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What a Panic Attack Is and What to Do While It’s Happening
Your heart is pounding. Your chest feels tight. Your hands may shake or tingle. You cannot seem to get a full breath, and suddenly you are certain something terrible is happening.
Maybe you think you are having a heart attack. Maybe you feel as if you are going to faint, throw up, lose control, or die. Maybe the room feels unreal, your body feels disconnected, and you cannot understand why everyone else seems calm when your entire system is screaming danger.
That is part of what makes a panic attack so frightening: it does not feel like “just anxiety.”
It feels physical, immediate, and completely real.
The sensations are real. But they do not always mean the story your fear is telling you is true.
What Is a Panic Attack?
A panic attack is a sudden surge of intense fear or discomfort accompanied by strong physical and emotional symptoms. It may happen in response to a recognizable trigger, or it can seem to come out of nowhere. Panic attacks can even occur during sleep.
During an attack, your body’s alarm system activates as though you are facing an immediate threat. Your heart rate may rise, your breathing may change, your muscles may tense, and your attention may narrow toward anything that could signal danger.
This response is designed to protect you. During panic, however, the alarm is much louder than the actual threat.
Common symptoms can include:
A racing or pounding heart
Chest pain or tightness
Shortness of breath or a choking sensation
Shaking, sweating, chills, or hot flashes
Dizziness, weakness, or feeling as though you may faint
Nausea, stomach pain, or retching
Tingling or numbness in the hands, feet, or face
Feeling detached from yourself
Feeling as though the world around you is unreal
Fear of losing control or embarrassing yourself
A powerful sense of impending doom
Fear that you are dying
Panic symptoms usually rise quickly and often peak within minutes, although some symptoms and exhaustion can last longer.
Having one panic attack does not automatically mean you have panic disorder. Panic disorder involves recurring, unexpected attacks along with ongoing fear, worry, avoidance, or behavioral changes related to having another attack.
First, Do Not Automatically Assume It Is Panic
Panic attacks can resemble heart, breathing, neurological, medication-related, and other medical problems. If this is your first episode, your symptoms are new or different, or you are unsure what is happening, seeking medical care is appropriate.
Call 911 or seek emergency medical help if you experience:
New, severe, crushing, or persistent chest pain or pressure
Chest pain with unusual sweating, nausea, or pain spreading into the arm, back, neck, or jaw
Severe difficulty breathing or difficulty speaking because you cannot catch your breath
Fainting, loss of consciousness, new confusion, or seizure-like activity
New weakness or numbness on one side, facial drooping, or difficulty speaking
Symptoms following a medication change, substance use, allergic reaction, or possible overdose
Symptoms that feel significantly different from your established pattern of panic
It is not an overreaction to have concerning symptoms medically evaluated.
Once medical causes have been considered and you recognize your familiar pattern of panic, the following steps may help you move through it.
What to Do While a Panic Attack Is Happening
You do not have to complete every step or do anything perfectly. Panic already creates the feeling that something must be fixed immediately. Instead, choose one small action and begin there.
1. Name What May Be Happening
Try saying silently or aloud:
“This feels frightening, and it may be a panic attack. My body’s alarm system is activated. I do not have to solve everything right now. I can help myself move through this moment.”
Naming panic gives your brain another possible explanation for the sensations you are experiencing.
If telling yourself that you are completely safe feels unbelievable, use language your nervous system can accept:
“I have felt something like this before, and it passed.”
“I can take the next thirty seconds one at a time.”
“I do not have to know exactly when this will end to know that the intensity can change.”
The goal is not to argue with yourself. It is to speak to yourself with steadiness instead of adding more fear.
2. Orient Yourself to the Present
Keep your eyes open if that feels comfortable. Look slowly around you and identify facts about where you are:
“I am in my office.”
“It is Saturday afternoon.”
“My feet are on the floor.”
“I can see a blue chair and hear the air conditioner.”
“I am here, in this moment.”
You can also try the 5-4-3-2-1 grounding exercise:
Name five things you can see.
Name four things you can feel.
Name three things you can hear.
Name two things you can smell.
Name one thing you can taste—or one kind thing you can say to yourself.
If counting feels like too much, hold one object and describe it. Is it cool or warm?
Smooth or rough? Light or heavy?
Grounding does not have to be complicated to be helpful.
3. Slow Your Breathing Without Forcing a Huge Breath
Panic can lead to rapid or overly deep breathing, which may increase dizziness, tingling, chest discomfort, and the sensation that you cannot get enough air. Repeatedly gasping for a large breath can sometimes make that cycle worse.
