By Karyn Hall, Ph.D., Founder of the Houston DBT Center
Last Update August 20, 2025
Understanding Panic Attacks
A panic attack can feel like your body and mind are being hijacked without warning. Many people describe it as a sudden wave of intense fear or discomfort that peaks within minutes. Even though panic attacks aren’t dangerous, the symptoms can feel so overwhelming that they’re often mistaken for a heart attack or other medical emergency. Most panic attacks peak within 10 minutes and start to ease within 20–30 minutes, though milder aftereffects like fatigue or shakiness can last for hours.
Here’s what you might experience during a panic attack:
Physical Sensations
- Racing or pounding heartbeat (palpitations)
- Shortness of breath or feeling like you can’t get enough air
- Tightness or pain in the chest
- Sweating, trembling, or shaking
- Dizziness or lightheadedness
- Nausea or stomach discomfort
- Chills or hot flashes
- Tingling or numbness in hands, feet, or face
Although panic attacks are not life-threatening, they can feel terrifying in the moment. Knowing exactly what to do can help you move through the episode more quickly and reduce its intensity.
Step 1: Remind Yourself That You Are Safe
The first step is to acknowledge what’s happening and remind yourself that a panic attack, while uncomfortable, is not dangerous. Labels help activate a “brake” in the brain that can help you regulate.
“This is my body’s fight-or-flight system. It will pass.”
Repeating a calming statement like the above can help interrupt the spiral of catastrophic thoughts.
Step 2: Focus on Your Breath
Shallow, rapid breathing can intensify panic symptoms. Try slow, controlled breaths:
- Inhale through your nose for a slow count of 4.
- Hold your breath for a count of 1–2.
- Exhale gently through your mouth for a count of 6.
- Repeat for 1–2 minutes.
Tip: Place your hand on your belly and feel it rise and fall to ensure you’re breathing deeply from your diaphragm. Breathing this way really makes a difference. Breathing seems like such a simple strategy—but it is amazingly helpful!
Step 3: Use Grounding Techniques
Grounding helps shift your focus away from panic and into the present moment.
- 5-4-3-2-1 Method:
- 5 things you can see
- 4 things you can touch
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste
- Temperature Shift: Splash cold water on your face or hold a cool object to help regulate your nervous system.
Focusing on the panic can escalate the symptoms. Distractions with your sense can help.
Step 4: Relax Your Body
Panic attacks trigger muscle tension. Try progressive muscle relaxation:
- Start at your feet, tense the muscles for a count of 5, then release.
- Move upward through your legs, abdomen, shoulders, arms, and face.
This sends a signal to your brain that it’s safe to relax.
Step 5: Visualize a Safe Place
Close your eyes and picture a calming scene — a beach, forest, or any place where you feel secure. Focus on the details: sounds, smells, temperature, and textures. You might consider making a recording of you describing your calm place to keep with you (such as on your phone) to play when you feel tension and panic.
Step 6: Stay in the Moment
Avoid running away from the situation unless you’re in genuine danger. Leaving can reinforce the idea that the environment is unsafe. If possible, remain where you are until the wave of panic passes.
Step 7: Practice Self-Compassion
After the attack subsides, be gentle with yourself. You may feel drained or emotional. Hydrate, rest if needed, and remind yourself that experiencing panic does not mean you are weak or broken.
When to Seek Professional Help
If panic attacks are frequent, intense, or interfere with your daily life, it’s important to reach out to a mental health professional. Treatments like Cognitive Behavioral Therapy (CBT), exposure therapy, and sometimes medication can significantly reduce symptoms.
Quick Panic Attack Calming Checklist
Acknowledge it’s a panic attack — you are safe- Slow, deep breathing (4-1-6 pattern)
- Use grounding techniques
- Relax your muscles
- Visualize a safe place
- Practice self-compassion after
Acknowledge it’s a panic attack — you are safeIf you suffer from panic attacks, contact us at the DBT Center. We are ready to work together to help.
713-973-2800 or complete the “make appointment form on our website.
FAQ Section: Panic Attacks
Q1: What’s the difference between a panic attack and an anxiety attack?
A: While both can cause intense fear and physical symptoms, panic attacks are sudden and reach peak intensity within minutes, often without a clear trigger. Anxiety attacks usually build gradually and are tied to ongoing worry or stress.
Q2: Can panic attacks happen while I’m asleep?
A: Yes. These are called nocturnal panic attacks. They can wake you from sleep with symptoms similar to daytime attacks, such as rapid heartbeat, shortness of breath, and intense fear.
Q3: Can diet or caffeine trigger a panic attack?
A: For some people, high caffeine intake, blood sugar drops, or certain food sensitivities can trigger symptoms. Keeping a symptom journal can help identify personal triggers.
Q4: Are panic attacks dangerous to my health?
A: Panic attacks themselves are not dangerous, but their symptoms can mimic serious health issues like heart problems. If you’re unsure whether it’s a panic attack or a medical emergency, seek medical care.
Q5: Can I prevent panic attacks before they start?
A: While you can’t always stop them, practicing stress management, regular exercise, adequate sleep, and mindfulness can reduce frequency and intensity. Identifying and addressing triggers can also help.
Disclaimer: This blog is for educational purposes only and is not a substitute for professional diagnosis or treatment. If you experience chest pain, difficulty breathing, or symptoms that could indicate a medical emergency, seek medical attention immediately.