How to stop a panic attack

Do this first

If you are in it right now, start here and read the rest later. Each step takes under a minute.

1. Make the out-breath longer than the in-breath. In through your nose for four, out through your mouth for six. Do not try to take a big breath — that usually makes it worse. Small breath in, long breath out.
2. Put your feet flat on the floor and press down. Feel the ground push back. If you can, sit rather than stand.
3. Name five things you can see. Out loud if you can. Then four you can hear, three you can touch, two you can smell, one you can taste^[4].
4. Tell yourself what is happening. “This is a panic attack. It is horrible. It peaks and then it goes.” Naming it is not a trick — it stops the second layer of fear, the one about the fear.
5. Do not try to make it stop. Fighting the wave adds effort and adrenaline. Let it be there, keep breathing out slowly, and let it come down on its own.
6. Stay where you are if it is safe to. Leaving usually brings relief in the moment and makes the place feel more dangerous next time. If you must leave, come back later if you can.

There is a version of these steps built as one screen you can use one-handed, with a breathing pacer and a grounding walkthrough: panic attack help.

What is happening in your body

A panic attack is a surge of fear that arrives with physical symptoms. NIMH lists a pounding or racing heart, sweating, chills, trembling, difficulty breathing, weakness or dizziness, tingly or numb hands, chest pain, and stomach pain or nausea^[2]. It is your body’s alarm system firing at full volume with nothing to fight or run from.

Two facts are worth holding on to. The NHS says plainly that “although panic attacks are frightening, they’re not dangerous” and that “an attack will not cause you any physical harm”^[1]. And they end: most last between five and twenty minutes, with some reported up to an hour^[1]; NIMH gives a similar range and notes the symptoms usually resolve with time^[2].

That is the whole basis for “let it pass”. You are not waiting for something dangerous to stop. You are waiting for an alarm to run out of fuel, and everything above is about making that wait survivable.

Why the slow out-breath is the first move

Breathing is the only part of this system you can operate on purpose. A 2018 systematic review of slow breathing found that breathing under about ten breaths a minute was associated with increased heart-rate variability and parasympathetic activity, and with lower reported arousal, anxiety and confusion^[3]. Lengthening the exhale is the simplest way to get there.

The best-designed trial in this area, published in Cell Reports Medicine in 2023, randomised 108 people to five minutes a day of breathwork or mindfulness meditation for a month. The extended-exhale “cyclic sighing” practice — two inhales, one long exhale — improved mood more than meditation and produced the largest drop in breathing rate^[5]. That is the pattern behind the physiological sigh, and it is a good choice in panic because there is nothing to count.

Be careful with deep breathing and with breath holds. Trying to force big breaths when you already feel short of air tends to increase the sense of suffocation. Small in, long out.

Why grounding works when breathing does not

For some people, attention on the breath during panic makes everything worse, because the breath is the frightening part. Grounding gives your attention somewhere else to go. The University of Rochester Medical Center’s behavioural health team publishes the 5-4-3-2-1 version — five things you see, then hearing, touch, smell and taste — beginning with slow breathing^[4].

It is a coping technique, not a treatment with its own trials, and the honest framing matters: the NIH’s complementary-health centre rates much of the relaxation literature low or very low quality^[6]. Grounding will not shorten an attack by a measured number of minutes. It gives you a task with an end, which is often the difference between an unbearable ten minutes and a bearable one.

What not to do

• Do not breathe into a paper bag. Old advice, and unsafe if the cause turns out not to be panic.
• Do not check your pulse repeatedly. It feeds the loop you are trying to leave.
• Do not search your symptoms while it is happening. Whatever you find will be read in the worst possible light.
• Do not judge how you handled it afterwards. Getting through it counts. There is no good or bad panic attack.

After it passes

You will probably feel wrung out, shaky and embarrassed. All of that is normal and none of it needs acting on. Have some water. Eat something if it has been a while. Let your body come down at its own pace rather than immediately going back to what you were doing.

Later — not now — it can help to write down what happened just before: where you were, what you had been thinking, how you had slept. Patterns show up over weeks, not in a single episode.

When to get help

Talk to a doctor if panic attacks keep happening, if you have started avoiding places in case one occurs, or if you are spending a lot of time dreading the next one. The NHS advice is to see a GP and describe how often the attacks happen and how long they last, so other causes can be ruled out^[1]. Effective treatments exist, and cognitive behavioural therapy has the strongest evidence base of any psychological approach for anxiety problems^[6].

Go to emergency services for new or severe chest pain or breathing difficulty, and contact a crisis line if you are thinking about harming yourself. The numbers are at the top of this page and they are free.

Try it in relif

relif keeps these two things — paced breathing and grounding — one tap from the home screen, with haptic pacing so you can follow the rhythm with your eyes closed, and it remembers which techniques you come back to. Liam, the in-app AI companion, is there to write to afterwards; it is an AI, not a therapist, and not a crisis service.

Related guides and tools

• Panic attack help — right nowOne screen: breathe, ground, reach out
• Physiological sighThirty seconds, nothing to count
• 5-4-3-2-1 groundingStep through it one sense at a time
• How to help someone elseWhat to say, and what not to

How this page was written: by the relif team, not by a clinician. We do not publish a “medically reviewed” badge we cannot stand behind. Instead we name and date every source, prefer systematic reviews and randomised trials over single studies, and match the strength of the wording to the strength of the evidence — “may help” and “research suggests”, never “cures” or “treats”.

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