What to Do When You’re Having a Panic Attack

If you suffer from panic attacks, you know they can be frightening, obtrusive, unpredictable and exhausting. You may experience a pounding heart, find yourself sweating, feel intense fear or anxiety, struggle to catch your breath and/or tremble and shake. If this sounds familiar, my first advice is to seek the support of a therapist that has training in trauma. Panic attacks aren’t always caused by trauma (hormonal changes, for example, can increase your likelihood of having anxiety and possibly panic attacks), but no matter what the initial cause of your panic attacks, a therapist trained in trauma will be able to support you in handling them. I have had many clients who came to me with frequent (2-3 times per week) panic attacks who now no longer experience them, with the only treatment being our talk therapy work together. So, now I will get off my soap box about how well therapy works and get you the information you came here to learn: what to do when a panic attack strikes?

The first and most important thing to remember is that the height of a panic attack will not last longer than about 10 minutes. So as the attack starts, take a look at the clock. If in 20 minutes you look up and you’re not feeling any better (you may still not feel great, but your symptoms should have declined at this point), then you may want to seek the help of a medical professional as this could be something other than a panic attack.

During that 10-minute period, here are some things you can do to help sooth yourself and decrease the symptoms. Try these out liberally and just see what works for you. My clients typically find 2-3 favorites that they use every time they are feeling anxious.

Sit in a chair with both your feet flat on the floor. Notice what it feels like to have your feet on the floor. Can you feel what parts of your foot connect with the ground? What does that feel like? Just spend a few moments noticing it.
While still seated, look around the room and notice where the door is. Just give your brain a moment to take that information in. Then look into the upper corners of the room. All you’re doing is noticing what is around you. Finally, turn and look at what is behind you (even if your back is to a wall). Essentially what we’re doing here is reminding the reptilian part of the brain that you are in a place that is safe and there is nothing behind you that can hurt you. Sounds a little crazy, I know, but that part of your brain is a very “proof is in the pudding” part of us, and it won’t work to just tell yourself that you’re safe. This part of the brain needs to see it to believe it.
Use your hands to squeeze around all the edges on your body. Not exactly hugging yourself, but making lightly pressured contact with your skin all down your shoulders, arms, hips and legs.
Take your left hand and put it on your forehead. Then, take your right hand and cup the base of your head at the nape of your neck. Remind yourself that your thoughts are only present in this small space between your two hands.
Spend several moments bringing your awareness to your senses in a mindful way. Notice what the temperature is in the room you are in. Can you feel the cool or warm air? Can you feel a breeze on your skin? Now notice if you can feel your clothing against your skin. Just notice what it feels like. Can you feel where your body is in contact with the chair you’re sitting in?
Try this breathing exercise. Breath in for three beats. Hold your breath for four beats, then out for six beats. It will help your nervous system move from the sympathetic to parasympathetic. The parasympathetic nervous system is engaged when we are relaxed and in a resting phase. When we are in fight or flight mode (which is happening during a panic attack), the sympathetic nervous system is active. This breathing exercise might prevent your nervous system from staying stuck in the sympathetic side.