If you’re having a panic attack, you can manage your symptoms in the moment with strategies like deep breathing, mindfulness exercises, muscle relaxation, and more. Working with a therapist may help prevent future panic attacks.

Panic attacks are sudden, intense surges of fear, panic, or anxiety. They are overwhelming, and they have physical as well as emotional symptoms.

If you have a panic attack, you might have difficulty breathing, sweat profusely, tremble, and you may feel your heart pounding.

Some people will also experience chest pain and a feeling of detachment from reality or themselves during a panic attack, so they may think they’re having a heart attack. Others have reported feeling like they’re having a stroke.

The Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5) defines a panic attack as “an abrupt surge of intense fear or discomfort.”

They tend to start without warning, and symptoms reach a peak within minutes.

Panic attacks can be scary and may hit you quickly. Here are 12 strategies you can use to try to stop or manage panic attacks. Some may help you in the moment, while others can help in the longer term.

Cognitive-behavioral therapy (CBT) and other types of counseling can often help people who have panic attacks and who have panic disorders. CBT aims to help you change the way you see challenging or frightening situations and to help you find new ways to approach these challenges as they arise.

As well as changing behavior, there’s some evidence that CBT might affect structures in your brain that are responsible for panic symptoms.

2018 research found evidence that people who attended four weekly sessions of exposure-based CBT experienced changes in the neural pathways involved in panic symptoms. However, this was an early study, and more research is needed.

Another 2018 meta-analysis of 41 studies found that CBT is moderately effective in treating anxiety disorders.

That said, CBT is not the only therapy modality that might help with anxiety, and it may not be the method that works best for you.

Learn about 7 types of therapy for anxiety and the evidence behind them.

Benzodiazepines, such as alprazolam (Xanax), can help treat the symptoms of panic when they occur.

However, they won’t help treat an underlying anxiety disorder and can quickly lead to dependence. For this reason, doctors only recommend them for short-term use during a crisis.

Because benzodiazepines are a prescription medication, you’ll likely need a panic disorder diagnosis to have the medication on hand.

In some cases, a doctor may prescribe anti-depressants for long-term use. Some anti-seizure medications, such as pregabalin or clonazepam, can also help treat anxiety.

Boxed warning

Xanax has a boxed warning from the Food and Drug Administration (FDA) for physical dependence and withdrawal if you stop taking the drug suddenly. It can also lead to misuse and addiction.

Misuse of benzodiazepines increases your risk of overdose and death. Only take benzodiazepines as your doctor prescribes. Talk with your healthcare professional if you have any concerns about their safety.

A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.

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Learn about drugs that can treat anxiety disorder.

While hyperventilating is a symptom of panic attacks that can increase fear, deep breathing can reduce symptoms of panic during an attack.

In one study, published in 2017, 40 people joined either a therapy group that involved deep or diaphragmatic breathing or a control group. After 20 intensive training sessions, those who practiced deep breathing saw improvements in their attention levels and emotional well-being.

Another 2018 review found that slow breathing could have similar effects.

Try to focus on taking a deep breath through your nose, feeling the air slowly fill your chest and belly. Then slowly exhale through your mouth and feel the air leave your body. Breathe in through your nose for a count of 4, hold for 1 second, and then breathe out through your nose for a count of 4:

Learn about diaphragmatic breathing and how to do it.

By recognizing that you’re having a panic attack instead of a heart attack, you can remind yourself that this is temporary, it will pass, and that you’re OK.

Try to set aside the fear that you may be dying or that impending doom is looming, both fears are only symptoms of panic attacks. This can allow you to focus on other techniques to reduce your symptoms.

Some panic attacks come from triggers that overwhelm you. If you’re in a fast-paced environment with a lot of stimuli, this can feed your panic attack.

To reduce the stimuli, close your eyes during your panic attack. This can block out any extra stimuli and make it easier to focus on your breathing.

Mindfulness can help ground you in the reality of what’s around you. Since panic attacks can cause a feeling of detachment or separation from reality, this can combat your panic attack as it’s approaching or actually happening.

