What to Do During a Panic Attack Right Now

First: what is happening in your body

A panic attack is a sudden surge of intense fear or discomfort that builds to a peak within minutes. It is your body's alarm system, the fight-or-flight response, firing when there is no real danger to fight or run from. Adrenaline speeds up your heart, your breathing gets faster and shallower, your muscles tense, and your attention locks onto anything that feels threatening, including the sensations themselves.

That last part matters most. A racing heart gets read as "something is wrong with my heart", which adds fear, which adds more adrenaline. Most of what keeps a panic attack going is this loop between body sensations and frightening interpretations of them. You cannot switch adrenaline off by force, but you can stop feeding the loop. That is what the steps below do.

You are also not unusual. In a large U.S. survey, more than a quarter of adults reported having had at least one panic attack in their lifetime, and most of them never developed an ongoing panic disorder. According to the NHS, most panic attacks last between 5 and 20 minutes.

Step 1: Slow the exhale, not the inhale

During panic, breathing speeds up and moves into the upper chest. Over-breathing blows off carbon dioxide faster than your body makes it, and low carbon dioxide is what produces the dizziness, tingling fingers, and "I can't get enough air" feeling. Gulping bigger breaths usually makes this worse.

Instead, breathe in gently through your nose for about 4 seconds, then breathe out slowly through slightly pursed lips for about 6 seconds. That works out to roughly six breaths a minute, a pace that research on heart rate variability links with stronger parasympathetic ("rest and digest") activity. Keep the inhale small and quiet. The exhale does the work.

• Inhale through the nose for a count of 4. Do not fill up completely.
• Exhale through pursed lips for a count of 6, like cooling soup.
• Repeat for at least 90 seconds before judging whether it is working.
• If counting feels impossible, just make each exhale a little longer than the inhale.

Step 2: Release the muscles that are bracing

Fear makes the body brace: raised shoulders, a locked jaw, clenched fists, a tight stomach. Tense chest and shoulder muscles make breathing feel harder and add to the pressure in your chest. Letting them go sends a "no threat here" signal back to the brain.

Drop your shoulders away from your ears on an exhale. Let your jaw hang slightly open with your tongue resting on the floor of your mouth. Open your hands and rest them palms-up on your legs. If you are standing, lean against a wall so your legs do not have to hold you rigid.

Step 3: Name it and let it run its course

It sounds backwards, but trying to make the feeling stop immediately tends to prolong it. When you fight the sensations, your brain treats them as a genuine emergency. When you label them accurately, you remove the fuel.

Say to yourself, silently or out loud: "This is a panic attack. It is adrenaline. It is unpleasant, but it is not dangerous, and it will pass on its own." Then give it permission to be there for a few minutes while you keep breathing slowly. Many people notice the peak starts to soften soon after they stop trying to escape it.

Step 4: Move your attention outside your body

Panic narrows attention inward, onto the heartbeat, the chest, the next breath. Deliberately widening your attention to the room gives your brain something neutral to process.

Pick three objects you can see and describe each one silently in detail: color, shape, texture, what it is made of. If you can, press your feet into the floor and notice the pressure. The full 5-4-3-2-1 version of this exercise is in our grounding guide.

What not to do during a panic attack

Some common instincts make panic attacks stronger or more likely to come back.

• Do not breathe into a paper bag. It is no longer recommended and can be unsafe if the cause is actually a heart or lung problem.
• Do not take big gulping breaths. They worsen the low-carbon-dioxide symptoms.
• Do not search your symptoms mid-attack. Reading worst-case explanations adds fuel.
• Avoid caffeine, energy drinks, and nicotine for the rest of the day. Stimulants mimic panic sensations.
• Avoid using alcohol to calm down. It can cause rebound anxiety a few hours later.
• Try not to flee the situation if you are physically safe. Leaving teaches your brain the place was dangerous.

Is it a panic attack or a medical emergency?

Panic attacks and heart problems can share symptoms: chest pain, a racing heart, shortness of breath, sweating, and nausea. Doctors do not expect you to tell them apart on your own. The American Heart Association advises that when in doubt, you should get checked.

Call your local emergency number (911 in the U.S., 999 in the UK, 112 in the EU) if any of the following applies:

• This is the first time you have felt anything like this.
• Chest pain or pressure spreads to your arm, jaw, neck, or back.
• You have known heart disease, diabetes, or several heart risk factors, and the pain feels different from your usual panic.
• You faint, or symptoms continue to get worse after 20 to 30 minutes instead of easing.
• You have one-sided weakness, facial drooping, or slurred speech.
• You have thoughts of harming yourself. In the U.S., you can also call or text 988.

After it passes: the next 30 minutes

Once the peak is over, it is common to feel shaky, drained, or tearful, and to have a lingering sense of unease for an hour or more. That is the after-effect of the adrenaline and is not a sign that another attack is coming.

Drink some water, eat something small if you have not eaten, and if possible go back to what you were doing. Returning to the activity, even briefly, teaches your brain that the situation was survivable. Later, it can help to note what was happening before the attack, without judging yourself. Patterns such as poor sleep, caffeine, or a particular place are useful information for preventing the next one.

If panic attacks keep happening

One panic attack does not mean you have a disorder. But if attacks keep coming back and you find yourself worrying about the next one or avoiding places because of them, that pattern may be panic disorder. It affects around 2 to 3 percent of adults each year, according to NIMH, and it is very treatable.

Clinical guidelines from NICE in the UK recommend starting with structured self-help based on cognitive behavioral therapy (CBT), followed by therapist-led CBT if needed. Some people are also offered an SSRI antidepressant. A doctor can also rule out physical causes such as thyroid problems or heart rhythm issues, which is worth doing at least once.