Emergency Action: Panic Attack Procedure

Helping Yourself

A panic attack is often a reaction to fear (either conscious or unconscious), and some of the strange physical reactions you experience during one are the result of your body reacting to this fear. Common catalysts of panic attacks include:

  • Anticipatory anxiety. You become mentally anxious over a past, traumatic event, and your body responds as if it will happen again right away. Catalysts can include photographs, conversations, or anything that triggers the bad memory.
  • Self-defeating visualization. You may not only picture yourself re-experiencing a traumatic event, but you may also fear losing control of a current situation and not being able to handle it. You interpret the situation as potentially dangerous, and your body secretes adrenaline to prepare for crisis.

Right away: Look around you. Find 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and one thing you can taste.

Understanding how your body and mind work during these episodes can help you develop a healthier response to frightening situations. Although there are innumerable variations, common reactions to panic include:

Your body goes on alert. Your brain sends a message to your body to protect it against the perceived danger, and your body prepares for the pseudo-emergency. For instance, the eyes may dilate to improve vision, your heart rate quickens to circulate blood faster to vital organs, breathing increases to get more oxygen to the circulating blood, and your muscles tense in case you have to move quickly.

Your mind remains stuck on fearful thoughts. Instead of reacting to either solve the problem or remove yourself from the situation (which you’d likely do in a real emergency), you get stuck on the perceived threat and remain unable to let go of the fear.

Your breathing becomes more rapid. Inhaled oxygen reacts with your cells to produce carbon dioxide, which is then exhaled. During a panic attack, breathing rates increase so your body can absorb oxygen more quickly in preparation for any necessary action. During rapid, heavy breathing (also called hyperventilation), your lungs exhale more carbon dioxide than your cells produce, causing the level of carbon dioxide in your blood and brain to fall. The results (which may include dizziness and heart palpitations) can cause some people to panic further, thereby increasing breathing even more.

Relax Your Breathing and Muscles

If you feel an attack coming on, simple breathing and relaxation techniques can help you feel more in control. But don’t wait until you’re having a panic attack to perfect the techniques. Practicing them twice a day for just 10 minutes at a time may make your panic attacks less frequent and easier to conquer.

Relax your breathing. Put one hand on your upper-chest, and the other over your diaphragm (where your rib cage meets your stomach).

  • Take in a slow, deep breath through your nose while counting to five. The hand on the chest should stay still, while the one over your diaphragm should raise with your breath. This is how you know the breath is deep enough.
  • When you reach the count of five, let the breath out slowly (through your nose) at the same rate. Concentrating on your hands and the counting will help focus you and calm you down. Continue these breaths until you feel relaxed.
  • Relax your muscles. Find a comfortable position to sit in (or lie down).
  • Close your eyes and begin to focus solely on your toes. Curl them under tightly for a count of five, squeezing the muscles together as hard as you can, then relax.
  • Next, concentrate on your feet. Contract all of their muscles tightly for a count of five, then relax.
  • Continue up your body, isolating each muscle group (calves, thighs, buttocks, stomach, chest, shoulders, neck, fingers, hands, and arms) all the way up to your face.

By the time you contract and relax your face muscles, you should feel much more calm.

If you're with someone currently having a panic attack: 

  1. Be calm
  2. Be patient
  3. Don’t be condescending
  4. Remind us that we’re not crazy
  5. Sit with us
  6. Ask us to tighten and relax our muscles one by one
  7. Remind us that we are breathing
  8. Engage us in a discussion (if we can talk, then we can breathe)
  9. If we are having trouble breathing, try getting us to exhale slowly
  10. Or breathe through our nose
  11. Or have us put our hands on our stomach to feel each breath
  12. Ask us what needs to change in our environment in order for us to feel safe
  13. Help us change it
  14. Usually, just knowing that we have someone on our side willing to fight our scary monsters with us is enough to calm us down