Panic Attack Treatment: 12 Ways to Stop a Panic Attack

What Is a Panic Attack?

A panic attack is a sudden and significantly distressing surge of fear or anxiety.¹ It is often accompanied by physical symptoms, such as trembling, choking, dizziness, and losing control. Panic attacks typically last between 5 and 20 minutes. Individuals who are not experienced with having a panic attack often confuse it for a heart attack.

Common panic attack symptoms include:

• Palpitations, pounding heart, or accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath or smothering
• Feelings of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, light-headed, or faint
• Chills or heat sensations
• Paresthesias (numbness or tingling sensations)
• Derealization or depersonalization
• Fear of losing control or “going crazy”
• Fear of dying¹

What Does a Panic Attack Feel Like?

Panic attacks often feel like an overwhelming and impending sense of doom. Common emotional symptoms include a sense of dying, feeling like you are having a heart attack, or “going crazy.” Additionally, people also experience physical symptoms that keep the panic attack cycle going; these physical symptoms increase the emotional symptoms and associated anxiety. Common physical symptoms include sweating, shaking, fast heart rate, or hyperventilation.

Causes of Panic Attacks

There is no singular cause for panic attacks. At times, there is a clear trigger for the anxiety and subsequent panic attack, while at other times, they may spring upon you unexpectedly. Trying to control everything that may cause a panic attack could even cause its own panic attack! However, there are some factors that can increase your likelihood of experiencing panic attacks.

You’re more likely to experience panic attacks if you also:

• Have a history in the family of panic attacks
• Have an anxiety disorder
• Have panic disorder
• Have a substance use disorder
• Have a depressive disorder
• Have experienced severe trauma
• Experience specific phobias
• Consume caffeine in excess
• Have a lack of coping skills¹

How to Stop a Panic Attack

There are many strategies that can be utilized to stop a panic attack, such as mindfulness and breathwork. Strategies are not one-size-fits-all, and it is important to find strategies that work for you. No matter what you choose to focus on, consistency is crucial.  If you wait to try these methods once you are having a severe panic attack, they will not help.

Depending on the setting of the panic attack, different strategies may be necessary. For example, if you are having a panic attack while driving, it would be important to pull over and park your car to allow time to deal with it. You may need to rely more heavily on mindfulness-based strategies to address your panic attack. If you are at home, you have easier access to comforting objects or settings.

Here are twelve ways to stop a panic attack:

1. Acknowledge You’re Having a Panic Attack

Giving voice to your experiences can help reduce panic attack symptoms. Doing this can help to order your thoughts and address your situation head-on. You may find that naming your situation can help to differentiate it from a heart attack, especially helpful if you also deal with cardiophobia. Describing your symptoms and linking it to your situation can help you slow down your experience.

2. Use Deep Breathing

Breathing exercises for anxiety, such as 4-7-8 breathing, is a good practice to build in calmer moments, but during a panic attack, controlling breathing can be an incredibly vital skill. A common symptom of panic attacks is hyperventilation, which can increase fear and anxiety during your panic attack. Deep breathing can help return this symptom back to more typical levels and calm your panic attack.¹

3. Practice Mindfulness

Practicing mindfulness for anxiety has been shown to be particularly helpful with panic disorder. This is especially true for people who have treatment-resistant anxiety.² Mindfulness can help to address changes like dizziness and dissociation. It does so by bringing focus back to the body and helping notice changes. From there, you can describe your situation better or make intentional choices to address what is happening in your body.

4. Set a Timer

Studies indicate that most panic attacks last between five to twenty minutes, although for the person having a panic attack, they can seem as if they are lasting forever. Sometimes, setting a timer can remind you to allow time to take its course. This may pair well with a breathing exercise or mindfulness activity, where you can check back in with yourself after five-minute intervals until you get to twenty minutes. Over time, you may be able to recognize how your panic attacks tend to show up and how long they tend to last.

