How to Calm Down During a Panic Attack
Reviewed by Theresa Fry, LPC, NCC, CTP-CE
I haven’t had a panic attack in over three months, but nevertheless, getting on the train has me feeling a little anxious. I know that if a panic attack does start, it will most likely peak within a few minutes, so I try to distract myself by focusing on my phone.
But even with all the mental preparation I’ve done, I can’t seem to stop thinking about trying not to have a panic attack. And this makes me feel even more anxious.
On the train, I’m surrounded by people and there’s nowhere to go because it’s jam packed. I start to feel claustrophobic and my heart races. Then, I start to feel lightheaded and like I’m about to be short of breath.
I know what to do. I’ve been through this before, and I have the tools to get through it. And so, I start running through the process of what I know works. Before long, I’m back to feeling like myself again. No panic attack this time.
The fear of having another panic attack is something that I deal with on a daily basis. It’s like a weight that’s always hanging over my head.
But even though I know that I can’t control when or where a panic attack will happen, I’ve learned how to manage them. In time, I hope to eventually become panic-free.
Spotting a Panic Attack
I’ve had many, so I know. You can spot a panic attack when you suddenly start feeling intensely anxious, like you’re about to lose control over yourself, or like you’re about to die. Some of the most common symptoms include:
- Increased heart rate
- Difficulty breathing
- Heart palpitations
My anxiety and fear of experiencing these symptoms is what used to cause me to avoid places like malls or big, busy events. It’s also what caused me to check the locks on my doors 10 times before I go to bed at night.
The Difference Between an Anxiety Attack and a Panic Attack
When I first started having panic attacks, I didn’t know they were different from anxiety attacks. I just knew that I was suddenly overcome with this intense fear and didn’t know what to do.
Anxiety attacks are more common than panic attacks and can be caused by a variety of things, like work stress or money problems. They’re generally associated with worrying about a real or perceived danger.
Panic attacks, on the other hand, are usually caused by sudden feelings of intense anxiety and fear, and tend to be more severe—often characterized by both mental and physical symptoms. Many of the symptoms of anxiety attacks are similar to panic attacks, but anxiety attacks are less intense.
How to Calm Down from a Panic Attack
I learned how to calm down from my panic attacks from my therapist, but when I first started putting what I learned into practice, it took me up to an hour to fully calm down. It’s hard to break out of that cycle because even though I’m finally calm after a panic attack, the anxiety lingers and I find myself worrying about when the next one might come.
Sometimes, I can trick my brain into thinking it’s not real, and that helps. Other times I have to breathe deeply until I feel ready to get up. And a lot of the time I just have to wait until the feelings go away on their own.
Here’s what I do:
Deep breathing helps prevent hyperventilating, which is a common symptom that can make other symptoms of a panic attack feel worse. It’s the number one thing I worry will draw attention to me if I’m in a public place when it strikes.
This one is easiest because everything is performed in increments of four seconds. Also known as “box breathing,” it’s a breathing technique that has been used by U.S. Navy Seals to keep them calm:
- Close your eyes.
- Exhale completely through your nose.
- Inhale through your nose for four seconds.
- Hold your breath for four seconds.
- Exhale through your nose for four seconds.
You can also try the 4-7-8 breathing exercise, also known as relaxing breath:
- Exhale completely.
- Inhale through your nose for four seconds.
- Hold your breath for seven seconds.
- Exhale completely through your mouth for eight seconds.
Release Muscle Tension
When I’m feeling really anxious, it’s common for me to tense up my muscles, which only aggravates my symptoms. To counteract this, I try to consciously release any muscle tension I’m holding onto. You can try this technique out for yourself:
- Start with your face and work your way down.
- Pretend that you’re trying to smile as wide as you can and hold it for a few seconds.
- Then, scrunch up your forehead and hold it for a few seconds.
- Make a fist with your hand and hold it for a few seconds.
- Clench your jaw and hold it for a few seconds.
- Tense up your shoulders and hold it for a few seconds.
- Now, try to relax all of those muscles.
It may sound strange to purposefully tense up right before or during a panic attack, but tensing the muscles intentionally will actually help them relax. Better yet, this is something you can practice when you’re not having a panic attack, so when the symptoms hit, you’ll be better prepared to release any tension and calm yourself down.
Move Your Body
This isn’t something I can really do when I’m sitting on a crowded train, but in other situations, like when I’m at work or just hanging out at home, it helps to move my body around and distract myself from what’s going on in my head. Sometimes I’ll even play some music and dance around.
It’s amazing how the simple act of getting up and moving around can help relieve stress and anxiety. If I barely move for an hour and then start doing some stretches or a few jumping jacks, I feel a lot better.
Before or during a panic attack, I tend to obsess over what I’m feeling. But if I can find something else to think about for a bit, my mind will often start to wander and even forget about having a panic attack altogether.
Here are some of my favorite distractions that seem to be most effective:
- Meditating using mindfulness techniques
- Doing visualizations
- Reciting and repeating a powerful mantra
- Talking to someone you trust
- Writing in a journal
- Doing a craft activity
- Using media like books, music, and television
- Engaging your senses by introducing new smells, sounds, textures, etc.
Getting Through a Panic Attack at Night
Nighttime panic attacks or “night terrors” can be especially frightening because they have the same symptoms as regular panic attacks, except they wake you up from your sleep, making it difficult to get back to sleep at times. They’re fairly common, but experts don’t really know why they happen.
It’s possible that our brains are still dealing with our anxieties and fears while we’re sleeping or that there’s something genetic that increases a person’s likelihood of experiencing them. Chronic stress, some medications, chronic physical illnesses, and consuming alcohol, cannabis, or caffeine can increase the chances of nighttime panic attacks.
To help deal with panic attacks that strike at night, I follow some of the same tips as listed above, but I also make sure to do a few things specifically for bedtime:
- Create a relaxing bedtime routine including reading, journaling, meditation, etc.
- Avoid caffeine and alcohol or other substances before going to bed.
- Abstain from eating three hours before bedtime (especially sugar and heavy foods)
- Make sure the room is cool, well ventilated, and dark—with as few distractions as possible.
- Take a hot shower or bath before going to bed to help the mind and body relax.
Getting Help with Anxiety and Panic
I wouldn’t know any of this if I hadn’t sought out help from a professional. If you’re struggling with anxiety or panic attacks, I highly recommend talking to someone about it. A therapist can help you understand what’s going on in your head and give you tools to deal with the symptoms.
I’ll always be afraid of another panic attack happening, but therapy has taught me how to deal with it in a healthy way. I know that I’m not alone in this, and there are plenty of people who understand what I’m going through.
If you or someone you know is struggling with panic attacks, please don’t hesitate to reach out for help. There are plenty of resources available, like therapy or medication, and it’s definitely worth trying to get your life back to as normal a state as possible.
The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.
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