How to Get Through a Panic Attack in the Moment

A panic attack is a sudden surge of fear that peaks within minutes and then fades, even though it feels like it will never end. The most useful plan is simple: name what is happening, slow your breathing, ground yourself in your senses, and let the wave pass without fighting it.

This guide is general information, not medical advice. It cannot diagnose anything. If you are in danger or think you may harm yourself, call or text 988 (the Suicide and Crisis Lifeline, available 24/7 in the US) or call 911 right now.

What a panic attack feels like

Panic can show up as:

• A pounding or racing heart
• Shortness of breath or a feeling of choking
• Chest tightness
• Sweating, shaking or chills
• Dizziness or feeling faint
• Tingling in hands or face
• Nausea
• A sense of unreality, like you are watching yourself from outside
• A strong fear of losing control, going crazy or dying

These symptoms are real, and they are frightening. Because several of them overlap with heart problems, many people go to the emergency room the first time. That is a reasonable thing to do, and we will cover when to do it below.

What is going on in your body

Your body has a built-in alarm, often called the fight-or-flight response. When it senses danger, it floods you with adrenaline. Your heart speeds up, your breathing gets fast and shallow, and blood moves toward your muscles.

In a panic attack, the alarm goes off without a real threat in front of you. The sensations are the same as they would be during danger, which makes your mind say, “Something is terribly wrong.” That thought adds more fear, which adds more adrenaline.

The good news is that this cycle burns itself out. Adrenaline cannot keep pumping forever. Most panic attacks peak within about ten minutes and then settle, though you may feel tired or shaky afterward.

Knowing this is part of the plan. Fear of the sensations feeds the attack, so understanding them takes away fuel.

The 10-minute plan

Read this once while you are calm. Then save it on your phone or print it for your wallet.

Minute 0 to 1: Name it

Say to yourself, quietly or out loud: “This is panic. It is uncomfortable, but it will pass. I have been through this before” (or, if it is your first time, “My body is giving a false alarm”).

Naming it does not make it vanish. It does stop the second wave of fear about what the fear means.

Minute 1 to 3: Slow your breathing

Fast breathing makes symptoms worse. Try this pattern:

1. Sit or lean against something solid if you can.
2. Breathe in through your nose for a count of four.
3. Hold for a count of one or two. Skip this if it feels uncomfortable.
4. Breathe out slowly through your mouth for a count of six.
5. Repeat for two or three minutes.

The long out-breath is the key part. If counting feels hard, breathe in as if smelling a flower and out as if cooling soup. Placing a hand on your belly can help you breathe lower.

Minute 3 to 6: Ground yourself with your senses

Panic pulls your attention into your head. Bring it back to the room.

Try the 5-4-3-2-1 method:

• Look for 5 things you can see
• Notice 4 things you can touch
• Listen for 3 things you can hear
• Find 2 things you can smell
• Name 1 thing you can taste

Say them out loud if you can. Other options: press your feet into the floor, hold something cold such as an ice cube or a glass of water, or run cool water over your hands.

Minute 6 to 8: Soften your body

Tension piles up in the jaw, shoulders and hands. Let them go one at a time.

• Unclench your jaw and let your tongue rest on the floor of your mouth.
• Drop your shoulders away from your ears.
• Open your hands.
• Shake out your arms and legs if you have room.

Minute 8 to 10: Ride the wave

Stop trying to push the feelings away. Fighting panic tends to make it stronger. Picture the feeling as a wave. It rises, it crests, and it falls.

Tell yourself: “I can feel this and still be safe. I do not have to do anything about it right now.”

If it helps, repeat a short sentence such as “This will pass” or “Just breathe, just wait.”

What to do if you are in public or driving

• In a store or at work. Step aside, find a wall to lean on, and use the breathing steps. You do not owe anyone an explanation. You can say, “I need a minute.”
• While driving. Pull over safely as soon as you can. Turn off the engine, put on your hazard lights, and use the plan. Do not keep driving through it.
• In bed at night. Sit up, turn on a dim light, and do the senses exercise. Our guide on how to wind down for better sleep can help with the evening afterward.
• On a call or in a meeting. Mute yourself, look at an object in the room, and breathe out slowly. Muting buys you time.

After the attack

When the wave settles, your body may feel drained. Be kind to yourself.

1. Drink some water.
2. Sit or lie down for a few minutes.
3. Eat something small if you have not eaten.
4. Skip caffeine for the rest of the day, since it can nudge your heart rate up.
5. Write down a few notes: where you were, what you had been doing, what you were thinking, how long it lasted, what helped.

Those notes become useful over time. A worry journal works well for this.

The week after: lower the odds of another one

You cannot fully control whether panic returns, but you can lower your baseline stress.

• Sleep. Keep a steady schedule.
• Caffeine and alcohol. Both can trigger or worsen symptoms in some people. Try cutting back for two weeks and see.
• Movement. Daily walking helps your body use up stress chemicals.
• Regular meals. Low blood sugar can mimic panic.
• Breathing practice. Spend five minutes a day on slow breathing when you are calm, so it is familiar when you need it.
• Talk to someone. A friend, family member, counselor or doctor.

Try not to avoid the places where panic happened. Avoiding can make the fear grow. If you feel stuck, a therapist can guide you through gradual steps.

Panic attack or something else?

You can have a panic attack and also have a real medical condition. Chest pain, trouble breathing and fainting can also come from heart, lung, thyroid or other problems. Medications and substances can also play a part.

Call 911 if you have chest pain or pressure that spreads to your arm, jaw or back, if you cannot catch your breath, if you faint, if you have symptoms of a stroke (face drooping, weakness on one side, trouble speaking), or if this feels different from anything you have had before. It is always okay to call and be told it was panic.

When to get help

• You have had more than one panic attack, or you worry a lot about having another.
• You have started avoiding places, work or activities.
• Panic is affecting sleep, school, work or relationships.
• You use alcohol or other substances to cope.
• You feel hopeless, or you have thoughts of harming yourself.

Start with your primary care doctor, who can check for physical causes and talk about options. Therapy, especially cognitive behavioral therapy, is widely used for panic. Many people also find peer or community support helpful.

If you are in crisis, call or text 988 any time, day or night. If someone is in immediate danger, call 911.

Helping someone else through a panic attack

• Stay calm and stay with them.
• Speak slowly and gently. “I’m here. You’re safe. This will pass.”
• Offer to breathe with them: in for four, out for six.
• Do not tell them to “calm down” or “it’s nothing.”
• Ask what helps, and respect the answer.
• Give them space and water afterward.

A quick card to save

• Say: “This is panic. It will pass.”
• Breathe in four, out six, for two to three minutes
• Do 5-4-3-2-1 with your senses
• Relax jaw, shoulders and hands
• Ride the wave, do not fight it
• Afterward: water, rest, notes
• If symptoms are severe or different, call 911
• If you are in crisis, call or text 988

A calm next step

If you would like the plan laid out on a single page to keep in your pocket, The 10-Minute Panic Plan walks through the moment and then the week after. It is a printable aid, not a substitute for care from a clinician. You can also begin with the card above and a notebook.

Panic is frightening and it is also survivable. Learn the steps while you are calm, and you will have something to hold on to the next time your body sounds the alarm.