Mindfulness involves:

  • focusing your attention on the present
  • recognizing the emotional state you’re in
  • meditating to reduce stress and help you relax

American Family Physician recommends mindfulness as a strategy for dealing with panic and anxiety, saying it can be as helpful for reducing stress as CBT and other behavioral therapies.

Learn more about how to practice mindfulness.

Online meditation options

Read our review of the best online meditation options to help find the right fit for you.

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Some people find it helpful to find something to focus all their attention on during a panic attack. Pick one object in clear sight and consciously note everything you can about it.

For example, you may notice how the hand on the clock jerks when it ticks and that it’s slightly lopsided. Describe the patterns, color, shapes, and size of the object to yourself. Focus all your energy on this object, and your panic symptoms may subside.

Muscle tension is a symptom of anxiety and muscle relaxation techniques can help reduce tension and promote relaxation during an attack.

Progressive muscle relaxation aims to release tension in one group of muscles at a time to relax the whole body.

Much like deep breathing, muscle relaxation techniques can help stop your panic attack in its tracks by controlling your body’s response as much as possible.

Learn more about the benefits of progressive muscle relaxation and how to do it.

Guided imagery techniques can help reduce stress and anxiety. Research suggests that both spending time in nature and visualizing nature can help treat and manage anxiety.

The place you visualize should be quiet, calm, and relaxing — no streets of New York or Hong Kong, no matter how much you love the cities in real life.

Learn about five visualization techniques that can help you meditate.

Research published in 2021 shows that regular exercise may not only keep the body healthy but reduce your chance of developing anxiety.

If you’re not used to exercising, talk with a doctor before starting. There’s some evidence that starting aerobic exercise anew can trigger additional anxiety in people with an anxiety disorder.

Building up gradually can help your body adjust and avoid breathing problems. If you feel stressed or you’re hyperventilating or struggling to breathe, stop and take a rest or choose a more moderate option, such as walking, swimming, or yoga.

Lavender is a traditional remedy that many people use to reduce stress and help them relax.

Older studies suggest lavender has a calming effect but doesn’t lead to dependence or cause withdrawal symptoms. Using products that contain diluted lavender essential oil may help reduce or manage symptoms of anxiety.

Learn how to use lavender safely.

Repeating a mantra internally can be relaxing and reassuring, and it can give you something to grasp onto during a panic attack.

Whether it’s simply “This too shall pass,” or a mantra that speaks to you personally, repeat it on a loop in your head until you feel the panic attack start to subside.

Letting a friend, loved one, or even a colleague know that you’re having a panic attack might help you feel less alone and more in control of your emotions.

Any trustworthy person in your vicinity can help calm you. It might be helpful to share ahead of time that you’re prone to panic attacks so they know what to expect.

Even when in public, you can still flag down a person who might be able to assist you by taking you somewhere where there’s less stimulation and staying with you as you calm down.

What are the 3 symptoms of a panic attack?

If you have a panic attack, you might experience symptoms such as heart palpitations, sweating, or difficulty breathing.

What causes panic attacks?

Panic attacks can happen for various reasons, and sometimes they happen for no apparent reason.

A panic attack often happens when you’re exposed to a trigger, but triggers vary widely between people. In some cases, there may be no clear trigger.

Learn more about the causes and triggers of panic attacks.

Can you prevent a panic attack?

It’s not always possible to prevent a panic attack, but certain strategies may help. Avoiding specific triggers may help prevent a panic attack, but this may not always be possible or appropriate. Some advice encourages people to “ride out” the attack and continue doing things, if possible.

Many people experience panic attacks, in which they suddenly feel anxious and not in control of a situation, possibly without knowing why.

You may feel breathless or as if you’re having a heart attack, and it can be very frightening.

Panic attacks can occur unexpectedly and have a significant impact on your daily life, but there are ways to manage them. Treatment is also available for panic and anxiety disorders, which may be an underlying condition.

If you have concerns about panic attacks, speak with your doctor. They can help you work out a suitable strategy to manage symptoms and reduce the impact. This may involve medications, such as antidepressants, alongside counseling.

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