How to calm a panic attack

What a panic attack is

A panic attack is a sudden surge of intense fear along with a rush of physical symptoms: a pounding heart, a tight chest, shortness of breath, dizziness, tingling hands, sweating, or a wave of unreality and dread. It can feel exactly like something is medically wrong, like a heart attack or like you're losing control.

Here's the key thing: it's your body's alarm system firing when there's no actual danger. The same fight-or-flight response that would save your life from a real threat has switched on by mistake. It's intensely uncomfortable, but the attack itself is not harming you.

Remember: it will pass

This is the single most useful fact to hold onto. A panic attack cannot sustain itself. It runs on adrenaline, and your body simply can't keep pumping it out, most attacks peak within about ten minutes and then fade. Fighting the wave tends to feed it. Letting it rise, crest, and fall is what lets it pass faster.

Six steps to calm it

1. Name it. Say to yourself: "This is a panic attack. It's not dangerous. It will pass." Naming it takes some of the power out of the fear-of-the-fear.
2. Slow your exhale. Breathe in for a count of 4, then out for 7 or 8, a pattern sometimes called 4-7-8 breathing. A long exhale is the fastest signal to your nervous system that you're safe. The physiological sigh is built for exactly this.
3. Ground through your senses. Name 5 things you can see, 4 you can feel, 3 you can hear, or splash cold water on your face, which snaps your attention out of your head fast. This pulls you back into the room. Full 5-4-3-2-1 method here.
4. Unclench. Drop your shoulders. Unlock your jaw. Let your hands go loose. Your body braces during panic; releasing the physical grip helps release the mental one.
5. Stay put if you safely can. The urge to flee is strong, but leaving teaches your brain that the place was dangerous, which makes the next attack more likely. Riding it out where you are teaches the opposite.
6. Ride the wave. Picture it as a wave that rises and falls. You're not trying to stop it, you're outlasting it. It's already on its way down.

What not to do

• Don't over-breathe. Gulping fast breaths (hyperventilating) makes the dizziness and tingling worse. Slow, long exhales are what you want.
• Don't fight to make it stop this second. Acceptance, "okay, this is happening, and it will pass", is almost always faster than force.

When to get help

Panic attacks are common and very treatable. But please take the physical side seriously too:

• If this is your first panic attack, or you have chest pain, fainting, or symptoms you're unsure about, get medical care to rule out other causes.
• If panic attacks keep happening or you're starting to avoid places because of them, talk to a doctor or therapist. Cognitive behavioral therapy (CBT) is highly effective for panic, and it works.

Common questions