Instead, allow your breathing to become a little slower and softer:
Relax your jaw and lower your shoulders if you can.
Breathe in gently through your nose for a comfortable count, such as three.
Breathe out slowly for a slightly longer count, such as four or five.
Pause naturally without holding your breath or straining.
Repeat several times.
Think slow and soft, not perfect and deep.
If focusing on your breathing makes you more anxious, skip this step. Use visual, sound, or touch-based grounding instead.
Do not breathe into a paper bag. Because symptoms that resemble panic can have medical causes, this outdated practice may be unsafe.
4. Give Your Body Steady Physical Information
Press both feet into the floor. Feel the chair supporting your weight. Place your hands against a table, wall, or your thighs and notice the pressure.
Slowly unclench your hands. If movement feels helpful and you are in a safe place, walk at an easy pace or gently shake out your arms.
Temperature and texture can also help some people reconnect with the present. You might:
Hold a cool washcloth
Splash cool, but not painfully cold, water on your face
Wrap yourself in a familiar blanket
Hold a textured object
Take a small sip of cold water
Smell something familiar and comforting
The goal is not to shock your body out of panic. It is to give your nervous system clear,
predictable information.
5. Reduce Stimulation and Create Physical Safety
If possible, move away from bright lights, crowds, loud noise, or intense conversation.
Loosen restrictive clothing and sit somewhere stable.
If you are driving, signal and pull into a safe location. Put the car in park and allow the intensity to decrease before deciding whether it is safe to continue. Call someone you trust if you need support or a ride.
6. Stop Demanding Immediate Calm
Desperately trying to force panic to stop can create another layer of fear:
“Why isn’t this working?”
“What if I cannot control it?”
“What if it never stops?”
Instead, imagine the panic attack as a wave. You do not have to like it or invite it. Your job is simply to stay with yourself while it rises, crests, and begins to change.
Try telling yourself:
“I can allow this sensation to be here without treating it as a command.”
Fear may tell you to escape immediately, check your pulse repeatedly, search every symptom online, or ask for reassurance again and again. Those responses make sense, but they can reinforce the belief that the sensations themselves are dangerous.
In the moment, aim for safe support—not perfect certainty.
7. Ask for the Kind of Help You Need
If another person is nearby, give them one simple instruction:
“Please sit with me and speak slowly.”
“Please help me find somewhere quieter.”
“Please remind me where I am.”
“Please do not ask me a lot of questions right now.”
“Please stay with me until this eases.”
If you are helping someone through a panic attack, remain calm and present. Ask before touching them. Avoid crowding them or repeatedly telling them to calm down.
A more helpful response might be:
“I can see that this is frightening. I’m here. Would you like quiet, help with grounding, or
help getting medical care?”
What to Do After a Panic Attack
Panic can leave you shaky, tearful, nauseated, embarrassed, or completely exhausted.
Give your body time to recover. Drink water, eat something gentle if you are able, reduce stimulation, and rest without criticizing yourself for needing it.
Later, when you feel calm, write down what happened before, during, and after the attack. Consider factors such as:
Lack of sleep
Caffeine or energy drinks
Illness or physical discomfort
Conflict or major stress
Sensory overload
Medication changes
Alcohol or substance use
Hormonal changes
Trauma reminders
Changes in routine
Sometimes there is an identifiable pattern. Sometimes there is not.
Try not to let fear of another attack make your life progressively smaller. Avoidance may provide temporary relief, but it can strengthen panic over time.
If you experience recurring attacks, constantly worry about having another one, or begin avoiding driving, work, school, stores, crowds, exercise, or being alone, professional support can help.
You Are Not Failing Because Your Body Sounded an Alarm
A panic attack is not a sign that you are weak, dramatic, or broken. It is an intense mind-body response that deserves both compassion and appropriate care.
The goal is not to guarantee that you will never experience panic again. It is to learn that you can recognize what is happening, respond safely, and remain connected to yourself until the wave changes.
Native Springs Counseling & Wellness provides trauma-informed, neurodiversity-affirming counseling for adults, couples, and teens ages 12 and older throughout Arkansas. Sessions are available in person in Rogers and through telehealth.
If anxiety or panic is beginning to control your decisions, visit Native Springs Counseling & Wellness to get started.
This article is educational and does not diagnose or replace individualized medical or mental health care. If you believe you may be experiencing a medical emergency, call 911. If you are in emotional crisis or experiencing thoughts of suicide or self-harm, call or text the 988 Suicide & Crisis Lifeline at 988.
Sources: National Institute of Mental Health, MedlinePlus, and the National Center for PTSD.
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