To calm a panic attack, slow your breathing, tell yourself it's a panic attack and that it will pass, and anchor your attention in your surroundings. Symptoms usually peak within about 10 minutes and the attack typically ends within 5 to 20 minutes. Panic attacks are frightening, but they aren't dangerous on their own.
There's one important exception: panic and heart attacks can feel alike. If you have chest pain, trouble breathing or you feel faint, and you aren't sure it's panic, call 911. Below are the steps for the moment itself, what to do afterward and at night, and how panic is treated.
What a panic attack feels like
A panic attack is a sudden surge of intense fear or discomfort, often with no real danger present (NIMH). It can feel like your body has hit an alarm button. Common symptoms include:
- A racing or pounding heart
- Shortness of breath, or feeling like you can't get enough air
- Chest pain or tightness
- Sweating, chills, trembling
- Dizziness or feeling faint
- Tingling or numbness in your hands or fingers
- Nausea or a churning stomach
- A sense of doom, losing control or dying
- Feeling detached from your body or surroundings
Those come from NIMH, the NHS and Cleveland Clinic.
You're far from alone. Up to 11% of people in the US have a panic attack each year, and about 2% to 3% have panic disorder, meaning repeated attacks (Cleveland Clinic). Symptoms usually peak within about 10 minutes, and most attacks last 5 to 20 minutes, though some people report up to an hour.
Panic attack or heart attack? When to call 911
You usually can't tell a panic attack from a medical emergency on your own: they can look alike, and you can have both at once (Cleveland Clinic). NIMH notes that panic symptoms can feel like a heart attack, and a physical exam can rule out other causes (NIMH).
Call 911 right away if:
- You have chest pain, pressure, squeezing or heaviness, especially if it spreads to your jaw, neck, shoulder, arm or back.
- You have trouble breathing, heavy sweating or nausea along with chest discomfort.
- You faint or nearly faint.
- It's your first episode, it feels different from your usual attacks, or you simply aren't sure.
These warning signs come from Cleveland Clinic's guidance on heart attack and on a feeling of impending doom, which says to treat it as an emergency if you're unsure. Don't drive yourself to the hospital; wait for emergency responders.
The calming steps below are for when you're confident it's panic, usually because a doctor has already checked you and you recognize the pattern.
How to calm a panic attack: 6 steps
1. Stay where you are
If it's safe, stay put rather than rushing somewhere (NHS). If you're driving, pull over somewhere safe first. Sit down if you can.
2. Name it
Tell yourself plainly: "This is a panic attack. It's not dangerous, and it will pass." Both the NHS and Cleveland Clinic recommend reminding yourself that the attack isn't life-threatening and will end.
3. Slow your breathing
Breathe slowly and deeply. The NHS method:
- Breathe in gently through your nose, counting from 1 to 5. Don't worry if you can't reach 5 at first.
- Breathe out gently through your mouth, counting from 1 to 5.
- Let the breath go down toward your belly, only as far as is comfortable.
- Keep it going for a few minutes (NHS).
Cleveland Clinic suggests closing your eyes and keeping your attention on the breath (Cleveland Clinic). A long exhale is the part to focus on. In a 2023 Stanford trial in healthy adults (not people with panic disorder), five minutes a day of "cyclic sighing," a double inhale through the nose followed by a long, slow exhale, lowered anxiety and improved mood (Balban et al., 2023).
The NHS recommends practicing breathing exercises regularly, not only during an attack, so the technique is familiar when you need it.
4. Ground yourself in the present
Use your senses to pull your attention out of the alarm and back into the room. Cleveland Clinic suggests mindfulness to focus on the present and feel grounded (Cleveland Clinic). In practice: name a few things you can see, feel your feet on the floor, notice the texture of what you're holding, listen for the quietest sound in the room.
5. Relax your muscles
Panic tightens your body. Tense and release one muscle group at a time, for example your hands, then your shoulders, then your jaw (Cleveland Clinic).
6. Picture something calm
The NHS suggests focusing on positive, peaceful and relaxing images (NHS). A place you know well works better than an abstract scene.
If you're with someone having a panic attack
Stay with them and stay calm. Ask what they need, use short sentences, and help them breathe slowly by counting to five on each breath in and out. Reassure them that they're safe and that it will pass (Cleveland Clinic). If there's any sign of a medical emergency, call 911.
