What to do During a Panic Attack: 10 Tools for Calming Anxiety

I was eating French toast in a diner across from a friend when my tongue started tingling. It was just at the edges at first, but a minute later it started going numb. Then my lips started going numb. My mind started racing, “Maybe I’m having an allergic reaction to the French toast… Maybe there’s nuts in this! Wait, I'm not allergic to nuts... But what if I am allergic to nuts and don’t know it?! Maybe my throat is about to close up, and I’m gonna die!” My heart started pounding, and I was having trouble focusing. The room started to feel far away. For a second, I tuned back in to realize my friend was still telling me some story about her dog. Couldn’t she see that I was about to die right in front of her?!

Why do panic attacks happen?

That was the beginning of my first panic attack. Panic typically begins with an uncomfortable body sensation associated with anxiety, such as tingling, dizziness, feeling light-headed, shortness of breath, or heart racing. It becomes a panic attack when you interpret the sensation as a sign of danger, such as, “I’m probably having a heart attack!,” or “I think I might be dying!” Your body reacts to these thoughts with more anxious feelings… which causes even more anxious thoughts… until it spirals out of control. Eventually, you may develop a fear of the panic attacks themselves. Then when you notice the same body sensation, you think, “Oh no! Not another panic attack!” And your body reacts to that thought with increased anxious feelings, and your thoughts and feelings reinforce each other once again in a downward spiral.

Breaking the cycle

So how do you break the cycle? As strange as it sounds, the first step is to try to befriend the anxiety. When you see anxiety as the enemy, it creates a fear of fear that perpetuates the cycle. Remember, your anxiety is here to protect you. Sometimes it overreacts, but it’s your brain doing its job to keep you safe. If our ancestors didn’t have fear or anxiety to tell them to avoid dangers, we wouldn’t be here today. Once you can notice the anxiety as just body sensations, and let it pass, it won’t be so scary.

What to do during a panic attack: 10 tools to calm anxiety

Here are some things you can try during a panic attack. Try different things and see what works best for you.

When you first notice anxious body sensations, tell yourself, “These are just body sensations. They can’t hurt me. They may be uncomfortable, but they’re not dangerous.”
Imagine just letting the body sensations pass through you like a wave. It may go up, but it will also come down. And it won’t last forever.
Remind yourself, "The feelings always end. You’ve always gotten through it before, and you can get through it again."
Start breathing in counting to 5 and breathing out counting to 7. Any time you breathe out longer than you breathe in, it activates the parasympathetic nervous system and helps slow down your body. Remind yourself you can breathe through it
Ground yourself by using your 5 senses to notice what’s around you right now. Notice at least 5 sounds you can hear, 5 things you can see, 5 things you can feel, and press your feet into the floor. Keep going if it's helpful. Become the observer of the world around you.
Observe the feelings as just body sensations. Bring an attitude of openness and acceptance and curiosity like a scientist. Notice where they stop and start, if they’re moving or still, what color they would be, or what temperature.
Each time you breathe in, imagine creating space around the anxiety sensation that bothers you most, remembering you can always make a space big enough for the sensation, and you are always bigger than the space.
Place a hand on your heart or your belly and offer yourself compassion, “I know you’re scared, but you’re ok right now. I’m here for you.” If you like, you can imagine breathing in a warm light of compassion for yourself and allowing it to gather at your heart area.
If there's someone who you trust or feel safe with (even an animal), imagine that person there comforting you.
Imagine other people experiencing anxiety (there are LOTS of them), and imagine sending some of that compassion energy to them, “May you be happy. May you be at peace.” You can continue breathing in compassion for yourself, and breathing out compassion to others, thinking some for me, and some for them.

Getting to the root of the problem

Several minutes after that first panic attack began, I realized what was happening when I hadn’t died from an undiscovered food allergy. It wasn’t fun or pleasant, but I was able to calm myself, notice my feelings as just body sensations, and let it pass. In counseling, we use techniques like these to help manage anxiety in the present, while using EMDR therapy to help clear the roots. That way, the anxiety surfaces less often in the first place. With a combination of mindfulness and EMDR, we calm the anxiety in the present, while clearing the roots from the past. Learn more about EMDR for panic attacks, and in the mean time practice the Feelings Meditation to learn to calm difficult emotions.