How to Stop a Panic Attack: 10 Steps That Help in the Moment

Quick answer

Recognise it, slow your breathing, ground yourself and let it pass

During a panic attack the body’s fight-or-flight system fires without a real threat. Symptoms peak within about 10 minutes and fade. Helpful steps are: recognise it as a panic attack, remind yourself it will pass and is not dangerous, slow your breathing (in for 4, out for 6–8), ground yourself with 5-4-3-2-1, relax your muscles, stay where you are if safe rather than fleeing, use a calming object or cold water, repeat a coping statement, move gently and afterwards rest and hydrate. Avoid caffeine, alcohol and fighting the sensations. Panic attacks that recur or cause fear of more attacks may be panic disorder, which responds very well to CBT and medication. First attacks and chest pain should be medically checked.

Important. Chest pain, pain spreading to the arm or jaw, fainting, severe breathlessness that does not settle, a first panic-like episode over age 50, or symptoms with sweating and nausea need emergency medical assessment to exclude a heart attack. Thoughts of self-harm need immediate help from emergency services or a crisis line.

What is a panic attack?

A panic attack is an abrupt wave of fear or discomfort that reaches a peak within minutes and includes at least four physical or mental symptoms: palpitations, sweating, trembling, shortness of breath, choking feeling, chest tightness, nausea, dizziness, chills or hot flushes, numbness or tingling, a sense of unreality, fear of losing control or dying. About one in three people has one at some point. See panic attack and ataque de pánico: qué hacer (Spanish).

10 steps to stop a panic attack

1. Name it: say “This is a panic attack. It is uncomfortable, not dangerous, and it will pass.”
2. Slow your breathing: breathe in through your nose for 4, out through your mouth for 6–8; place a hand on your belly. Do this for several minutes. See deep breathing for anxiety.
3. Stay where you are if it is safe, rather than escaping; fleeing teaches your brain the situation was dangerous. If you need to move, step outside or sit down.
4. Ground yourself: 5-4-3-2-1 senses, feel your feet on the floor and the support of the chair. See grounding techniques for anxiety.
5. Release muscle tension: unclench your jaw and hands, drop your shoulders, tense and relax muscle groups.
6. Use cold: splash cold water on your face or hold a cold drink or an ice cube.
7. Use a coping statement: “I have felt this before and I have always come through.” “These sensations are just adrenaline.”
8. Let the sensations be there: do not fight or analyse them; imagine riding a wave that rises and falls.
9. Keep gentle focus: count, describe objects, or do a simple task to occupy your attention.
10. After it passes: sit quietly, sip water, notice how long it lasted and what helped; avoid caffeine and alcohol.

What not to do

Do not breathe into a paper bag; it can be dangerous and is not recommended.
Do not fight, resist or tell yourself to “calm down” harshly.
Do not avoid places where attacks happened; avoidance maintains panic.
Do not rely on alcohol or sedatives to cope.
Do not drink more coffee or energy drinks.
Do not hyperventilate by breathing fast and deep; slow, gentle breathing is key.
Do not assume it is “just anxiety” if you have chest pain, are over 50, or it is your first episode; get checked.

Why panic attacks feel so physical

The surge of adrenaline speeds the heart, tightens muscles and increases breathing. Over-breathing lowers carbon dioxide in the blood, which causes tingling, lightheadedness and chest tightness; slow breathing reverses this. Your body is protecting you from a danger that is not there. The heart is not damaged by a panic attack, and you will not faint from it in most cases because blood pressure usually rises. See mareos por ansiedad (Spanish) and anxiety symptoms.

How long do panic attacks last?

Most panic attacks peak within 10 minutes and subside within 20–30 minutes, although you may feel drained afterwards for some hours. Attacks lasting much longer, or with chest pain, are worth checking. Nocturnal attacks wake people from sleep. See nocturnal panic attacks.

Reducing future panic attacks

Cognitive behavioural therapy (CBT) is the most effective treatment, teaching you to understand and face the sensations.
Regular exercise, which lowers baseline anxiety.
Sleep and routine: poor sleep increases vulnerability.
Limit caffeine, nicotine and alcohol.
Practise slow breathing and relaxation daily, not only during attacks.
Face avoided situations gradually with support.
Medicine (SSRIs or SNRIs) when advised by a doctor. See panic disorder treatment.
Manage stress, with mindfulness, hobbies and social support.

Helping someone who is having a panic attack

Stay calm and speak in a gentle, steady voice.
Ask how you can help; do not tell them to “calm down”.
Guide slow breathing with them: “in for 4, out for 6”.
Help them ground themselves by describing what they can see and hear.
Move to a quieter place if possible.
Stay with them until it passes, and do not take over unless asked.
Call emergency services if they have chest pain, are over 50 or it is their first attack, or if symptoms do not improve.

When to see a doctor

Chest pain, palpitations or breathlessness during a first attack: emergency.
Repeated panic attacks or constant worry about having another.
Avoiding places or activities because of fear.
Attacks waking you at night.
Use of alcohol or drugs to manage panic.
Low mood or thoughts of self-harm.
Other symptoms such as weight loss, tremor or heat intolerance (possible thyroid problems).

Three common situations

A person with a racing heart and tight chest on a train: slow breathing, grounding, staying put and reminding themselves it will pass.

A student who wakes at night in panic: sit up, breathe slowly, orient to the room and avoid checking the pulse repeatedly.

A 55-year-old with a first episode of chest tightness and sweating: call emergency services to exclude a heart attack.

Key points to remember

A panic attack is frightening but harmless and passes in minutes. Slow your breathing, ground yourself, stay put and let the wave pass. Get recurrent attacks or first-time chest symptoms checked, and consider CBT. Our psychology team can help you overcome panic.

This guide is for general information and does not replace an assessment by your own doctor or psychologist. If you are in crisis or thinking of harming yourself, contact your local emergency number or a crisis line right away.

Questions about stopping a panic attack

These answers are general information and do not replace an examination or individual medical advice.

How do I stop a panic attack quickly?

Slow your breathing, ground yourself with your senses, stay where you are and remind yourself it will pass.

How long does a panic attack last?

Usually 10–20 minutes, peaking in the first 10.

Can a panic attack hurt me?

It is frightening but not dangerous; the heart is not harmed.

Should I breathe into a paper bag?

No, it is not recommended; use slow, gentle breathing.

When should I go to the ER?

For chest pain, a first attack after 50, severe breathlessness or if you cannot tell it from a heart problem.

How can I prevent panic attacks?

CBT, exercise, good sleep, limiting caffeine and alcohol and, if advised, medicine.

Sources

This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.