Panic Attack First Aid: 7 Quick Strategies to Regain Control

Panic attack first aid means using simple, physical steps to ride out a surge of fear until it passes: slow your breathing, ground yourself in the room, remind yourself the feeling is temporary and reach out if you need support. These steps do not stop every attack instantly, but they can make one feel shorter, less frightening and more manageable.

This article is for adults and older teens in Texas who have had a panic attack, or who want to help a friend, partner or coworker through one. It covers what an attack feels like, how to tell it apart from an emergency, seven quick strategies, what to say and when to get help sooner.

What is panic attack first aid?

It is a short set of calming actions you can use in the moment, wherever you are. Like basic first aid for a cut, it is meant to steady things now, not to replace care if attacks keep happening.

The National Institute of Mental Health (NIMH) describes panic attacks as sudden periods of intense fear, discomfort or a sense of losing control, even when there is no clear danger. Because the body's alarm system is firing, the most useful first steps work directly on the body: breathing, senses and movement.

Having a plan ahead of time matters. When fear spikes, it is harder to think clearly, so a short, familiar routine is easier to follow than a long list.

What does a panic attack feel like?

A panic attack usually feels like a sudden rush of physical symptoms and fear that can feel overwhelming. NIMH lists symptoms such as a pounding or racing heart, sweating, trembling, trouble breathing, chest pain, dizziness and feelings of doom or being out of control.

Some people also feel numbness or tingling, chills or hot flashes, nausea, or a sense that things around them are unreal. Many fear they are dying, having a heart attack or "going crazy." Those fears are a common part of panic, not a sign that something is wrong with your character.

To understand why the body reacts this way, see why you just had a panic attack.

Is it a panic attack or a medical emergency?

You cannot always tell on your own, so if symptoms are new, severe or different from your usual pattern, treat them as a possible emergency. MedlinePlus advises that a first episode of rapid breathing may be a medical emergency and should be checked.

The Centers for Disease Control and Prevention (CDC) lists major heart attack symptoms, including chest pain or discomfort, feeling weak, light-headed or faint, pain in the jaw, neck, back, arm or shoulder, and shortness of breath, and advises calling 911 right away.

Call 911 if you have chest pain with any of those features, trouble breathing or talking, fainting, or if you have heart or lung conditions. Once a health care provider has ruled out a medical cause, you and they can plan for future attacks.

What are 7 quick strategies to regain control?

Seven quick strategies are slow breathing, grounding, calm self-talk, holding a calming object, gentle movement, a cool sensation and contacting someone you trust. Try them in order, or pick the two or three that work best for you:

1. Slow your breathing. Breathe in gently through your nose and out slowly through pursed lips, making the out-breath longer than the in-breath.
2. Ground yourself with your senses. Name five things you can see, four you can touch, three you can hear, two you can smell and one you can taste.
3. Use calm self-talk. Repeat a short phrase such as "This is panic. It is uncomfortable, and it will pass."
4. Hold a calming object. Focus on the weight, texture and temperature of a stone, keychain, ring or photo.
5. Move gently. Plant your feet, press your palms together, stretch your shoulders or walk slowly if it is safe.
6. Try a cool sensation. Some people find that cool water on the face or wrists, or holding something cold, helps them refocus.
7. Reach out. Text or call someone you trust and tell them what is happening.

The National Center for Complementary and Integrative Health (NCCIH) notes that relaxation techniques are generally considered safe for healthy people, though a few people report feeling more anxious. If one technique makes you feel worse, switch to another. More options are in how to ground yourself during a panic attack.

How should you breathe during a panic attack?

You should breathe slowly and low into your belly, with a longer out-breath, rather than taking fast, deep gulps of air. MedlinePlus describes pursed-lip breathing and diaphragmatic (belly) breathing as techniques for people who hyperventilate.

A simple way to practice:

1. Sit or stand with one hand on your chest and one on your belly.
2. Breathe in gently through your nose so the hand on your belly rises more than the one on your chest.
3. Purse your lips as if blowing out a candle and exhale slowly.
4. Repeat for a minute or two, without forcing it.

Practicing when you are calm makes it easier to use when panic hits. If counting helps, an example is in for about four and out for about six, but comfort matters more than exact numbers.

What can you say to yourself or someone having a panic attack?

You can use short, steady words that name what is happening and offer support without pressure. These examples can be adapted:

To yourself

• "This is a panic attack. I have had one before, and it passed."
• "My body is in alarm mode. I am going to slow my breath."
• "I do not have to fight this. I can let it rise and fall."

To someone else

• "I'm here. You're not alone."
• "Do you want to breathe with me?"
• "Would you like me to stay, get you water or give you space?"

Panic attack first aid checklist

• Is this new, severe or different? If yes, call 911.
• Slow breathing for one to two minutes.
• Ground with your senses.
• Stay where you are if it is safe; avoid driving until you feel steady.
• Afterward, drink water and rest.

What should you do after a panic attack passes?

After an attack passes, give yourself time to recover and then make a few notes for the future. It is normal to feel tired, shaky or embarrassed afterward.

• Rest, drink water and eat something light if you can.
• Write down when it happened, what you were doing and what helped.
• Notice any caffeine, alcohol, missed sleep or stress beforehand.
• Tell someone you trust, even briefly.

MedlinePlus notes that people with panic disorder often worry about having another attack and may avoid places where attacks happened. Writing down what helped can make that worry smaller. Our article on your first anxiety attack covers next steps.

When should you get help sooner?

You should get help soon if attacks keep happening, if you worry constantly about the next one, or if you start avoiding places, driving or activities. Those patterns may suggest panic disorder, which is treatable.

NIMH advises people who have panic symptoms to talk to a health care provider, such as a primary care doctor or psychiatrist, and an exam can help rule out other causes. Seek urgent help if you have chest pain or trouble breathing that does not settle, if you faint, or if you have thoughts of suicide or self-harm. Call or text 988 for a mental health crisis, or call 911 for immediate danger.

How are panic attacks treated long term?

Panic attacks are usually treated long term with therapy, medication or both, chosen with a clinician. NIMH notes that cognitive behavioral therapy is commonly used to treat panic disorder and describes it as the "gold standard" choice for psychotherapy.

Some people do well with therapy alone, and others benefit from adding medication. Our guide to when therapy is enough and when medication helps explains that choice. Panic attack first aid remains useful alongside treatment.

Where can Texans get help for panic attacks?

Texans can get help through primary care, outpatient mental health care and, for urgent needs, county crisis lines. Texas Health and Human Services lists 24/7 crisis lines run by local mental health authorities by county.

A primary care provider is a good first stop to rule out medical causes. Telehealth rules depend on where you are located during a visit and vary by state, so confirm details before booking.

Getting support in Texas

Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. In-person visits are available at Lyte Psychiatry's clinic in Pantego, in the Dallas–Fort Worth area. Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit.

Most new patients are seen within 1–2 business days. Weekend appointments are limited. All Lyte Psychiatry services are available in Spanish. Availability, insurance, age range and clinician fit require confirmation.

Lyte Psychiatry is an outpatient practice. It does not provide inpatient care, crisis or after-hours coverage, medically supervised detox, or intensive outpatient or partial hospitalization programs.

Learn more about anxiety care at Lyte Psychiatry.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.