How to Stop a Panic/Anxiety Attack
What’s the difference between a panic attack and anxiety attack?
As with anything, knowing what you are dealing with and labeling it appropriately will help connect you to further resources to find the care you deserve. Although the labels are used interchangeably sometimes, both a panic attack and anxiety attack are different experiences. Each is awful in their own way. The key areas of difference include the onset, intensity, duration, and experience. For onset, anxiety attacks tend to slowly present themselves, whereas panic attacks are much more sudden. Regarding intensity and duration, anxiety attacks tend to be less intense for a much longer period. This can include an attack that lasts more than a day. Panic attacks are more intense but rarely last more than one hour.
Lastly, we have experience. Anxiety attacks are not formally recognized by the DSM tend to be more subjective. It is often described as a heightened and prolonged state of worry, stress, and hypervigilance (being sensitive to any sounds or movements in your environment). For a panic attack, the symptoms are well defined. These attacks include a racing heartbeat and racing thoughts, shortness of breath, sudden sense of disconnection and/or that the world does not feel real, dizziness, and a strong desire that they have to get out of their current location.
As both of these experiences involve a heightened nervous system response, I encourage everyone to be mindful of their caffeine and stimulant use when they are experiencing these challenges. Many are in such overwhelming times when these issues come up. This often interferes with sleep greatly. So, it makes sense to reach for some extra caffeine. However, if overdone, caffine and stimulants alone can prolong or cause these issues.
How to deal with an Anxiety or Panic Attack?
Fortunately, many of the strategies you can use to get through one will be helpful for the other. I also strongly encourage checking in with how you are feeling before and after each exercise you try. Take note of ones that seem to especially help. Just knowing that you have some effective strategies you can refer to later can do wonders to reassure yourself in the midst of such difficult experiences.
Calming an Anxiety Attack
Breathing: In – In – Out. The main foundation here will be slowing your breathing. There are lots of wonderful techniques to do so. The most impressive research I’ve read on it is for the “in in out” technique. As the name suggests, you take a deep breath through your nose, another small breath in through your nose, and a forceful breath out through your mouth.
Name It to Tame It: This is an odd one, but simply saying allowed that you think you’re having an anxiety attack often helps to bring the body into a calmer state.
Grounding: Noticing and trying to connect with the world around you is often a wonderful way to break the cycle. Regularly checking in with something like the blanket around you and lending attention to how it feels can do wonders. I’ll put an effective and popular grounding strategy below.
5, 4, 3, 2, 1 - involves connecting with your physical senses as a means of grounding. If you search online, you can find lots of different variants. This one is my favorite version of it:
Take three deep breaths (bonus points for the in - in - out breaths).
5. Name five things you can see around you. If you cannot see five that’s okay, just name as many as you can.
4. Name four things you can feel. This includes things you can touch or are already touching you. This might be a shirt, glasses, things next to you, or things happening inside of you like your heart beating.
3. Name three things you can hear. Again, if you can’t hear three, that’s okay. Just do your best to notice what you can hear - even if that is nothing at all.
2. Name two things you can smell. The goal here is to attend to your sense of smell. It’s common to not smell two different things at once.
1. Name one thing that are looking forward to.
Take three deep breaths, and you’ll have completed the exercise.
Vagus Nerve: There are lots of options here. For starters, if you are a side sleeper or feeling particularly overwhelmed, lying down on your right side can help stimulate this path. Some of my other favorites include placing a cold can or bottle on the back or sides of your neck with medium pressure. Cold showers or even dunking your face in cold water also are wonderfully effective options. Lastly, there’s a technique called “Prayer Breathes” that is quite helpful too. Here is a YouTube short that can walk you through it: https://youtube.com/shorts/2d1IyISFb0A?si=2tiXUj1coGX9VZUk
Walking: Being outside in open spaces and walking can also do wonders. As you might imagine, my favorite strategies tend to combine various techniques. By hearing the crunching of leaves, the bright leaves decorating the trees around you, and the smell of the air, you will likely have a much easier time being grounded in such a state.
Bonus points for having bird noises or water nearby
Calming a Panic Attack
I am going to put many of the same strategies that we used above for this section as well. There are some extra strategies that will be added as well.
Breathing: In – In – Out. The main foundation here will be slowing your breathing. There are lots of wonderful techniques to do so. The most impressive research I’ve read on it is for the “in in out” technique. As the name suggests, you take a deep breath through your nose, another small breath in through your nose, and a forceful breath out through your mouth.
