Coping with a Panic Attack

Learn how to cope with panic attacks and reduce their severity and frequency.

People who struggle with panic attacks often wonder exactly how to deal with them. These attacks can be debilitating and difficult to control. The fear of them can make normal activities of life seem more daunting.

There are two key types of strategies that can be used for coping with panic attacks: strategies that help prevent panic attacks from occurring in the first place and strategies for helping alleviate or lessen panic attacks that are currently occurring. It can be difficult to control your actions and thoughts during a panic attack. By practicing coping strategies before a panic attack occurs, you will be better able to use them during an actual panic attack. 

1. Take Deep Breaths

During a panic attack, breathing tends to change from its normal pattern to quick, short, shallow breaths. This pattern of breathing is called hyperventilation and occurs as a result of the anxiety that happens during a panic attack. Hyperventilation can lead to low levels of carbon dioxide in the blood, creating several symptoms, including chest tightness, numbness of the lips and fingers and a feeling of faintness or lightheadedness. During the middle of a panic attack, these symptoms from hyperventilation cause anxiety to worsen, as these physical symptoms are very worrying to most people. 

By taking slow and deep breaths, you can avoid hyperventilation, reducing the feeling of chest tightness, numbness, and lightheadedness that can occur. This reduction in physical symptoms will, in turn, reduce your overall anxiety and give you more of a sense of control during the panic attack.

Breathing exercises for panic attacks focus on breathing slowly and deeply. The best way to practice deep breathing during a panic attack is to breathe in through your nose, deliberately taking your time and ensuring that your lungs are full. This inhalation should take about three to four seconds. Once you have inhaled, try to hold your breath for one or two seconds, then slowly exhale through your mouth, pursing your lips as you exhale like you are trying to blow out a candle. Exhaling should take about six to eight seconds. 

Because it will likely be difficult to actually follow this breathing pattern during a panic attack, it’s helpful to have a friend or family member who can help guide you through deep breathing techniques.

2. Limit Caffeine

There is a connection between caffeine and panic attacks. Caffeine increases chemicals in the body that are also created from anxiety. Using caffeine regularly has been shown to increase anxiety and will consequently increase the risk of different conditions that are caused by anxiety, including panic attacks. With the regular use of caffeine, panic attacks may be more likely to occur, and those with regular panic attacks may find that their panic attacks are more frequent and more severe. Evidence even shows that a  caffeine-induced panic attack may be caused when high doses of caffeine are used.

Limiting caffeine use can help reduce anxiety and panic attacks. If you do use high amounts of caffeine, consider cutting back. When possible, monitor how you respond to caffeine when you do drink it. If you find that many of your anxiety attacks occur within an hour of drinking caffeine, then you may need to consider completely eliminating caffeine from your diet.

3. Close Your Eyes

During a panic attack or in a situation where a panic attack could occur, anything that is stimulating can make your symptoms worse. Sitting down and closing your eyes can help drown out some of the stimuli and help you focus. Closing your eyes will also help reduce your attention on things in your environment that can cause fear and make your anxiety worse.

4. Recite an Internal Mantra

A mantra is a word or phrase that is repeated during prayer or meditation. It is used to help provide focus and avoid other distracting thoughts. During a panic attack, it can be very helpful to redirect and focus your thoughts on a particular mantra and avoid other, unhelpful thoughts and feelings. A mantra can be repeated internally in your thoughts or audibly if this helps more. 

There are numerous mantras that could be used, and the best mantra to use will be different for everyone. Some common panic attack mantras include:

• “It will be okay”
• “Calm down”
• “All is well”
• ‘You are loveable”
• “It’s not about me”
• “This too shall pass”

People who recite mantras during panic attacks often find that using a mantra in rhythm with their breathing can also help to better control their breathing while providing increased internal focus.

