Panic attacks can make you feel like you’ve lost control, but with the right tips, you can get back in the driver’s seat.
Unsettled. Scared. Anxious. Physically ill. The way you feel during a panic attack can be frightening and overwhelming.
With everything going on in the world, panic attacks might be new to you or have made a reappearance — or maybe this isn’t your first rodeo.
Whether you’ve had many panic attacks or just one, many strategies exist that can help you get through an attack.
Panic attacks are sudden surges of overwhelming fear and anxiety that typically reach their peak intensity within a few minutes.
They’re common in people with anxiety disorders, but can occur in pretty much anyone. Having a panic attack doesn’t necessarily mean you have panic disorder.
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During a panic attack, you might experience:
- a racing heart or palpitations
- sweating
- shortness of breath
- dizziness or lightheadedness
- derealization or depersonalization
- a fear of dying
- chest pain
- chills or hot flashes
- shaking
- tingling or numbness
- nausea
- stomach pain or upset
For some people, panic attacks have a trigger — maybe they come on from a specific event, like crossing a bridge or speaking in public. For other people, a panic attack comes on unexpectedly with no apparent cause.
Though they pose no real danger, your fears of having another panic attack can be severe enough to significantly impact your daily life.
Everyone will experience panic attacks in unique ways, so strategies that work for one person may not work for you. Some strategies may work at one point, but not at others.
The key is to try a variety of techniques until you find the ones that fit best for you.
1. Recognize that this is a panic attack
The first thing you can do once your symptoms start is to acknowledge them for what they are — a panic attack. It’s not life threatening, won’t harm you, and will be gone soon.
It can be tempting to run from feelings of panic, but accepting your emotional state can be helpful for getting through an attack.
Tell yourself: This is temporary. It will pass soon.
2. Stay grounded
Many people who have panic attacks find it helpful to ground themselves in their surroundings. Staying in the present can lessen your feelings of unreality and fear.
There are a lot of techniques to keep yourself grounded.
One of these is the 5-4-3-2-1 method. It involves focusing on your five senses to anchor you to your surroundings.
How the 5-4-3-2-1 method works:
- 5: Acknowledge FIVE things you see around you.
- 4: Acknowledge FOUR things you can touch around you.
- 3: Acknowledge THREE things you can hear.
- 2: Acknowledge TWO things you can smell.
- 1: Acknowledge ONE thing you can taste.
Need some other grounding techniques to try?
- Press your feet firmly into the ground.
- Eat or drink one of your favorite foods (for added benefit, do it mindfully).
- Write down how you’re feeling in a journal.
- Find and focus on your pulse.
3. Relax your muscles
Muscle relaxation techniques can offer plenty of health benefits, including:
- lowering blood pressure
- improving sleep
- reducing anxiety
The goal of muscle relaxation techniques is to reduce stress by contracting and then slowly relaxing muscles, thus releasing tension throughout the body. You can tense your muscles for between 5 and 10 seconds, or however long feels comfortable to you.
How to do it
- Start by sitting or lying down in a comfortable position. Close your eyes.
- Take a deep breath, noticing the feeling of air filling your lungs. Hold your breath for a few seconds, then release.
- Take another deep breath and hold it, then slowly release.
- Now, start at your feet. Tense your feet by curling your toes and arching your feet. Hold it, then release the tension in your feet.
- Tense the muscles in your calves. Hold it, then release.
- Move on to your thighs, squeezing them together. Hold, then release.
- Tense up the muscles in your stomach and chest. Suck in your stomach, squeeze, and hold it. Then release, letting your body go limp.
- Tense the muscles in your back by bringing your shoulders together. Hold, then release.
- Move to your arms. Make a tight fist and squeeze your entire arm. Hold it, then release.
- Tense the muscles in your head, neck, and face. Hold it, then release.
- Finally, tense your entire body all at once. Squeeze harder, hold it, then release.
- Slowly move your muscles to wake them up. Shake it out. Stretch, then open your eyes when you’re ready.
4. Practice mindfulness
Mindfulness is all about being aware, staying present, and accepting how you feel in the moment.
By simply acknowledging how you feel mentally and physically — without judgment — you may be able to lessen the discomfort brought on by a panic attack. Instead of being angry and scared, you can accept and reflect on your symptoms.
If your panic attacks are often triggered by unsettling bodily sensations, practicing mindfulness may be especially helpful. Learning to accept nonthreatening physical feelings rather than fight them can help prevent panic symptoms.
Mindfulness strategies include:
- meditation
- yoga
- breathing exercises
5. Visualize your happy place
It sounds simple, but picturing yourself in an environment that brings you joy or where you’re surrounded by people who support you can bring great comfort during a panic attack.
Consider keeping a picture handy of people or places that make you feel at peace.
