A panic attack can feel frightening precisely because it arrives so suddenly: your heart pounds, your breathing quickens, your chest tightens, and a powerful sense of danger takes hold — even when you are, in fact, safe. Many people fear they are having a heart attack, losing control, or about to faint. Those fears are understandable, and they are also part of what keeps the surge going.
The good news is that a panic attack, however intense, is time-limited, and there are practical things you can do while it is happening to ride it out more steadily. This article explains what is happening in your body, shares in-the-moment techniques you can practise, and helps you plan what to do after the surge passes.
What the research says
Cognitive behavioural therapy (CBT) explains panic as a cycle in which ordinary body sensations are misread as danger. A slightly faster heartbeat, a moment of breathlessness or a wave of dizziness is noticed, interpreted as a sign of catastrophe, and that interpretation triggers more arousal — which produces more sensations. Learning this cycle alone reduces fear for many people, because the sensations stop feeling like proof of imminent disaster and start to make sense as a false alarm.
Research on relaxation also shows that slow breathing with an extended out-breath lowers physiological arousal. That is why breathing techniques help: they do not force calm, but they gently signal to the body that the alarm can stand down. Grounding attention in present-day senses works in a similar way — it interrupts catastrophic spirals by bringing attention back to what is actually happening around you, rather than what might happen next.
Finally, planned exposure to feared sensations — known as interoceptive exposure — is effective for panic, but it should be done with a professional. Deliberately bringing on sensations such as dizziness or a racing heart can be distressing if done alone or too quickly, so this article focuses on safe, in-the-moment coping, and leaves structured exposure to guided therapy.
In the moment: a step-by-step sequence
Practise these steps when you are calm first, so they are familiar when you need them. During an attack, use them in order and give each one a little time. You do not need to do them perfectly; doing something steady is enough.
1. Name what is happening
Say to yourself, silently or aloud: “This is a panic attack. It feels dangerous, but it is a false alarm. It will pass.” Naming it matters because it interrupts the story that something terrible is happening right now. Remind yourself of what you know: panic peaks and then falls, even if you do nothing at all. You are not in immediate danger because your body is alarmed; your body is alarmed because it has misread a signal.
2. Slow your breathing, with a longer out-breath
Place one hand on your chest and one on your stomach if that helps. Breathe in gently through your nose for a count of four, then breathe out slowly through pursed lips for a count of six. Keep your shoulders relaxed and your breathing comfortable, not forced. If counting feels hard, simply aim to make each out-breath a little longer than the in-breath. Practise for two to three minutes. If breathing exercises make you feel dizzy or more panicked, stop and move to grounding instead — breathing techniques should help, not become another struggle.
3. Ground yourself with your senses
Look around and silently name five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste. Press your feet firmly into the floor, hold something cool or textured, or run cold water over your wrists. The point is not distraction for its own sake; it is to anchor your attention in the present room, the present chair, the present moment — evidence that you are here and safe, even while your body is sounding an alarm.
4. Use steady, realistic self-talk
Replace catastrophic thoughts with short, believable sentences: “My heart is beating fast because adrenaline is high. That is uncomfortable, not dangerous.” “I have felt this before and it passed.” “I can stay here until the wave eases.” Avoid arguing with yourself or demanding instant calm. Speak to yourself as you would to a frightened friend: firmly, kindly, and with facts rather than reassurance that everything will be perfect.
5. Stay, rather than flee, if you safely can
Leaving a place in a rush can bring quick relief, but it can also teach your brain that the place was dangerous, making the next visit harder. If you are safe, try to stay where you are until the peak passes, even if you sit quietly, sip water, or step to a calmer corner of the same room. If you genuinely need to leave — for example, to get fresh air or privacy — do so slowly and plan to return another day, rather than avoiding the place altogether.
6. Ride the wave and let it fall
Imagine the panic as a wave: it rises, crests, and falls. Fighting it — tensing, gasping, scanning your body constantly — often prolongs it. Instead, allow the sensations to be there while you keep breathing slowly and grounding yourself. Notice, without judgement, that the intensity changes from minute to minute. Most surges ease within a few minutes, and the skills above help you get through those minutes with less fear.
After the attack: a short recovery routine
Once the surge eases, drink some water, sit for a few minutes, and move gently — a slow walk or a stretch. Avoid immediately analysing every sensation or searching online for worst-case explanations, which can restart the cycle. Later, when you feel steadier, note briefly what happened: where you were, what you noticed first, what helped, and what you would try next time. This record turns a frightening experience into useful information, and it is exactly the kind of detail a therapist can use to help you further.
Preparing between attacks
Between attacks, build habits that lower your baseline arousal: regular sleep, moderate caffeine, gentle daily movement, and a short daily breathing practice when you are calm. Learn your early warning signs — a tight chest, restlessness, or a particular thought — so you can start the sequence earlier next time. Tell a trusted person what helps you, so they can sit with you calmly rather than rushing to fix the situation. Preparation does not guarantee you will never panic again, but it does mean you will not face the next surge unarmed.
When to seek professional help
Seek professional help if panic attacks keep happening, if you start avoiding places, journeys or activities for fear of panicking, or if worry about the next attack is shrinking your life. You can learn more about professional support on the panic attacks therapy page and in our earlier article, Panic Attacks: What Is Happening in Your Body, and How Therapy Helps. Seek urgent medical help if you have chest pain, breathlessness or other new physical symptoms and are unsure of the cause, and seek emergency help if you feel unsafe or are thinking of harming yourself.
You can learn to ride it out
Panic feels overwhelming because your body is doing its job too loudly. With understanding, slow breathing, grounding and steady self-talk, you can learn to meet the surge without being carried away by it — and with professional guidance, you can address the cycle at its root.
Therapy with Anjum — by Anjum Mehmood Siddiqui, Consultant Clinical Psychologist, Personality Analyst and Psychotherapist. Therapy in Islamabad, Rawalpindi and online.
To take a first step, book an appointment with Therapy with Anjum today.
Disclaimer: This article is general information only. It is not a diagnosis and is not a substitute for professional care. If you feel unsafe or are thinking of harming yourself, please seek emergency help immediately.