When a panic attack hits, time doesn’t slow down-it vanishes.
You’re sitting at your desk, scrolling through emails, and suddenly your chest tightens. Your heart pounds like it’s trying to escape. Your hands go numb. Your thoughts spiral: “I’m having a heart attack. I’m going to pass out. I’m dying.” But you’re not. You’re having a panic attack. And it’s not dangerous-it’s just terrifying. The good news? You can stop it. Not by fighting it, but by using a simple, proven action plan built on breathing, grounding, and, when needed, medication.
Why breathing is your first line of defense
During a panic attack, your body thinks it’s under attack. Your breathing gets shallow and fast. That’s not just a symptom-it’s what makes the panic worse. Hyperventilation drops carbon dioxide levels in your blood. That triggers dizziness, tingling, chest pain-all the things that scream “Something’s wrong!” when it’s just your body misfiring.
The fix isn’t to breathe harder. It’s to breathe slower. Two techniques work best for most people.
- 2-2-6 breathing: Inhale through your nose for 2 seconds. Hold for 2 seconds. Exhale through your nose for 6 seconds. Pause for 1 second. Repeat. This pattern tells your nervous system: “We’re safe.”
- Diaphragmatic breathing: Place one hand on your belly. Breathe in slowly through your nose, letting your belly rise-not your chest. Exhale through your mouth. Feel your hand fall. Do this for 30 seconds, even if you’re shaking. It doesn’t fix everything, but it breaks the cycle.
Research from the Journal of Anxiety Disorders shows people who practiced these techniques 15 minutes a day for eight weeks cut their panic attacks by nearly half. The key isn’t doing it during the attack-it’s doing it every day so your body learns the rhythm. Think of it like training a muscle. You don’t lift weights only when you’re tired-you train when you’re calm so you’re ready when you’re not.
Grounding: How to pull yourself back from the edge
When panic takes over, your mind gets stuck in a loop of fear. Grounding techniques don’t try to stop the fear. They redirect your brain. They say: “Look outside. Right now. This moment.”
One of the most effective tools is the 5-4-3-2-1 method, even if it’s not in every clinical guide-it’s in every person’s toolkit who’s survived an attack.
- Find 5 things you can see. The lamp. The crack in the wall. Your coffee mug. Your shoelace. The logo on your phone.
- Touch 4 things. The fabric of your shirt. The cool metal of your watch. The desk. Your own knee.
- Listen for 3 sounds. The AC hum. A car outside. Your own breath.
- Smell 2 things. Your soap. Your lotion. Even your own skin.
- Taste 1 thing. Sip water. Chew gum. Lick your lips.
This works because it forces your brain out of the panic loop and into your senses. Your amygdala can’t scream “DANGER!” if you’re naming your socks.
Another powerful tool? Personalized affirmations. Write them down. Save them in your phone. Say them out loud. Not vague ones like “I’m fine.” But specific, truthful ones: “This is panic. It’s not a heart attack. It will pass. I’ve done this before. I’m safe.” A Mental Health America survey found people who used these statements cut their attack duration from 22 minutes to 14 minutes in just eight weeks.
And if you’re overwhelmed? Close your eyes. Seriously. Reducing sensory input lowers intensity by 32% in under 90 seconds, according to the Anxiety and Depression Association of America. You don’t need to be brave. You just need to be still.
Medication: When it helps-and when it doesn’t
Medication isn’t a crutch. It’s a bridge. For some people, breathing and grounding aren’t enough-not yet. If you’re having more than two panic attacks a week, or if you’re avoiding places because you’re scared of having one, medication can give you the space to learn the skills.
There are two main types:
- SSRIs (like sertraline or paroxetine): These are daily pills. They take 6 to 12 weeks to work. They don’t stop an attack in the moment, but they reduce frequency by 60-70% over time. Side effects? Nausea, insomnia, or feeling “numb” at first. But 79% of people who stick with them say it’s worth it.
- Benzodiazepines (like alprazolam or clonazepam): These work fast-within 15 to 30 minutes. They’re for emergencies only. They’re not for daily use. The FDA says 23% of people who take them daily for more than a month develop tolerance. That means you need more to get the same effect. And stopping suddenly can make panic worse. Use them like a fire extinguisher-not a candle.
Here’s the hard truth: Medication alone doesn’t cure panic disorder. CBT does. But medication can make CBT possible. If you’re too scared to leave your house, you can’t practice grounding. If you’re shaking every time you step outside, you can’t learn breathing. A 2022 NIMH study showed 68% of people who combined medication with therapy reached remission. Only 42% did with medication alone.
Dr. Paul Holtzheimer from Dartmouth warns: If you rely on benzodiazepines to avoid discomfort, you never learn to tolerate it. And that’s the whole point of recovery-you don’t need to feel calm to be safe.
How to build your own action plan
There’s no one-size-fits-all plan. But here’s how to build yours in four steps:
- Start small. Pick one breathing technique. Practice it for 5 minutes every morning. Set a phone reminder. Don’t wait for panic to start-you’re training your body to respond.
