PANIC & ANXIETY
Panic attacks: what can help in the moment and afterwards
A practical guide to grounding, comfortable breathing, recognising when to seek medical help and finding longer-term support.
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By Elena Krechko · Registered Clinical Counsellor (RCC, BCACC), ICF Master Certified Coach (MCC), EMDR Europe Certified Practitioner and accredited clinical psychologist in Russia.
A panic attack can feel frightening: your heart races, breathing feels difficult and you may fear losing control. Panic can involve an intense alarm response even when there is no immediate danger. Knowing this may help, but an article cannot establish that a new symptom is caused by panic.
First, consider medical safety. New or severe chest pain, fainting, significant breathing difficulty or symptoms that feel different from previous assessed attacks need urgent medical attention. Do not delay seeking help because you assume it is “only anxiety”. If this is your first episode, arrange a healthcare assessment. NHS information on panic disorder.
I work with panic-related difficulties as a psychotherapist, psychologist and coach. We can explore both ways of responding during an episode and the patterns that may be maintaining fear afterwards.
In the first moments: reduce the struggle
When you recognise a familiar, previously assessed panic response, it may help to stop demanding that every sensation disappear immediately. Fighting the feeling or judging yourself can add another layer of fear. There is no thirty-second test that determines whether you will cope successfully.
1. Use a realistic reminder. You might say: “This feels like the panic I have experienced before. It is distressing, and I can take one step at a time.” Choose words that acknowledge your experience rather than trying to argue it away.
2. Find a safe position. If it is safe, sit down or pause where you are. Move away from traffic, stairs or another hazard if needed. You do not have to prove anything by staying in a place that is unsafe. Seeking medical help when symptoms are concerning is appropriate.
3. Describe what you notice without jumping to a conclusion. “My heart is beating quickly.” “My hands feel tingly.” Naming a sensation can create a little distance from a catastrophic thought. It does not diagnose the cause or literally switch off one part of the brain.
Three options for the present moment
Grounding: 5–4–3–2–1
Gently bring attention to your surroundings. You can name five things you see, four things you feel against your body, three sounds you hear, two smells you notice and one taste or another simple sensory detail.
There is no need to strain to find a smell or taste, or to complete the sequence perfectly. Notice the chair supporting you, the floor under your feet or a familiar object nearby. The aim is to orient yourself to the present. It is not a guarantee that an attack will end within ninety seconds.
Comfortable, unforced breathing
Try breathing gently and regularly rather than taking repeated large breaths or holding your breath for long counts. Let the breath move in and out at a pace that feels comfortable. If counting helps, use a simple, easy rhythm without forcing it.
Box breathing is sometimes suggested, but breath holds do not feel helpful to everyone during panic. If an exercise makes you more light-headed or distressed, stop forcing it and return to comfortable breathing. Do not use a paper bag.
A neutral sensory anchor
Some people find it helpful to notice the texture of an object, hold a comfortably cool drink or touch a stable surface. Use a sensation that feels safe and ordinary. You do not need ice directly on your skin, freezing water on your face or a painful stimulus to “reset” your nervous system.
After the episode: care before criticism
When the intensity settles, allow a little time to recover. You might drink some water, contact a supportive person and acknowledge: “That was difficult, and I got through it.” You do not need to turn the experience into a verdict about your strength.
It can be useful to make a brief note of what happened, without monitoring every sensation for the rest of the day. Consider three questions:
When avoidance begins to shrink your life
After an attack on public transport or in a shop, you may understandably want to avoid that place. Avoidance can provide short-term relief while making future encounters feel more threatening. You may find yourself giving up more and more activities.
Therapy can help you consider a gradual, agreed plan for returning to situations that matter to you. Exposure-based work is a recognised part of treatment for panic-related difficulties; it should be tailored to your circumstances and relevant medical assessment. The aim is not to force yourself abruptly into your greatest fear.
Reducing or avoiding caffeine may be helpful for some people, so this is not automatically an unhelpful response. We distinguish sensible care from restrictions driven by fear that are increasingly limiting your life.
When to seek professional help
You do not need to wait until attacks happen several times a week or continue for a month. If fear is affecting work, travel, relationships or leaving home, ask for support. New symptoms, hearing voices or a marked change in your mental state also call for an appropriate clinical assessment rather than self-diagnosis from a panic checklist.
Panic-related conditions can be treated. Psychotherapy and, for some people, medication are options to discuss with a qualified healthcare professional. The choice depends on your needs, preferences and health circumstances. NIMH information on panic disorder and treatment.
Taking back a little room to live
You are not broken because your alarm response feels overwhelming. You can learn ways of understanding it and gradually reduce its control over your choices. Grounding, gentle breathing and a record of patterns may support that process, alongside suitable professional care.
If you would like an individual consultation, use the private enquiry form. We can discuss what you have experienced, what has already been assessed and an appropriate plan for further support.
