What to do during a panic attack: steps that can help

During a panic attack, the most helpful things are usually to stay where you are if you can, slow your breathing, and remind yourself that the feelings are frightening but not dangerous and will pass. Trying to fight the feelings often makes them stronger, so it can help to let the wave rise and fall while you focus on something steady, such as your breath or what you can see and touch around you. The NHS notes that most panic attacks last between 5 and 20 minutes.

Key points

• Panic attacks are frightening, but the NHS describes them as not dangerous and not physically harmful.
• Most last 5 to 20 minutes, although some can last up to an hour.
• Slow breathing, grounding through your senses and reminding yourself it will pass can all help.
• If you have chest pain or are unsure what is happening, seek medical help rather than assuming it is panic.
• If panic attacks keep happening, talking therapy such as CBT can help. In England you can self-refer to NHS Talking Therapies.

What is happening in my body during a panic attack?

A panic attack is a sudden rush of intense fear, together with strong physical sensations. The NHS lists symptoms such as a racing heartbeat, sweating, feeling sick, chest pain, shortness of breath, trembling, dizziness and a choking feeling. Some people feel faint or numb, feel detached from their body, or feel sure they are about to die or lose control.

These sensations are part of the body’s alarm response, the same system that prepares us to deal with danger. In a panic attack the alarm goes off when there is no real threat, and the frightening sensations can then feel like proof that something is badly wrong. That fear can feed the sensations, which can feed the fear. Understanding this cycle does not stop a panic attack on its own, but many people find it makes the experience a little less terrifying.

What should I do during a panic attack?

There is no single technique that works for everyone, and it is worth trying a few to see what suits you. These steps draw on guidance from the NHS and the mental health charity Rethink Mental Illness.

1. Stay where you are, if you can. If you are somewhere unsafe, such as driving, find a safe place to stop first. Otherwise, sit or stand somewhere you feel supported.
2. Try not to fight it. Rather than battling the feelings, let them run their course. You might say to yourself, “This is panic. It feels awful, but it will pass.”
3. Slow your breathing. Breathe in gently through your nose and out through your mouth, letting the breath go down into your belly without forcing it. Counting slowly, for example from one to five on each in-breath and out-breath, gives your mind something to hold on to. You can follow a guided version on my breathing exercise page.
4. Ground yourself through your senses. Look around and name a few things you can see, hear and touch. Press your feet into the floor, hold something with an interesting texture, or notice the temperature of the air. There is a step-by-step version on my grounding exercise page.
5. Remind yourself that you are safe. The NHS advises reminding yourself that the attack will pass and is not life-threatening. Some people also find it helps to picture a calm, familiar place.
6. Reach out if you would like to. Sitting with someone you trust, or calling them, can be steadying. You do not have to explain everything; simply having company can help.

It is completely normal for these techniques to feel clumsy at first, especially in the middle of an attack. Practising them when you are calm, even for a few minutes a day, can make them easier to reach for when you need them.

Is it a panic attack or something else?

Many symptoms of a panic attack, especially chest pain and breathlessness, can also be caused by physical health problems. It is important not to assume it is “just panic”, particularly if it is the first time or if it feels different from usual.

The NHS advises calling 999 if you have sudden chest pain that does not go away, pain that spreads to your arms, neck, jaw, stomach or back, or chest pain together with sweating, feeling sick, light-headedness or shortness of breath. Rethink Mental Illness suggests calling NHS 111 if a panic attack lasts longer than 20 minutes, or if you have chest pain or an irregular heartbeat. If you are worried about physical symptoms, please see your GP. Getting checked can be a relief in itself.

What can I do after a panic attack?

Panic attacks can leave you feeling drained, shaky or tearful. Afterwards, try to be gentle with yourself. Have a drink of water, rest if you can, and give your body time to settle. It can help to tell someone what happened, rather than carrying it alone.

Many people start to worry about when the next attack will come, and may begin to avoid the places or situations where panic has happened before. This is very understandable, but avoidance can gradually make life smaller. If you notice this happening, it is a good sign that support could help.

When should I get help for panic attacks?

The NHS suggests seeing a GP if you think you might have panic disorder. Panic disorder is when you have regular, unexpected panic attacks, followed by at least a month of ongoing worry about having another one. Your GP can talk through what is happening, check for any physical causes, and explain the options.

Cognitive behavioural therapy (CBT) is one of the main treatments the NHS describes for panic disorder. In England, if you are 18 or over (or 16 or over in some areas), you can refer yourself to NHS Talking Therapies without seeing your GP first. Medication may also be an option for some people, and this is something to discuss with your GP. As a psychotherapist, I do not prescribe or advise on medication.

How can therapy help with panic attacks?

Therapy offers a space to understand your panic rather than simply trying to get rid of it. That can include learning more about the body’s alarm response, noticing the thoughts that tend to escalate an attack, and gently reducing the avoidance that can build up around it. It can also be a place to explore what else is going on in your life, as panic sometimes appears during times of stress, change or loss.

I am an integrative psychotherapist registered with the BACP. I draw on person-centred, psychodynamic and CBT-informed ideas, and I work at a pace that feels manageable for you. You can read more on my pages about panic attacks and anxiety. I see adults in person in Farringdon, Central London, and online by secure video, in English or Turkish.

If you are in crisis, call 999, go to A&E, call NHS 111, or contact Samaritans on 116 123 (free, 24/7).

If panic attacks are affecting your life and you would like support, you are welcome to get in touch to arrange an initial consultation. We can talk about what you are experiencing and whether working together feels right for you.