What is happening in a panic attack
A panic attack is a sudden surge of intense fear with strong body symptoms: racing heart, shortness of breath, dizziness, shaking or chest tightness. It usually peaks within a few minutes and then settles.
Not dangerous
It feels frightening, but a panic attack is not life-threatening.
It passes
It settles on its own, usually within minutes, whatever you do.
Fighting feeds it
Running away or fighting the feeling makes it stronger. Staying put teaches your brain it is safe.
What to do while it is happening
- Stay where you are, if it is safe to do so.
- Slow your breathing. In gently through the nose for about 4 seconds, out slowly through the mouth for 4 to 6 seconds.
- Name it: "This is panic, not danger. It will pass."
- Look outward. Focus on one object, a sound, or what is around you.
- Use a coping line: "I have felt this before and it passed. I can handle this."
Breathing: practise when calm
Slow breathing calms the body's alarm response. It works best when practised daily, so it becomes automatic when panic arrives.
Sit or stand comfortably. Breathe in through the nose and let your stomach rise. Out slowly through the mouth.
Grounding: the 5-4-3-2-1 technique
Grounding pulls your attention out of racing thoughts and into the present moment. Say each one silently or out loud.
| Notice | For example |
|---|---|
| 5 things you can see | colours, shapes, objects |
| 4 things you can touch | chair, phone, fabric |
| 3 things you can hear | traffic, a fan, voices |
| 2 things you can smell | or 2 textures |
| 1 thing you can taste | or 1 slow breath |
Cut down your safety behaviours
Safety behaviours feel protective but keep panic going. Each one tells your brain the danger was real. Common ones are:
- Always carrying water
- Sitting near exits
- Avoiding exercise
- Checking your pulse
- Needing someone with you
Daily routine that lowers baseline anxiety
Move
Walking, running, swimming or yoga, most days.
Sleep
Keep a steady sleep and wake time.
Eat
Regular, balanced meals keep energy stable.
Cut back
Alcohol, nicotine and recreational drugs worsen anxiety.
Add one relaxation practice each day: breathing, stretching, mindfulness or a short walk.
When the worry is about your health
Checking your body, searching symptoms online and asking for reassurance bring short relief, but they keep health worries alive.
Reduce checking and reassurance-seeking
- Keep a one-week diary of how often you check your body, search symptoms or ask for reassurance.
- Reduce it gradually. If you check 10 times a day, aim for 8, then 6.
- Delay the urge. When you want to check or google, wait 10 to 15 minutes and do something else.
- Limit symptom searching. Set specific times, if at all, and use trusted sources only.
Swap the catastrophic thought for a balanced one
| Worry thought | More balanced thought |
|---|---|
| "This headache means I have a brain tumour." | "Headaches are common and usually not serious. I have had this before and it passed." |
| "My heart is racing, something is wrong." | "Anxiety can make the heart race. This has settled before and it will again." |
Ask yourself: What is the evidence for and against this thought? What would I tell a friend with this worry?
Reduce avoidance
Skipping exercise, appointments or social plans out of health fear keeps anxiety strong. List what you avoid, do the easiest one this week, then work up. Avoiding the gym for fear of a heart problem? Start with a 5-minute walk.
When to seek professional help
Professional support can speed recovery. Talk to a clinician if:
- Panic attacks are frequent, or you are avoiding many places and activities
- Health worries take over your day or cause significant distress
- You have chest pain, fainting or symptoms you are unsure about. Get medical advice first to rule out physical causes.
CBT (including guided self-help) is effective, and sometimes medication alongside therapy helps.
Quick reminder card
During panic
- Stay put.
- Breathe: in 4, out 4 to 6.
- Say: "This will pass. I am safe."
- Ground with 5-4-3-2-1.
Health worries
- Delay checking or googling 10 to 15 minutes.
- Write the worry, then a balanced thought.
- Do one avoided activity this week.
Daily basics
- Move your body.
- Sleep at regular times.
- Practise breathing once a day.