6. Talk to someone
Even better than visualizing the person who brings you comfort is actually talking to them. Not only can they provide a needed sense of security and joy, but they can remind you that your symptoms are momentary and can’t hurt you.
Maybe what you need is a friend or family member to hold your hand or occupy you with conversation in the midst of an attack.
7. Ride it out
Another technique is to simply ride the panic attack out. It may seem counterintuitive, but confronting your fear rather than running from it can help panic attacks pass faster and prevent them in the future.
If you show yourself that you can fully experience all these overwhelming symptoms and come out of it safe and healthy, you allow yourself to regain control. You learn that the panic attack won’t hurt you.
One popular technique used for getting through panic attacks is called the “DARE response,” developed by Barry McDonagh for facing anxiety head-on. The idea is to actually engage with your feelings of panic, reframing them as positive excitement rather than fear.
It should be noted that the DARE response technique hasn’t been assessed with scientific experimentation.
DARE stands for:
- Defuse: Respond to invasive “what-if” scenarios in your head with “So what?”
- Allow: Allow yourself to sit with and accept your feelings.
- Run toward: Reframe your anxiety as excitement.
- Engage: Keep busy by doing an engaging activity, like reading or having a conversation.
Learning how to cope when you’re not currently in the throes of a panic attack can help reduce the likelihood and severity of attacks in the future.
8. Learn your triggers
Panic attacks can seem to come out of nowhere. But in many cases, there are actually subtle underlying triggers to panic.
Figuring out what’s most likely causing your panic attacks can be an important step in managing them. Identifying your triggers is especially helpful in psychotherapy.
Since it can take some time, keeping a journal to reflect on your past panic attacks can help you determine patterns and triggers.
The goal isn’t to avoid the triggers, but rather to learn how to cope with them and address them head-on.
9. Make a plan
Planning for a panic attack includes educating yourself on what to expect and why they happen.
If you’ve already experienced a panic attack, you likely have some insight into what worked and what didn’t. Did breathing exercises help or worsen your symptoms? What about physical activity?
Thinking about these things and making a plan can help you feel more in control and lessen the severity of future panic attacks.
10. Manage your stress
One of the best ways to manage panic attacks and improve overall well-being is with stress management.
Treatment plans will vary from person to person — some people will take meds to manage their symptoms or go to regular therapy. Others may find that relaxation and self-care tools can help them in managing their panic attacks.
Sometimes it’s a little bit of everything, but managing stress can benefit everyone.
Some options for stress management include:
- breathing exercises
- practicing meditation
- keeping a journal
- spending time in nature
11. Exercise
The benefits of exercise on levels of anxiety and panic vary for each person.
Since exercise can raise your heart rate, make you sweat, and have other side effects that mimic panic, you might want to first try more gentle exercise if exercise brings on a panic attack for you.
Also, consider trying an exercise routine or activity you enjoy, such as yoga or walking, to help manage your stress and anxiety.
12. Take your prescribed medication
If a healthcare professional has prescribed you medication, it’s important to continue taking your meds as instructed. If you have concerns about side effects or want to make adjustments, you can always reach out to them for tweaks.
There are other meds that may be prescribed for panic attacks or anxiety. Benzodiazepines (like Xanax or Ativan) are powerful meds that can quickly reduce symptoms of panic attacks. That being said, use of these medications are often carefully considered since they can lead to tolerance or dependence.
13. Challenge unhealthy thoughts
CBT is widely used and typically regarded as one of the most effective treatments for panic disorder and other anxiety disorders.
People who have panic attacks often experience negative and fear-based thought processes, which turn into or increase anxiety.
The goal of CBT is to replace distorted and destructive thinking with more logical and accurate thoughts.
CBT techniques can also help you develop coping mechanisms and make changes that can help you better manage panic and anxiety.
14. Try exposure therapy
Exposure therapy involves being exposed to whatever triggers your panic attacks or fears. A
Exposing yourself to your triggers may seem scary and unproductive. But repeatedly learning that these events can’t actually hurt you can make a difference in the long run.
Exposure therapy should always begin under the direction of a mental health professional.
15. Talk with a doctor
If you or a loved one has been having panic attacks, you can reach out to a healthcare professional for support.
If you don’t have access to a healthcare professional, you may want to consider telehealth services or call a nearby clinic.
Need more resources for therapy? You can check out our handy Psych Central guides:
Professionals can provide more information on treatment options and recommend other strategies for coping.
Dealing with panic attacks can be scary and frustrating, no matter how few or many attacks you’ve had. In severe cases, panic attacks can interfere with your day-to-day life and cause overwhelming stress and anxiety.
While figuring out what works for you might take some time, along with trial and error, panic attacks are highly manageable.
Don’t be afraid to switch things up and try something new if a technique doesn’t work for you.
If your panic attacks become overwhelming, less manageable, or start happening more frequently, you can always reach out to a mental health professional for support.