5. Begin a Focused Meditation

Trying to meditate during a panic attack would be extremely difficult. However, it is possible if you have practiced meditation during calmer moments, making it accessible to you during a panic attack. Focused meditation helps you reset yourself during a panic attack and helps you return to a calmer state of mind. Meditation is a valuable tool to help during a panic attack, helping you feel more in control.

Meditation is not just for sitting down cross-legged with your hands to the side. You can meditate when walking, standing up in a crowded space, or lying down on your bed—in fact, you can practice it anywhere at all. Practice is important, but meditation can help you come to a peaceful place in your body during a panic attack.

6. Repeat a Positive Mantra

Positive mantras are phrases that can offer comfort and affirmation during panic attacks. They give your brain a place to focus, which may offer temporary relief and distraction from anxiety. For example, “This feeling will pass” or “I am strong enough to handle this.”

Mantras can also be a place to tie in your sense of faith and spirituality to help with your anxiety. For example, your religion or your relationship to your deity, deities, or The Universe can be incorporated into mantras to offer you a sense of belonging during times of panic.

7. Try Progressive Muscle Relaxation

Progressive muscle relaxation is a process of systematically tensing and relaxing muscles. It is a good way to draw your focus into your body during a panic attack, slowing your heart rate and thereby reducing your anxiety.³ If you are having a panic attack and want to try this, begin by tensing the muscles in your neck. After holding for a brief time, relax this tension. Then, move down to your shoulders, arms, core, legs, and so on. This can be repeated as necessary.

8. Do a Guided Imagery Meditation

Guided imagery for anxiety involves focusing on a series of images meant to be relaxing and calming in order to reduce your panic symptoms.⁴ This process can help bring your mind to a place of stability that allows your body to relax. There are a variety of images you can picture, such as a protective force field surrounding you or a calming walk in the woods. None are specifically better than the other, and you can choose your own.

9. Find a Focus Object

When you are experiencing a panic attack, it can be hard to feel connected to your body. One technique that can help address this panic symptom is to find an object in your field of view and focus on it. You could choose a poster, a tree, or even something like a pencil. Doing this is similar to guided imagery, except the focus object is one you can see rather than something you focus on in your mind.

10. Ground Yourself

Grounding techniques for panic attacks can help you connect with your body and use those sense experiences to reset your body’s response to panic attacks.⁵ Grounding is a kind of exercise that helps keep you where you are. One example of grounding would be to notice the texture of your pants with your hand. Notice the feeling on your leg and your hand while you touch your pants. Do this to draw focus to that part of your body, away from parts that feel like panic.

11. Use Movement as Distraction

Moving your body can offer both a distraction from anxious thoughts and relief from physical symptoms. Sometimes, when people are caught in a cycle of panic, their body and mind keep reacting to the physical sensations of panic. This stops the panic attack from ending.

Going outside for a walk may slightly raise your heart rate, but if you are simply sitting on the couch and having a panic attack, your body is more likely to mistakenly read the physical sensations of panicking as a threat. Walking can also provide a sensory distraction and bilateral stimulation, two other common interventions for anxiety and panic.

12. Take a Prescribed Anti-Anxiety Medication

If you are prescribed benzodiazepines, such as Valium or Xanax, the beginning of a panic attack is the correct time to use the medication. Over time, you may learn when it is necessary to use your rescue medication and when there are times that you can use other coping skills to deal with the panic attack. Remember to always follow your doctor’s specific instructions regarding dosage.

How to Prevent Panic Attacks in the Future

Aside from immediate coping skills, there are many strategies you can use to decrease the severity and frequency of panic symptoms. These include therapy, medication management, and lifestyle changes. There is no right way to do this, and what works may vary from person to person.

Here are several panic attack treatments to help prevent and manage panic disorder:

Identify Possible Triggers

When you notice a panic attack is beginning, try to identify what has happened to set it off. It may not prevent this panic attack, but even noticing it can help you protect yourself from future panic attacks. By noticing these triggers, you can be better prepared and plan how to address them.

