How to Stop a Panic Attack in the Moment

The most useful thing to know before anything else: a panic attack peaks and then subsides, typically within several minutes, whether or not you do anything. It does not build forever. That fact alone takes some of the fear out of the middle of it, and fear of the panic is a large part of what keeps it going.

So the goal is not to stop it by force. It is to get through the peak with less struggle, which in practice tends to shorten it.

Make the exhale longer than the inhale

Not deep breathing. Deep breathing frequently makes things worse when you are already breathing fast, because taking in more air is not the problem. Instead, keep the breaths ordinary and make the out-breath longer than the in-breath. In for four, out for six, for a handful of rounds.

This is the most reliable item on the list and the only one nobody can see you doing. If you remember one thing, remember this one.

Cold on the skin

Cold water on the face or wrists, a cold drink against the palm, a metal object out of your pocket. Cold is immediate and difficult to ignore, which is the point: it interrupts.

You do not need it to be shocking. Comfortably cool, held for thirty seconds, does the work.

Something solid to hold

Press your feet flat into the floor and notice the weight going through your heels. Grip something with a definite shape and trace it slowly. Both do the same job as the cold, more quietly: they give attention a fixed physical place to be instead of the loop it is in.

This is where carrying an object earns its place. Under pressure, reaching for a specific thing is easier than recalling a specific technique. We have written more on what to hold and why.

If it happens in public

Two things help, and neither involves leaving.

First, you are far less visible than you feel. The physical signs of panic are dramatic from the inside and almost invisible from the outside. Second, all three techniques above work while seated, in a meeting, on a train, mid-conversation. Feet into the floor, longer exhale, thumb on something textured. Nobody at the table can tell.

If you can step out without a fuss, do. If you cannot, you are not stuck.

Afterwards

The hour after a panic attack is usually flat and tiring, and that is normal rather than a sign it is about to happen again. Eat something, drink water, and do not immediately analyse what triggered it. Working out the trigger is useful later, in a calmer state, and useless while your system is still settling.

The calmer state is also when it is worth practising, so that the technique is familiar rather than new the next time. Our overview of grounding techniques for anxiety sorts the options by how fast each one acts, which makes it easier to pick one to rehearse.

When this needs more than technique

This article is about getting through a moment. It is not treatment, and it is not a diagnosis. Panic attacks are very treatable, and cognitive behavioural approaches in particular have a strong record with them, which is a good reason to talk to someone rather than manage alone.

Two things genuinely matter here. Chest pain, a racing heart and breathlessness overlap with symptoms of physical conditions that deserve proper assessment, so a first episode is worth getting checked rather than assumed. And if you are having them repeatedly, or reorganising your life to avoid situations where one might happen, that is the point to see a doctor or a therapist. Nothing in a pocket substitutes for that.

Common questions