Feeling overwhelmed, out of control, or like something terrible is about to happen, even when there’s no clear reason, can be deeply unsettling. If you’ve ever experienced this, you’re not alone. These sudden waves of intense fear or discomfort are known as panic attacks, and they can come on without warning. Many people have them at least once in their lives, and for some, they occur more than once. Understanding what’s happening inside your body and mind during a panic attack can help make the experience a little less frightening. Knowing what to do in the moment can also make all the difference.

Need all your wellness solutions in one place? A whole new world awaits just a click away.

We spoke with Dr. V. Mridulla Abirami, a psychiatrist, to gain insights on how to manage a panic attack when it occurs. Keep reading to discover the strategies she shared to help you navigate through these overwhelming moments and regain control.

Book a consultation with Dr. V. Mridulla Abirami 

Dr Abirami mentions, “A panic attack is a sudden episode which may include rapid breathing, racing heartbeat, chest pain, dizziness, sweating, trembling, and a sense of doom or detachment from reality. People often believe they are dying or having a heart attack. A panic attack can be a terrifying experience. It might feel life-threatening for both the person going through it and those witnessing it, but they are not dangerous.”

During an episode of a panic attack, your brain and body react as if you’re in serious danger, even when you’re not. It starts in the brain when the part called the amygdala, which controls fear, sends out a warning signal. This triggers the release of stress hormones like adrenaline, which prepare your body for a fight-or-flight response. As a result, your heart beats faster, your breathing speeds up, and your muscles tense. You might feel dizzy, shaky, or like you can’t catch your breath. Your stomach may feel upset, and you might start sweating or feel cold. These symptoms can be so intense that it feels like something is really wrong, such as having a heart attack or losing control. Most panic attacks peak within 10 minutes and go away within about 30 minutes, but they can leave you feeling tired and shaken. Even though they’re not dangerous, they can be very scary when they happen.

8 Ways to Handle a Panic Attack

1. Recognise What’s Happening

The first step in calming a panic attack is to recognise that it is a panic attack. Reminding yourself, “This is a panic attack. It’s not dangerous. It will pass,” can actually change how your brain responds. When you name what’s happening, the logical part of your brain (the prefrontal cortex) starts to come back online and helps you override the fear signals from the amygdala, the part of the brain that triggers the panic. This simple act of recognition can reduce the feeling that you’re dying, going crazy, or losing control, which are common fears during an attack. It helps ground you in reality, reminding you that the symptoms, though intense, are temporary and not life-threatening.

2. Ride the Wave

Panic attacks feel overwhelming because your body is flooded with adrenaline, which ramps up physical symptoms like a racing heart, rapid breathing, and trembling. But panic attacks don’t last forever; they typically reach their peak within about 10 minutes and then slowly fade. Instead of fighting the feelings or trying to push them away (which can make them worse), imagine them like a wave in the ocean. Waves rise and fall, so let yourself “ride” it. Trust that the wave will pass. When you stop resisting the symptoms and just allow them to happen, your nervous system doesn’t stay in a high-alert state as long. Accepting the experience helps shorten its intensity and duration.

3. Control Your Breathing

One of the first things that happens during a panic attack is hyperventilation, or breathing too quickly. This reduces the level of carbon dioxide in your blood, which can make you feel dizzy, lightheaded, or like you can’t breathe. It creates a scary loop that makes the panic worse. Slow, deep breathing helps break that cycle. When you breathe in slowly for 4 seconds, hold it for 4 seconds, and breathe out for 6 seconds, you are helping your body rebalance its oxygen and carbon dioxide levels. This tells your nervous system that you're safe, activating the parasympathetic nervous system, which is responsible for calming you down. The longer you exhale, the more it signals to the brain that the danger has passed. Over time, this kind of breathing can help lower your heart rate and bring your body out of the fight-or-flight state

4. Ground Yourself

When you’re having a panic attack, your mind can feel like it’s spinning out of control. You might feel disconnected from your body or surroundings, a sensation called derealisation or depersonalisation, which can be very scary. Grounding exercises help bring your attention back to the present moment and reconnect you to the real world. A popular method is the 5-4-3-2-1 technique:

• 5 things you can see
   
• 4 things you can touch
   
• 3 things you can hear
   
• 2 things you can smell
   
• 1 thing you can taste

Engaging your five senses helps you activate parts of the brain responsible for awareness and focus. This shifts your attention away from fear and panic and helps stop the spiral of anxious thoughts. It signals to your nervous system that there’s no real threat and that you’re safe in your environment.

5. Relax Your Body

A panic attack not only shakes your brain functioning but also triggers physical symptoms. When panic hits, your body tightens up automatically. You might notice symptoms like your shoulders rising, your jaw clenching, and your muscles bracing as if preparing to defend against danger. These physical signs are part of the fight-or-flight response, but they can also keep the panic going if your body stays tense. The solution: Consciously relax your body. This will eventually help in dropping your shoulders, unclenching your jaw, and loosening your fists. This further indicates to your brain that the emergency is over. This physical release helps calm your nervous system. Even small adjustments can send a strong message to your brain that you are not under real threat, which helps reduce the overall intensity of the panic attack.

6. Use a Calming Phrase or Mantra

Racing thoughts can take over quickly, making it hard to think clearly. You might find yourself caught in frightening beliefs like “I can’t do this” or “Something terrible is happening.” In moments like this, repeating a calming phrase such as “I am safe. This will pass. I’ve gotten through this before” can help bring your focus back. This technique, called self-soothing, gives your brain something steady to hold onto. It engages the more rational part of your mind and can weaken the grip of anxious thinking. The more you use the same phrase, the more powerful it becomes. This is a kind of mental anchor that helps you feel grounded and secure, even when everything feels chaotic.

7. Stay Where You Are (If Safe)

When a panic attack strikes, your instinct may be to escape, to leave the room, get outside, or run somewhere you think you’ll feel safer. This is part of your body’s fight-or-flight response, trying to get you away from what it mistakenly believes is danger. But if you’re in a safe place, staying put is actually more helpful in the long run. When you remain where you are and let the panic pass, your brain starts to learn that the situation wasn’t truly dangerous. Over time, this helps reduce the fear of that place or situation, which can prevent future panic attacks from being tied to certain environments. Escaping may give short-term relief, but staying helps your brain unlearn the fear.

8. After It Passes, Rest and Reflect

Once the intense feelings begin to ease, your body and mind may feel worn out. This is normal- your system just went through a powerful stress response. Take some time to rest. Sit down somewhere quiet, drink some water, and breathe slowly. Giving yourself this moment helps you return to balance. Later on, when you feel ready, gently think about what might have led up to the panic. Understanding any patterns or triggers can help you feel more in control next time. If these experiences are becoming frequent or hard to manage, consider reaching out to a therapist, who can support you with tools and techniques tailored to your needs.

Need all your wellness solutions in one place? A whole new world awaits just a click away.