Rina's first panic attack happened on a jeepney in the rain

It had been raining since lunch. By six, Commonwealth Avenue was a long line of red lights, and Rina sat at the back of a jeepney with her laptop bag on her lap, thinking about the audit deadline on Friday.

It started with her heart. It began to pound, hard and fast, for no reason she could see. Then her chest felt tight. Her hands tingled and went cold. The jeepney suddenly felt too small, the rain too loud, the air too thick to breathe.

She was sure something terrible was happening. Heart attack, she thought. At 26. In traffic. She grabbed the handrail and told the woman beside her, "Ate, parang hindi po ako makahinga." The woman held her arm and asked the driver to stop near a hospital.

Ate, parang hindi po ako makahinga.

In the emergency room they checked her heart, her blood pressure and her breathing. Everything came back normal. The doctor pulled up a chair and said, "I think you had a panic attack."

Rina felt relieved and embarrassed at the same time. Relieved that her heart was fine. Embarrassed that she had made a scene over what her Tita later called "just nerves."

Nothing about it had felt small. A panic attack can bring a racing heart, a tight chest, shortness of breath, shaking, sweating, dizziness, tingling hands, and a strong sense that something terrible is about to happen. Many people think it is a heart attack the first time.

The hardest part came after. She started to fear the next one. She avoided jeepneys and paid for Grab rides she couldn't really afford. She checked her pulse at her desk. Every flutter in her chest made her wonder, "Is this happening again?"

Looking back, the signs had been building for months: audit season, long nights, skipped meals, a lot of coffee and almost no rest. Her body had been running on alarm for a long time.

The ER doctor had told her two things she held on to. A panic attack is frightening, and it passes, often within 5 to 20 minutes. And if the attacks kept coming, she should see a doctor for follow-up. She booked a check-up that week.

Her doctor explained what happens in the body during panic and suggested slow breathing. Rina practised it while she was calm, so it would come easily when she wasn't: in through the nose for 4 counts, out through the mouth for 6, for two minutes. She did it every morning before work, like brushing her teeth.

She learned to talk to the panic when it came. "This is a panic attack. It feels awful, and it will pass." She would put her feet flat on the floor and name five things she could see. The second time it happened, in a meeting, it still felt bad. It ended faster.

This is a panic attack. It feels awful, and it will pass.

She also started riding jeepneys again, a little at a time. First short trips with her younger sister. Then the full ride home on a dry day. Then a rainy one. Each ride that ended fine made the next one easier.

She told her manager about the audit workload, cut her coffee to one cup a day, and started eating lunch away from her desk. Her mother prayed with her over the phone on Sunday nights. Psalm 56:3 became the verse she whispered in traffic.

When the fear of another attack still hung over her after a few months, her doctor referred her to a counselor. That helped her understand the worry underneath the panic, and what to do with it.

If your heart is racing as you read this, put your feet on the floor. Breathe in for 4, out for 6. Panic rises, peaks and then passes. You can ride this one out.

If it is your first time having chest pain or trouble breathing, get checked by a doctor or go to the ER. That was the right call for Rina, and it is the right call for you. Once other causes are ruled out, you can treat the panic for what it is.

If panic attacks keep coming back, or you start avoiding places because of them, talk to a doctor or counselor. Panic attacks can be treated, and seeing someone about them is a normal next step.

For the next time, Having a panic attack? Breathe with us walks you through two minutes of breathing, step by step. And HopeBegins is free: pick how you feel and get one small thing to try today, calming tools, someone to pray for you, and an e-coach you can message on Messenger.