What to Do During a Panic Attack: Effective 3-Step Strategy for Coping

Panic attacks are a form of extreme, heightened anxiety that turn on the body’s fight-or-flight response without warning or the presence of real danger. There are a variety of reasons as to why a person may experience symptoms of a panic attack, such as medical conditions, an anxiety disorder, lifestyle habits, prolonged stress, caffeine, and intense exercise, to name a few. Throughout the following paragraphs, we’ll discuss what you should do during a panic attack, and how to prevent them from happening as frequently.

Key takeaways:

Panic attacks can be just as scary as they are unpleasant. Unfortunately, 11% of the U.S. population experiences a panic attack each year. The symptoms can come on without warning, and some describe the experience as feeling like they are going to die. As debilitating and scary as panic attacks can feel, they are not dangerous, and the symptoms will generally subside within a few minutes to half an hour, with lingering effects that can last up to a few hours.

3-step strategy to cope with panic attacks

Should you worry that you may experience a panic attack, or if you’ve had one before, there are some techniques that you can adopt to help better cope in the face of an attack, as well as lifestyle habits that can be incorporated into your day-to-day routine that can lessen their prevalence.

Step 1. Self-soothing self-talk

Should you find yourself having a panic attack, the first thing that you should do is to consciously remind yourself that you are safe, you aren’t dying or going crazy, and you don’t need to go to the ER. You’re merely experiencing symptoms that are being caused by anxiety, but you are not in any real or present danger. Once you are able to become cognizant of what is happening to your body, your anxiety should begin to de-escalate enough for you to implement the next two coping techniques: breathing exercises and the 333 rule.

Step 2. Breathing exercises

One of the best ways to help your body calm down, recenter, and become grounded in the face of a panic attack is by engaging in deep breathing exercises. This involves breathing in deeply through your nose and breathing out deeply through your mouth. It’s important to breathe slowly, as rapid breathing can add fuel to the fire of your panic attack symptoms. It may help to breathe slowly into a bag or to sit in the fetal position on the ground until you are able to reduce your anxiety enough to focus on grounding.

Breathing exercise

Step 3. The 333 mindfulness rule

After slowing down your breath, make a conscious effort to observe your surroundings and move three different body parts and focus on three different objects and three different sounds in your environment. This will help to focus your mind and help you to feel grounded and less anxious. This mindfulness technique can help you get out of the thick of your panic attack symptoms enough so that you can stand up, relocate, call a friend, or regroup in a quiet space if you are in a public place.

Mindfulness rule

What to do after a panic attack

Following a panic attack, it may help you to speak with a trusted friend or a therapist. Cognitive-behavioral therapy (CBT) has been found to help reduce panic attacks and symptoms of anxiety.

There are also some lifestyle changes that you can make that can help reduce the likelihood of having a panic attack, such as reducing or eliminating:

  • Caffeine
  • Alcohol
  • Tobacco

Developing positive habits:

  1. Engaging in regular exercise
  2. Eating healthy
  3. Engaging in daily mindfulness or meditation exercises
  4. Practice self-care routine

When to see a medical doctor

There are times when symptoms of anxiety or panic are being caused by a medical condition, so before you see a psychiatrist and ask for anti-anxiety medication, it’s important to see your primary care physician to rule out any pre-existing medical conditions that may be causing the panic attacks.

A good therapist will also recommend this, regardless of whether or not you'd like medication, and before referring you to a psychiatrist for meds. Combining medication with therapy has been shown by research to be the most effective defense. Once it is determined that there aren’t any medical conditions causing your symptoms, a psychiatrist should be seen if you feel like you need some extra help to combat symptoms of panic and anxiety.

For daily management of anxiety, a selective serotonin reuptake inhibitor (SSRI) is typically prescribed, and for help managing symptoms of a panic attack, a benzodiazepine may be prescribed to take as needed. Talk to your doctor and psychiatrist to see which options are best for you. It’s always wisest to engage in therapy while taking any sort of psychotropic medication, as the goal of treatment is to improve over time and learn to manage your symptoms without the aid of a therapist or medication.

Merely depending on a medication to take every day without developing healthy coping skills to manage your symptoms is really only masking the issue at the end of the day. It's also important to only take certain medications as needed, as some medications, such as benzodiazepines, can be highly addictive, and withdrawal symptoms can be fatal.

If you or someone you love has experienced a panic attack, it’s important to seek professional help from a trained, licensed therapist paired with a visit to a medical doctor and psychiatrist. Refraining from seeking help can cause the fear and anxiety surrounding having another panic attack to build up, and this can turn into agoraphobia if left untreated.

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Tom Bunn LCSW
prefix 11 months ago
Completely useless. In a state of panic, a person is overwhelmed. ANYTHING the person tries to do puts the overwhelm over the top and makes the attack worse and longer. Panic can be cured only by training the mind to automatically activate the parasympathetic nervous system in responses to the physical sensations that arise as panic begins.

As to CBT, research shows only 16% of patients who receive six to eight sessions CBT become free of panic. In a state of panic, the cognition CBT requires is not available.