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According to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) a panic attack is "a discrete period of intense fear or discomfort in the absence of real danger that is accompanied by at least 4 of 13 somatic or cognitive symptoms." The symptoms include things like heart palpitations, sweating, chills, hot flushes, trembling, tingling sensations, shortness of breath, a sensation of choking, chest pain, nausea, dizziness, a sense of unreality or detachment, fear of going crazy, and even fear of dying. The attacks can be triggered by specific cues (such as public speaking or reminders of past traumas) or can seem to come out of nowhere. Panic attacks usually begin suddenly and reach a peak in ten or fewer minutes. Panic attacks are a feature of some medical conditions and some mental disorders. Those who have experienced panic attacks can attest to how frightening the episodes can be.
Many factors—including biology, heredity, temperament, stress, and experiences—can contribute to panic attacks. It is wise to talk with a doctor about any medical or other interventions needed. That being said, the underlying issue involved is fear, often both during the attack and the fear that another could occur. Those who are children of God through faith in Jesus Christ ultimately need not fear. We can look to God and His Word to help us learn how to manage feelings of fear or panic we might have, whether related specifically to panic attacks or in life in general.
The Bible does not speak of panic attacks by name, but it does present several situations that could provoke one. Many times the Bible reports that people were “filled with fear.” That describes panic. In panic mode, a person is completely overcome by the fear response. Psalm 55:4–8 describes what a panic attack feels like: “My heart is in anguish within me; the terrors of death have fallen on me. Fear and trembling have beset me; horror has overwhelmed me. I said, ‘Oh, that I had the wings of a dove! I would fly away and be at rest. I would flee far away and stay in the desert.’” A few verses later David writes, “As for me, I call to God, and the LORD saves me. Evening, morning and noon I cry out in distress, and he hears my voice” (Psalm 55:16–17). He concludes the psalm by saying, “Cast your cares on the Lord and he will sustain you; he will never let the righteous be shaken. But you, God, will bring down the wicked into the pit of decay; the bloodthirsty and deceitful will not live out half their days. But as for me, I trust in you” (Psalm 55:22–23).
Psalm 55 shows us a positive response to times of fear. We cry out to God in our distress, recall His character and His faithfulness, and continue to trust in Him. First Peter 5:7 similarly encourages us to “Cast all your anxiety on [God] because he cares for you.” Denying that we are afraid, pretending we are not worried, or obsessing over our fears can all contribute to our bodies reacting in panic. We should acknowledge our fears within the safety of our relationship with God. We can bring our concerns to Him because He is big enough to handle them and we belong to Him in Jesus Christ. “Fear not” is one of the most common commands in the Bible. God understands that we are prone to fear. Life in this world is often dangerous and scary. But God does not want us to live in that fear; He wants us to have faith in Him instead (Isaiah 35:4; 41:10; Luke 12:4; 1 Peter 3:14). When we begin learning how to let God handle our daily fears, we remove some of the stimuli that could contribute to a panic attack.
Perhaps the best way to start doing this is to study the character and nature of God. The more we know God, the more we are able to trust Him. The more we trust Him, the less we will be overrun with fear. This means engaging in regular study of God’s Word, spending daily time with Him in prayer, and being in active relationship with other believers. When we surround ourselves with the truth of God and allow His Holy Spirit to transform our hearts, we grow in our faith.
Philippians 4:4–8 offers helpful advice, “Rejoice in the Lord always. I will say it again: Rejoice! … Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things.” When we are rejoicing, entrusting our fears to Lord, thanking God, and keeping our minds on things that reflect God’s holiness and beauty, we are less prone to anxiety and panic. In fact, God even promises that His peace will guard our hearts and minds when we come to Him in prayer.
Jesus put fear in perspective when He said, “Do not be afraid of those who kill the body but cannot kill the soul. Rather, be afraid of the One who can destroy both soul and body in hell” (Matthew 10:28). He was calling attention to the fact that most of what we fear is temporary and of no eternal consequence. We should rather focus our concerns on having a right relationship with God. He has then promised to meet all our other needs (Philippians 4:19; Matthew 6:33). One way we focus on the important is by applying Proverbs 3:5: “Trust in the LORD with all your heart and lean not on your own understanding.” When we refuse to allow our limited understanding to determine our level of peace and joy, we are on our way to escaping the grip of panic attacks.