Understand What’s Happening: Many who suffer from panic attacks find this out in an emergency room after going there believing they are suffering from a heart attack. If you have been medically cleared as being okay, knowing this and reassuring yourself that you are safe and you are okay is wildly important.
Reassurance: This is something you can provide for yourself, but I encourage leaning on your support system if you have a good one. Having someone you can call or using a support line can make such a difference when going through such an awful experience. I also recommend telling someone in your support system what you’d like to see from them if you were to call. That could include reminding you that you are alright, coming over, and/or simply being present with you. You can also remind yourself of these things during a panic attack. Saying, “You’re okay. You’re safe.” is a helpful way to do that.
Crisis Support Services: 1-800-273-8255 has 24/7 support for those experiencing crises, including panic attacks.
Grounding: Noticing and trying to connect with the world around you is often a wonderful way to break the cycle. Regularly checking in with something like the blanket around you and lending attention to how it feels can do wonders. I’ll put an effective and popular grounding strategy below.
5, 4, 3, 2, 1 - involves connecting with your physical senses as a means of grounding. If you search online, you can find lots of different variants. This one is my favorite version of it:
Take three deep breaths (bonus points for the in - in - out breaths).
5. Name five things you can see around you. If you cannot see five that’s okay, just name as many as you can.
4. Name four things you can feel. This includes things you can touch or are already touching you. This might be a shirt, glasses, things next to you, or things happening inside of you like your heart beating.
3. Name three things you can hear. Again, if you can’t hear three, that’s okay. Just do your best to notice what you can hear - even if that is nothing at all.
2. Name two things you can smell. The goal here is to attend to your sense of smell. It’s common to not smell two different things at once.
1. Name one thing that are looking forward to.
Take three deep breaths, and you’ll have completed the exercise.
Vagus Nerve: There are lots of options here. For starters, if you are a side sleeper or feeling particularly overwhelmed, lying down on your right side can help stimulate this path. Some of my other favorites include placing a cold can or bottle on the back or sides of your neck with medium pressure. Cold showers or even dunking your face in cold water also are wonderfully effective options. Lastly, there’s a technique called “Prayer Breathes” that is quite helpful too. Here is a YouTube short that can walk you through it: https://youtube.com/shorts/2d1IyISFb0A?si=2tiXUj1coGX9VZUk
Walking or Even Sitting: Being outside in open spaces and walking can also do wonders. As you might imagine, my favorite strategies tend to combine various techniques. By hearing the crunching of leaves, the bright leaves decorating the trees around you, and the smell of the air, you will likely have a much easier time being grounded in such a state.
Bonus points for having bird noises or water nearby
This is an unpleasant point but can make the difference between having one panic attack versus having numerous ones. Be careful of the desire to flee from your environment. Of course, keeping yourself safe should be the top priority. If you are in an unsafe environment, please go to a safer one. If you are in a safe spot but you feel the urge to flee, that can make panic attacks worse in the long run. You may experience intense relief when escaping from a situation, but that may train your body to believe you’ve dodged a major threat. It may tell your mind that there was something awful there. You just managed to avoid it. This will make it much more likely that your nervous system will respond just as intensely the next time you are in such a situation.
Alternatively, sitting and recovering in that difficult environment can help your body to learn that it was safe and not associate that place or circumstance with such fear.
Both anxiety and panic attacks can often come in waves. When our bodies are in extremely stressed states, we are more vulnerable to these events. This makes recovery and prevention important for anyone. These events are exhausting for everyone. I strongly encourage anyone to take a break if that have that ability. If not, I invite you to simply do what you can with the space you have.
Recovery
Things That You Enjoy: Anything that is not overly stimulating and stressful will often be a wonderful way to recover from the stress here.
Exercise: Low-Medium intensity exercise.
Sleep: If you’re waking up around 3am, I invite you to try some of these strategies later at night and even consider doing a journaling exercise two hours before bedtime. This 3am wakeup may also be indicitive of heightened levels of cortisol. I encourage you to do some of your own research on how you might work to identify and overcome this if it is the case. I’ll plan to write out some of my strategies for this in the future.
Distractions: Taking time to do things that capture your attention and give you a break from everything your mind is juggling can do wonders. I do encourage also doing regular check-ins with yourself. We don’t want to be caught in a pattern of running from our internal experiences. By
Warm Water: Warm showers or baths, cooling off, and then bundling up can be a wonderful way to rest
Written by Dr. Luke Bieber on September 19, 2025.