Short answer: A panic attack feels terrifying, but in itself it is usually not physically dangerous, and most attacks peak within a few minutes and then fade on their own. The most useful things you can do are to lengthen your out-breath, bring your attention back to your senses, name what is happening ("this is a panic wave, it will pass") and stay where you are rather than fleeing. These steps let the attack run its course and, over time, can help make future attacks less likely.
What happens in the body during a panic attack?
A panic attack is the body's fight-or-flight alarm going off when there is no real danger. Adrenaline is released: the heart races, breathing becomes fast and shallow, muscles tense, palms sweat, and you may feel dizzy, tight-chested or tingly. None of this is a malfunction; it is the response your body would need to run from a real threat.
The problem is that the sensations themselves are frightening. Read a racing heart as "heart attack" or dizziness as "I'm going to faint", and fear rises, which makes the sensations stronger. That is the panic cycle. The alarm cannot run at full strength for long; symptoms usually peak within about ten minutes and then settle. Unsure whether you experience anxiety or panic? We cover the difference in this post.
What should I do in the first 60 seconds? 5 steps
- 1. Label it. Say to yourself: "This is a panic wave. Frightening, but temporary. It will pass." Naming it removes the uncertainty that feeds the cycle.
- 2. Lengthen your out-breath. Focus on breathing out, not in: in through the nose for four, out through the mouth for six. Details below.
- 3. Ground yourself (5-4-3-2-1). Silently list five things you can see, four you can touch, three you can hear, two you can smell and one you can taste. Attention moves from the body to the room.
- 4. Stay put. Sit down, lean on a wall, slow your pace. Leaving brings relief now but teaches the brain that the place was dangerous.
- 5. Let the wave pass. Watch the sensations rise, crest and fall instead of fighting them. Feeling shaky afterwards is normal; drink water and move gently.
How do I do the breathing exercise?
The most common mistake is gulping deep breaths because it feels like you cannot get enough air. Over-breathing can upset the carbon dioxide balance in the blood and can worsen dizziness and tingling; a slow, long out-breath helps restore it.
- Place one hand on your belly and drop your shoulders.
- Breathe in quietly through your nose for about four seconds.
- Purse your lips and breathe out slowly for about six seconds, as if making a candle flame flicker.
- Pause briefly, then repeat for six to ten rounds, roughly two minutes.
Exact counts vary; what matters is an out-breath longer than the in-breath. Practising a few minutes a day when calm makes it far easier to remember during an attack.
How can I help someone who is having a panic attack?
The best thing you can do is stay calm and slow the pace; your alarm becomes their alarm.
- Use short, calm sentences: "I'm here. This is a panic attack, it will pass. Breathe out with me."
- Avoid "calm down" or "you're overreacting"; they make the person feel unseen.
- Count the out-breath out loud together.
- Ask what they need: to sit, water, quiet. Ask before touching them.
- Do not rush them out; stay until it passes. Afterwards, "it's over, you did well" is enough.
When should I see a psychologist?
One panic attack in a stressful period happens to many people and does not by itself mean something is wrong. Consider support if:
- Attacks are recurring or becoming more frequent.
- You avoid places where an attack happened (the metro, shopping centres, meetings, being alone).
- Much of the day goes to worrying it will happen again.
- Symptoms continue although a doctor has ruled out physical causes.
With a clinical psychologist you look at how the panic cycle works for you, learn breathing and grounding skills, and return to avoided situations step by step. Cognitive behavioural therapy is one of the approaches best supported by research here. Whether medication is needed is a separate question for a psychiatrist. See our anxiety and panic page and our services.
When should I go to the emergency department?
Panic symptoms can overlap with medical conditions, including heart problems, and that distinction cannot be made online. Call 112 or go to the nearest emergency department if:
- You have chest pain or shortness of breath for the first time.
- Pain spreads to your arm, jaw or back, or does not ease with rest.
- There is fainting, slurred speech or one-sided weakness.
- Symptoms last more than half an hour without easing.
- You have a known heart, blood pressure or breathing condition.
Assessing the heart is a doctor's job. Once a physical cause is ruled out, you can apply the steps above with more confidence. If thoughts of harming yourself are present, seek urgent help as well: 112.
Key takeaways
- A panic attack is frightening but in itself usually not physically dangerous; it usually peaks and fades within minutes.
- First minute: label it, lengthen the out-breath, ground with 5-4-3-2-1, stay put, let the wave pass.
- Help others with calm, short sentences; never "calm down".
- Recurring attacks, avoidance and fear of the next one: see a psychologist.
- First-time chest pain or breathlessness: call 112.
Support for panic attacks in Beylikdüzü
At Sone Wellbeing Unit in Beylikdüzü, Istanbul, you can meet our clinical psychologists in person or online. To understand how panic attacks work for you and build a plan that fits, request an appointment. This article is general information; please discuss your own situation with your clinician.
