Sometimes the hardest part is trying to feel understood through the stigma and misunderstanding of panic attacks.

Health and wellness touch each of us differently. This is one person’s story.

The first time I had a panic attack, I was 19 and walking back from the dining hall to my college dorm.

I couldn’t pinpoint what started it, what prompted the rush of color to my face, the shortness of breath, the quick onset of intense fear. But I began sobbing, wrapped my arms around my body, and hurried back to the room I’d just moved into — a triple with two other college students.

There was nowhere to go — nowhere to hide my shame at this intense and unexplainable emotion — so I curled up in bed and faced the wall.

What was happening to me? Why was it happening? And how could I make it stop?

It took years of therapy, education, and understanding the stigma surrounding mental illness to fully get a grasp on what was going on.

I eventually understood that the intense rush of fear and distress I’d experienced many times by that point was called a panic attack.

There are many misconceptions about what panic attacks look and feel like. Part of reducing the stigma around these experiences is exploring what panic attacks look like and separating fact from fiction.

Reality: Panic attacks can feel different for everyone, and largely depend on your personal experience.

Common symptoms include:

  • shortness of breath
  • a racing heart
  • feeling a loss of control or safety
  • chest pain
  • nausea
  • dizziness

There are many different symptoms and it’s possible to experience feeling some of the symptoms, and not all of them.

For me, panic attacks often begin with a rush of heat and flushed face, intense fear, increased heart rate, and crying without significant triggers.

For a long time, I wondered whether I could call what I experienced a panic attack, and struggled to “claim” my right to care and concern, assuming I was just being dramatic.

In reality, panic can look like many different things, and regardless of what label you put on it, you deserve to receive support.

Reality: Contrary to stigmatizing beliefs, panic attacks aren’t something people can control. We don’t know exactly what causes panic attacks, but we do know that they can often be triggered by stressful events, mental illness, or unspecified stimuli or changes in the environment.

Panic attacks are uncomfortable, involuntary, and often occur without warning.

Rather than looking for attention, most people who experience panic attacks have a great deal of internalized stigma and shame, and hate having panic attacks in public or around others.

In the past, when I felt close to a panic attack, I’d quickly leave a situation or go home as soon as possible in order to avoid feeling embarrassed in public.

Often people would say things to me like “There’s nothing to even be upset about!” or “Can’t you just calm down?” These things usually upset me more and made it even harder to calm myself.

The best thing you can do for someone having a panic attack is just ask them directly what they need and how you can best support them.

If you know a friend or loved one who often experiences panic attacks, ask them in a calm moment what they’d like from you or those around them if one was to occur.

Often, people have panic attack or crisis plans they can share that outline what helps them to calm down and return to baseline.

Reality: It can be scary to observe someone experiencing a panic attack. But it’s important to remember that they’re not in any immediate danger. The best thing you can do is to remain calm.

While it’s important to be able to help someone distinguish between a panic attack and a heart attack, usually people who have panic attacks often are able to tell the difference.

If you’re around someone having a panic attack and have already asked them if they need support, the best thing to do is respect whatever their answer is, and believe them if they state they can take care of it on their own.

Many people become adept at developing skills and tricks for stopping panic attacks and have a default plan of action when such situations occur.

I know exactly what to do to take care of myself in such situations, and often just need a bit of time to do the things that I know will help me — without worrying about judgement from those around me.

If you’ve asked someone having panic attack if they need help, the best thing to do is respect their answer — even if they say that they can handle it alone.

Reality: Anyone can experience a panic attack, even without a diagnosis of mental illness.

That said, some people are more at risk for experiencing multiple panic attacks throughout their life, including people with a family history of panic attacks or history of child abuse or trauma. Someone also has a higher risk if they have diagnoses of:

People who don’t meet that criteria are still at risk — especially if they experience a traumatic event, are in a stressful work or school environment, or haven’t had enough sleep, food, or water.

For this reason, it’s a good idea for everyone to have a general idea of what a panic attack feels like and the best things they can do to return to feeling calm.

Understanding panic attacks and learning how best to support yourself and others goes a long way in reducing the stigma surrounding mental illness. It can reduce one of the most difficult parts of panic attacks — explaining what happened, or what is happening, to the people around you.

The stigma of mental illness is frequently the most difficult part to cope with in situations when someone is already having a tough time.

For this reason, learning to separate myth from reality can make all the difference, both to people who experience panic attacks, and for those who want to understand how to support the people they love.

I’ve been consistently impressed by the way my friends who’ve learned about anxiety and panic attacks respond when I’m having a rough time.

The support I’ve received has been incredible. From just quietly sitting with me while I’m upset to helping me advocate for my needs when I’m having trouble speaking, I’m extremely grateful for friends and allies who help me navigate mental illness.

Caroline Catlin is an artist, activist, and mental health worker. She enjoys cats, sour candy, and empathy. You can find her on her website.