Panic Attack Toolkit

What is actually happening

A panic attack is your body's alarm system firing at full volume when there is no immediate threat. Adrenaline surges, your heart races, your breathing speeds up, and you may feel dizzy, tingly, hot, cold, or disconnected. It feelsdangerous. It is not. Every panic attack peaks and passes — usually within 10 minutes.

In the moment: the 5-step reset

1. Name it. "This is a panic attack. It is not dangerous. It will pass."
2. Slow the exhale. Breathe in for 4, out for 6 or 8. Longer out than in.
3. Ground. 5 things you see, 4 you can touch, 3 you hear, 2 you smell, 1 you taste.
4. Change temperature. Cold water on face or wrists. Ice cube in hand.
5. Wait it out. Do not fight the wave. Sit or stand still and let it move through.

What not to do

• Do not try to breathe deeply and quickly — that makes hyperventilation worse.
• Do not run from the situation — this teaches your brain the situation was dangerous.
• Do not check your pulse repeatedly.
• Do not scroll your phone for symptom searches.

After an attack

• Drink water. Eat something.
• Notice you survived it. Write down what helped.
• Rest. Attacks are exhausting.
• If you were in a specific place, try to return within a day or two so avoidance does not build.

Prevention

• Reduce caffeine.
• Sleep on a regular schedule.
• Move your body most days.
• Limit alcohol, especially in the evening.
• Address chronic stress at the source.
• Consider therapy — Cognitive Behavioral Therapy for panic is one of the best-studied treatments in mental health.

When to seek immediate care

Panic attacks can mimic serious medical problems. If it is your first attack, if symptoms are unusual for you, or if you have any risk factors for heart or lung problems, seek medical evaluation to be safe. Once medical causes are ruled out, therapy is the primary treatment.