Begin Counseling or Therapy

Panic attacks are overwhelming, and you do not need to go through them alone. Finding a counselor or a therapist is an excellent first step to reducing panic symptoms. Talk with a professional, and let them help you treat your panic disorder and decrease the panic disorder’s severity and frequency in your life.

Here are some effective types of therapy for panic attacks to explore:

• Cognitive behavioral therapy (CBT): CBT for panic disorder is considered a first-line intervention for panic disorder.⁶ CBT works to address panic disorders by challenging thoughts and helping to connect triggers with helpful coping skills.
• Exposure therapy: Exposure therapy for anxiety works to introduce potential triggers to help decrease trigger response gradually. It slowly gets you used to things that can cause a panic attack. This can help make your anxiety less likely to cause a panic attack. Exposure therapy can help people specifically as avoidance behaviors and fears interact with their panic disorder and has shown to be very effective.^{7, 8}
• Panic-focused psychodynamic psychotherapy (PPFP): Psychoanalysis is one of the earliest forms of psychotherapy, and PPFP was designed particularly as an alternative to CBT for panic disorder. PPFP works by focusing on what your feelings could mean and how those feelings shape your thinking.⁹

An online therapist directory is a great way to find a therapist in your area who specializes in treating anxiety and panic disorders. You can also ask your general practitioner or your friends and family for a referral. If your panic makes it difficult to leave your home, an online therapy service is a good alternative.

Consider Anxiety Medication

For individuals with severe symptoms of panic disorder, anxiety medications can provide the quickest relief and restore a sense of control. It is important to pair medication with therapy because while medication is the fastest-acting medicine, therapy can provide a person with a deeper insight into what they are struggling with panic attacks.

It is important to find a psychiatrist who is familiar with panic disorders and whom you feel safe with. Your healthcare provider, therapist, and/or loved ones can all provide you with referrals. Alternatively, if panic makes it difficult to leave home, you can take advantage of online psychiatry platforms, which make anxiety medication management incredibly easy.

Here are some medications commonly used for panic disorder:

• Selective serotonin reuptake inhibitors (SSRIs): SSRIs are the most common first-line treatment (meaning it is prescribed first) and are widely seen as the most effective pharmacological support for panic disorder.¹⁰
• Benzodiazepines: Benzodiazepines are a common class of medications used to treat panic disorder.¹¹ However, some clinicians prefer other options, specifically antidepressants, due to the addictive properties of benzodiazepines.¹²
• Serotonin-norepinephrine reuptake inhibitor (SNRI): SNRIs, specifically Effexor (venlafaxine) have been shown to be effective at treating panic disorder specifically.¹³

Make Healthy Lifestyle Changes

In addition to therapy and medication, small adjustments to a person’s routine can help to reduce the number and frequency of panic attacks they are having. Some of these changes are behavioral, such as exercising more and decreasing caffeine intake. Other changes are psychological, such as becoming more willing to ask for and accept support from others.

Here are some lifestyle changes that can help with panic attacks:

• Reduce your coffee (or caffeinated tea) intake: Caffeine increases anxiety by releasing stress hormones like adrenaline and cortisol. Therefore, limiting caffeine intake can decrease a person’s anxiety and reduce the likelihood of a panic attack.¹⁴
• Focus on nutrition: Food can impact anxiety. Nutrients like omega-3 fatty acids, magnesium, and B vitamins can regulate mood. Conversely, foods high in processed sugar can cause blood spikes, which increase cortisol in the body and put a person at higher risk for panic attacks.
• Increase the quality and amount of sleep: Sleep regulates stress, and a lack of sleep can increase a person’s anxiety and panic. Improving sleep hygiene can go a long way in decreasing panic symptoms. Some tips include buying blackout currents, finding a soothing noise machine, and leaving your phone to charge outside the bedroom.
• Incorporate supplements: There are several supplements that can decrease anxiety, such as magnesium, GABA, and l-theanine, that can possibly decrease anxiety and thereby reduce the risk of panic attacks.
• Exercise: Exercise helps to reduce anxiety and increase “happy” chemicals like endorphin, which can lower a person’s risk of panic attacks.¹⁵