Request a free introductory conversation · 15–20 minutes
Explore counselling and coaching · Email Elena
By Elena Krechko · Registered Clinical Counsellor (RCC, BCACC), ICF Master Certified Coach (MCC), EMDR Europe Certified Practitioner and accredited clinical psychologist in Russia.
A panic attack can feel frightening: your heart races, breathing feels difficult and you may fear losing control. Panic can involve an intense alarm response even when there is no immediate danger. Knowing this may help, but an article cannot establish that a new symptom is caused by panic.
First, consider medical safety. New or severe chest pain, fainting, significant breathing difficulty or symptoms that feel different from previous assessed attacks need urgent medical attention. Do not delay seeking help because you assume it is “only anxiety”. If this is your first episode, arrange a healthcare assessment. NHS information on panic disorder.
I work with panic-related difficulties as a psychotherapist, psychologist and coach. We can explore both ways of responding during an episode and the patterns that may be maintaining fear afterwards.
In the first moments: reduce the struggle
When you recognise a familiar, previously assessed panic response, it may help to stop demanding that every sensation disappear immediately. Fighting the feeling or judging yourself can add another layer of fear. There is no thirty-second test that determines whether you will cope successfully.
1. Use a realistic reminder. You might say: “This feels like the panic I have experienced before. It is distressing, and I can take one step at a time.” Choose words that acknowledge your experience rather than trying to argue it away.
2. Find a safe position. If it is safe, sit down or pause where you are. Move away from traffic, stairs or another hazard if needed. You do not have to prove anything by staying in a place that is unsafe. Seeking medical help when symptoms are concerning is appropriate.
3. Describe what you notice without jumping to a conclusion. “My heart is beating quickly.” “My hands feel tingly.” Naming a sensation can create a little distance from a catastrophic thought. It does not diagnose the cause or literally switch off one part of the brain.
Three options for the present moment
Grounding: 5–4–3–2–1
Gently bring attention to your surroundings. You can name five things you see, four things you feel against your body, three sounds you hear, two smells you notice and one taste or another simple sensory detail.
There is no need to strain to find a smell or taste, or to complete the sequence perfectly. Notice the chair supporting you, the floor under your feet or a familiar object nearby. The aim is to orient yourself to the present. It is not a guarantee that an attack will end within ninety seconds.
Comfortable, unforced breathing
Try breathing gently and regularly rather than taking repeated large breaths or holding your breath for long counts. Let the breath move in and out at a pace that feels comfortable. If counting helps, use a simple, easy rhythm without forcing it.
Box breathing is sometimes suggested, but breath holds do not feel helpful to everyone during panic. If an exercise makes you more light-headed or distressed, stop forcing it and return to comfortable breathing. Do not use a paper bag.
A neutral sensory anchor
Some people find it helpful to notice the texture of an object, hold a comfortably cool drink or touch a stable surface. Use a sensation that feels safe and ordinary. You do not need ice directly on your skin, freezing water on your face or a painful stimulus to “reset” your nervous system.
After the episode: care before criticism
When the intensity settles, allow a little time to recover. You might drink some water, contact a supportive person and acknowledge: “That was difficult, and I got through it.” You do not need to turn the experience into a verdict about your strength.
It can be useful to make a brief note of what happened, without monitoring every sensation for the rest of the day. Consider three questions:
- Where was I, and what was happening?
- What might have contributed: poor sleep, missed meals, a stressful event, caffeine or another factor?
- What seemed helpful, and what made the fear stronger?
When avoidance begins to shrink your life
After an attack on public transport or in a shop, you may understandably want to avoid that place. Avoidance can provide short-term relief while making future encounters feel more threatening. You may find yourself giving up more and more activities.
Therapy can help you consider a gradual, agreed plan for returning to situations that matter to you. Exposure-based work is a recognised part of treatment for panic-related difficulties; it should be tailored to your circumstances and relevant medical assessment. The aim is not to force yourself abruptly into your greatest fear.
Reducing or avoiding caffeine may be helpful for some people, so this is not automatically an unhelpful response. We distinguish sensible care from restrictions driven by fear that are increasingly limiting your life.
When to seek professional help
You do not need to wait until attacks happen several times a week or continue for a month. If fear is affecting work, travel, relationships or leaving home, ask for support. New symptoms, hearing voices or a marked change in your mental state also call for an appropriate clinical assessment rather than self-diagnosis from a panic checklist.
Panic-related conditions can be treated. Psychotherapy and, for some people, medication are options to discuss with a qualified healthcare professional. The choice depends on your needs, preferences and health circumstances. NIMH information on panic disorder and treatment.
Taking back a little room to live
You are not broken because your alarm response feels overwhelming. You can learn ways of understanding it and gradually reduce its control over your choices. Grounding, gentle breathing and a record of patterns may support that process, alongside suitable professional care.
If you would like an individual consultation, use the private enquiry form. We can discuss what you have experienced, what has already been assessed and an appropriate plan for further support.
Request a free introductory conversation · 15–20 minutes
Explore counselling and coaching · Email Elena