How to Stop a Panic Attack: What You Can Do Right Now

What "stopping" a panic attack really means

Cleveland Clinic says there is no way to immediately stop a panic attack right after it starts, but there are steps you can take to manage the symptoms until the attack resolves. The NHS says most panic attacks last between 5 and 20 minutes, and Cleveland Clinic says the symptoms usually peak within 10 minutes and then disappear soon after.

The NHS describes a panic attack as a rush of intense mental and physical symptoms that can come on very quickly and for no apparent reason. The National Institute of Mental Health (NIMH) says panic attacks themselves are not life-threatening and that the physical symptoms usually resolve with time.

So the realistic aim is not to make every sensation disappear at once. It is to get through the attack in a way that does not add to your fear.

You are not unusual. In a nationally representative survey of U.S. adults, Kessler and colleagues estimated that the lifetime prevalence of isolated panic attacks without agoraphobia was 22.7%, and that of panic disorder without agoraphobia was 3.7%.

Step 1: Breathe slowly and deeply

The NHS advice is to stay where you are, if possible, and breathe slowly and deeply. Cleveland Clinic says that hyperventilating is a symptom of panic attacks that can increase fear, and that deep breathing can reduce symptoms of panic during an attack.

Cleveland Clinic describes it this way: breathe in as slowly, deeply and gently as you can through your nose, then breathe out slowly through your mouth. Close your eyes and focus on your breathing.

• Breathe in through your nose, slowly and gently.
• Breathe out slowly through your mouth.
• The guided breathing circle on this site uses 4 seconds in and 6 seconds out, which is our own choice of pace.
• If counting feels impossible, just breathe slowly and focus on your breathing.

Step 2: Release the muscles that are bracing

Cleveland Clinic notes that anxiety attacks can cause you to tense your muscles, and suggests relaxing one muscle group at a time to reduce tension and stay present.

Drop your shoulders away from your ears. Let your jaw loosen. Open your hands and rest them on your legs.

Step 3: Name it and remind yourself it will pass

Cleveland Clinic says that knowing you are having a panic attack, and not a dangerous health episode, can help manage the fear, and suggests reminding yourself that the attack is temporary and will pass. The NHS gives the same advice: remind yourself that the attack will pass, and remember it is not life threatening.

You could say to yourself, silently or out loud: "This is a panic attack. It is unpleasant, but it will pass." The NHS also suggests focusing on positive, peaceful and relaxing images.

Step 4: Bring your attention to the present

Cleveland Clinic says a panic attack can make you feel detached from reality or your body, and suggests practising mindfulness and focusing on the present to centre your thoughts and ground yourself.

One way to do that is to pick three objects you can see and describe each one silently in detail: color, shape, texture. If you can, press your feet into the floor and notice the pressure. The full 5-4-3-2-1 exercise is in our grounding guide. None of the sources on this page tests that exercise, so treat it as something to try rather than a treatment.

Why avoidance and safety behaviours can keep panic going

The NHS says people with panic disorder may start to avoid certain situations because they fear they will trigger another attack, which can create a cycle of living "in fear of fear" that adds to the sense of panic and may cause more attacks.

A 1999 experiment by Salkovskis and colleagues studied a related idea in patients with panic disorder with agoraphobia. The researchers tested the idea that safety-seeking behaviours help to maintain anxiety because they prevent people from learning from experience. In the study, patients who stopped their safety-seeking behaviours during a 15-minute period of exposure showed a significantly greater decrease in catastrophic beliefs and anxiety, when tested again within two days, than patients who kept using them. This was a clinic experiment, not a self-help trial, so it does not tell you what to do in the middle of an attack. If you notice you are avoiding places or relying on routines to feel safe, that is worth discussing with a doctor.

What one breathing study tested

Balban and colleagues ran a randomized, controlled study in which people did a daily 5-minute breathing exercise, or 5 minutes of mindfulness meditation, for a month. They report that breathwork, especially the exhale-focused cyclic sighing, produced greater improvement in mood and a greater reduction in respiratory rate than mindfulness meditation.

That study measured mood, anxiety and physical arousal. It was not about panic attacks, most participants were recruited from an undergraduate psychology class at Stanford University, and it did not test the slow breathing described by the NHS or Cleveland Clinic. It shows that short, regular breathing practice can be worth trying, not that any method will stop a panic attack.

Things that can make attacks worse

The NHS says to avoid sugary food and drinks, caffeine and alcohol, and to stop smoking, as they can all make panic attacks worse. Cleveland Clinic gives the same advice to avoid caffeine, alcohol and smoking, and also says to talk to your provider before taking herbal supplements or over-the-counter medications, because certain substances can increase anxiety.

Is it a panic attack or a medical emergency?

Panic attacks and heart problems can share symptoms. The American Heart Association (AHA) article lists chest pain, heart palpitations, shortness of breath, lightheadedness and nausea, and quotes a cardiologist, Dr. Glenn N. Levine: "If in doubt, one would want to err on the side of caution and be quickly evaluated in an ER to make sure this was not a heart attack." He also says that when in doubt, get symptoms checked out.

Cleveland Clinic says that if you have chest pain, trouble breathing or lose consciousness, you should seek emergency medical care, and that you should call a healthcare provider if panic attack symptoms last longer than 15 minutes. The NHS heart attack page says to call 999 in the UK if you have chest pain that feels tight or like squeezing on your chest, chest pain that is spreading to your arms, neck or jaw, severe difficulty breathing (gasping, choking or not able to get words out), pale, blue or grey lips or skin, or if someone has passed out and is not responding normally. In the U.S., the AHA article says that for a heart attack, calling 911 and getting immediate treatment is critical.

If you ever have thoughts of harming yourself, contact emergency services or a crisis line straight away. In the U.S., you can call or text 988 (NIMH).

After it passes: the next 30 minutes

NIMH says the physical symptoms usually resolve with time. The sources on this page do not describe how people feel in the hours after an attack, so take it easy and treat yourself gently.

Later, it can help to make a note of what was happening before the attack, without judging yourself, so you can describe it to a doctor if you decide to see one. The NHS says a GP will ask you to describe your symptoms, how often you get them and how long you have had them.

If panic attacks keep happening

NIMH says an isolated panic attack is not a mental disorder, and that panic attacks can occur as frequently as several times a day or as rarely as a few times a year. This page is self-help and cannot say whether you have a condition.

For everyday habits, the NHS lists reading a self-help book for anxiety based on cognitive behavioural therapy (CBT, which it suggests asking your GP to recommend), activities like yoga and pilates, breathing exercises for stress, and regular physical exercise to reduce stress and tension.

The NHS says to see a GP if you have been experiencing symptoms of panic disorder, and that panic disorder is treatable, so it is best to get medical help as soon as you can. If you take a prescribed medicine, the NHS says to keep taking it even if you feel it is not working, and to stop only if your GP advises you to. NIMH says that if anxiety starts to cause problems in everyday life, such as at school, at work or with friends and family, it is time to seek professional help.