After a panic attack
Once the peak passes, you may feel shaky, drained or embarrassed. That's normal. Give your body a few minutes to settle before getting back to what you were doing.
- Do something gentle. Sit somewhere quiet, sip water, keep breathing slowly. This is also where calming audio, including ASMR, may help some people settle (more below).
- Skip the things that make panic worse. Caffeine, alcohol and smoking can all worsen attacks (NHS).
- Get checked if it's new. A healthcare provider should evaluate new panic symptoms to rule out a physical cause (Cleveland Clinic).
Panic attacks at night
Panic attacks can strike at any time, sometimes even during sleep (NIMH). Waking up already in the middle of one can be especially scary, because there's no obvious trigger and the room is dark.
The same steps apply: sit up, turn on a soft light, name it, breathe slowly. Then:
- Don't force sleep. If you can't fall back asleep within about 20 minutes, Mayo Clinic advises getting up, doing something calming in another room and going back to bed when you feel sleepy (Mayo Clinic).
- Watch evening caffeine and alcohol. Caffeine stays active for hours, and alcohol tends to disrupt sleep later in the night (Mayo Clinic).
- Settle worries before bed. Writing them down and setting the list aside can help (Mayo Clinic). Our guide on how to stop overthinking at night has more.
If night-time attacks keep happening, tell your doctor.
How panic attacks are treated
A single panic attack isn't a disorder. Panic disorder means repeated, unexpected attacks plus at least a month of worrying about more attacks or changing your behavior to avoid them (NIMH). It's treatable, and with treatment most people improve (Cleveland Clinic).
- Cognitive behavioral therapy (CBT). NIMH calls CBT the gold-standard psychotherapy for panic disorder. It teaches new ways to think about and respond to the physical sensations of panic. It often includes exposure, including gradually getting used to the body sensations that set off panic, sometimes combined with breathing and relaxation skills (NIMH). Mayo Clinic describes CBT as the most effective form of psychotherapy for anxiety disorders (Mayo Clinic). A course is usually short, often 5 to 15 sessions (NHS).
- Medication. Antidepressants called SSRIs and SNRIs are common options and can take several weeks to work. Benzodiazepines can ease symptoms quickly but can lead to tolerance or dependence, so they're often prescribed for short periods (NIMH).
- Healthy habits. Sleep, exercise, diet and leaning on people you trust support treatment, but they don't replace it (NIMH).
Start with your primary care provider, who can rule out physical causes and refer you to a psychologist, psychiatrist or clinical social worker. See someone if anxiety interferes with daily life, if you're avoiding places because of attacks, or if panic is disrupting your sleep (Cleveland Clinic).
Where ASMR fits
No study has tested ASMR for panic attacks or panic disorder. Here's what we do know, and how it might fit.
During a severe attack, it's probably not the main tool. Fumbling with your phone to find a video can keep you in your head. Breathing and grounding are the steps health bodies recommend, so start there.
Afterward, it may help you settle. In a lab study, people who experience ASMR had their heart rate drop by an average of 3.41 beats per minute while watching ASMR videos, and they reported feeling calmer (Poerio et al., 2018). That was in a calm lab setting, not after panic, and only in people who feel ASMR. For people who don't, it may do nothing: in one study, non-responders felt less relaxed after ASMR videos than after neutral walking-tour videos (Lohaus et al., 2023).
As a nightly routine, it may help you wind down. In the first large survey of ASMR fans, 70% said they watched to deal with stress and 82% to help them sleep (Barratt & Davis, 2015). That's self-reported, from people who already like ASMR, but it matches how many people use it: a predictable, calm cue at the end of the day.
If you want to try it, pick a quiet, steady voice. Soft-spoken ASMR and affirmations ASMR are good places to start. Keep the volume low and skip anything fast or unpredictable. Our guide to ASMR for anxiety goes deeper into the research.
Get help now
- Possible heart attack or other emergency: call 911.
- Crisis or thoughts of harming yourself: call or text 988 to reach the 988 Suicide & Crisis Lifeline (US). It's free and confidential.
- Repeated panic attacks: make an appointment with your doctor. Panic disorder is treatable, and most people improve with treatment.