5. Find a Focus Object

Focusing on an object during a panic attack can help reduce intrusive thoughts or anxieties and can provide a way to shift attention to other stimuli and distractors. By focusing on a single object, you can achieve a better internal focus by avoiding dividing your attention between multiple thoughts. Focusing on an object includes looking at it, feeling it, and thinking about its shape, texture, color, and other physical features. 

An object that you focus on can be anything in your environment. There is no wrong type of object to focus on unless it increases your anxiety. Some people like to carry around a particular object that is small and portable to use to relieve their anxiety. If you choose something that helps remind you of your mantra or of another coping technique, it can be particularly helpful. Having a familiar object with you can provide a sense of comfort in the familiarity that it brings.

6. Exercise

Exercise can help reduce anxiety and subsequent panic attacks. Exercise releases chemicals in the brain called endorphins. These chemicals promote relaxation and well-being which leads to a reduction in anxiety. 

While many people may understand that exercise helps panic attacks, they are not sure of exactly where to start or how to best exercise. While vigorous exercise is definitely beneficial and can help to reduce anxiety, scientists who study how exercise influences anxiety say that anxiety can be reduced from just a 10-minute walk. While a more intense exercise routine could have more significant and lasting effects on anxiety, starting with some simple walks could be beneficial. 

7. Challenge Negative Thoughts

Intrusive negative thoughts are often present during panic attacks. Challenging these thoughts in a rational way can help reduce symptoms of anxiety 

A common negative thought experienced during a panic attack ist “I’m going to die from this.” Challenging this thought could involve stopping and taking the time to rationally evaluate this thought. This thought process could look something like: “Panic attacks don’t kill people. I have felt like this before, and it hasn’t hurt me. I will not die from a panic attack. I will be okay.”

In addition to challenging negative thoughts, people often find that focusing on and developing calming thoughts for panic attacks will help them when they experience panic attacks. These thoughts can include focusing on thoughts that are calming. For instance, thinking of a happy time with one’s family or a relaxing vacation can help replace negative thoughts and anxiety.

8. Face Your Fears

People who have panic attacks will often develop a fear of panic attacks. This fear can lead them to start avoiding situations they believe might cause a panic attack. Fear of panic attacks can sometimes lead to agoraphobia, a condition where people fear being in a situation that will trigger a panic attack. 

One of the most healthy ways to overcome fear, anxiety and panic attacks is to confront your fears. This may involve doing things outside your comfort zone that could cause panic attacks to occur. One of the best ways to confront fears is through acclimatization, a process of gradual adjustment.  Acclimatization should be done slowly and with support from someone who does not share the same fear. It is most successful when completed under the guidance of an experienced counselor or psychologist. 

9. Consider Medication

Sometimes, overcoming panic attacks may require medical support. Panic attack medication can help balance neurotransmitters that contribute to anxiety or mental health disorders that cause panic attacks.

Medication is not for everyone, and each medication has certain risks and benefits. Medications for panic attacks also only affect certain chemicals in the brain. Because of this specificity, using the wrong medication could make things worse. 

10. Practice Mindfulness

Mindfulness is the art of bringing your mind to focus on the present and often involves meditation. Mindfulness for panic attacks can best be practiced prior to a panic attack, but can also be practiced during a panic attack to reduce symptoms. 

Mindfulness meditation focuses on clearing one’s mind and focusing on the present. This meditation can be self-directed, where you practice focusing on the present by yourself in a quiet place, or it can be guided meditation, where a guide helps you clear your mind and focus on the present. For those who have never practiced meditation before, guided meditation is a good place to start.

While meditation may not be possible to practice during a panic attack, mindfulness can still be possible. This will involve dismissing thoughts and worries about the future or the past, and focusing on the present and thinking about your breathing.

If you or a loved one find that you are struggling to cope with panic attacks and are turning to drugs or alcohol to cope with them, then you may need professional help. The Recovery Village is experienced at helping those who struggle with co-occurring disorders. Reach out to one of our understanding team members to learn more about how we can help.

Editor – Megan Hull

Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more

Medically Reviewed By – Benjamin Caleb Williams, RN

Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more