are not crazy. You're going to be OK. You're not going to die.’ Just repeating those mantras helps me get grounded,” she says.