- Write your grounding script. List 3 things you see, touch, hear, smell, taste. Write your affirmations. Put them on your fridge. Save them in your phone notes. Print them on a card. Keep one in your wallet.
- Track your attacks. For two weeks, write down: When? Where? What were you doing? What thoughts popped up? What helped? You’ll start seeing patterns. Maybe it’s always after meetings. Maybe it’s when you’re alone in the car. Knowing the trigger lets you prepare.
- Talk to your doctor. If attacks are frequent or disabling, ask about SSRIs. If you’ve ever used benzodiazepines, be honest about how often. Your doctor isn’t judging-you’re building a team.
Most people get the basics down in 2-3 weeks. But using them during an actual panic attack? That takes 8-12 weeks. That’s not slow. That’s normal. Your brain has to rewire. And it will.
What doesn’t work-and what to avoid
Don’t try to “think positive.” Telling yourself “I’m calm” during a panic attack just adds guilt: “Why can’t I just calm down?” That’s another loop.
Don’t rely on alcohol or marijuana to “calm you.” They might help short-term, but they worsen anxiety long-term. Studies show people who use them for panic end up with more attacks over time.
Don’t wait until you’re in crisis to learn this. Practice when you’re calm. Use the “Panic Relief” app from UCSF. It’s free, has guided breathing, and a 4.3-star rating from nearly 2,000 users. Or try the free ADAA webinars-they’re not flashy, but they’re real.
And if you’ve ever snapped a rubber band on your wrist to interrupt a panic thought? You’re not weird. You’re smart. That’s the “stop technique” from McGill University. It’s simple. It works. And it’s evidence-based.
It gets better-because you’re not alone
4.7% of U.S. adults have panic disorder. That’s over 12 million people. You’re not broken. You’re not weak. You’re someone who’s learned your body can trick you-and now you’re learning how to outsmart it.
The goal isn’t to never feel anxious. The goal is to feel anxious and still be okay. To know that panic is loud, but it’s not dangerous. That your breathing can calm your body. That your senses can anchor your mind. And that medication, if used right, gives you the breathing room to heal.
One person on Reddit said it best: “I used to think panic attacks meant I was losing control. Now I know-they’re my body screaming for help. And I finally know how to answer.”
Can breathing techniques stop a panic attack in 30 seconds?
Yes, if you’ve practiced them regularly. During an attack, your body is in overdrive. Slow, deep breathing signals safety to your nervous system. The 2-2-6 or diaphragmatic method can reduce heart rate and dizziness within 30 to 90 seconds. But it’s not magic-it’s muscle memory. People who practice daily report much faster relief than those who only try it during panic.
Is it safe to use Xanax every time I have a panic attack?
No. Alprazolam (Xanax) is meant for emergency use only. Taking it more than once or twice a week increases your risk of dependence. The FDA reports that 23% of daily users develop tolerance within 4-6 weeks. That means you’ll need higher doses to get the same effect. Over time, this can make panic worse when you stop. Use it only when absolutely necessary-and always under a doctor’s supervision.
Why do I feel worse after starting an SSRI like Zoloft?
It’s common. SSRIs take 6 to 12 weeks to work. In the first few weeks, some people feel more anxious, nauseous, or have trouble sleeping. These side effects usually fade. A 2023 survey by the Anxiety and Depression Association of America found 79% of users continued treatment because the long-term benefits outweighed the early discomfort. If side effects are unbearable, talk to your doctor about adjusting the dose or switching meds.
Do I need therapy if I’m on medication?
Yes. Medication reduces the frequency and intensity of attacks, but it doesn’t teach you how to manage them. Cognitive Behavioral Therapy (CBT) helps you understand the thoughts that fuel panic and rewires your response. The American Psychological Association gives CBT the highest rating for panic disorder. Studies show 68% of people who combine medication with CBT reach remission-compared to 42% with medication alone.
Can grounding techniques work in public?
Absolutely. Grounding doesn’t require privacy. You can use the 5-4-3-2-1 method while waiting in line, sitting on the bus, or in a meeting. You don’t need to say anything aloud. Just focus internally: name five things you see, feel four textures, listen for three sounds. Even closing your eyes for 20 seconds helps. Most people won’t notice-and you’ll feel calmer in seconds.
Next steps: What to do right now
If you’re reading this during a calm moment-do this now:
- Open your phone’s notes app. Type: “My panic plan: 2-2-6 breathing, 5-4-3-2-1 grounding, affirmations: I’m safe, this will pass.”
- Set a daily alarm for 7 a.m. to practice breathing for 5 minutes.
- Text a trusted friend: “I’ve been having panic attacks. I’m working on a plan. Can I call you if I need to talk?”
- Schedule a 15-minute chat with your doctor. Say: “I think I might have panic disorder. Can we talk about options?”
You don’t need to fix everything today. Just start. One breath. One grounding step. One conversation. That’s how recovery begins.
