How to Manage a Panic Attack

When fear takes over

Panic attacks can feel terrifying: sudden, overwhelming, and completely out of your control. If you’ve ever had one, you know how quickly your body can convince you that something is deeply wrong, even when you can’t explain why. If you haven’t experienced one yourself, chances are someone you love has.

In this practical start to our new series, How to Handle Life, Austin delves into panic attacks: what they are, why they feel so intense, and, most importantly, what you can do in the moment when one hits.

This episode isn’t about quick fixes or pretending anxiety doesn’t exist. It’s about understanding what’s happening in your body, learning practical tools to calm your system, and remembering that you’re not alone in the middle of it.

Whether panic attacks are a regular part of your life or something you’ve only encountered once or twice, we hope you find clarity, comfort, and a sense of steady ground beneath your feet.

A few disclaimers: The information shared here is not a failsafe way to prevent a panic attack. It isn’t a replacement for seeing a medical professional. And we aren’t going to get into why you have a panic attack in the first place. There are many possible reasons for that, and most likely, you will need to see a therapist to get to the root of it.

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New year, new series!

Have you felt the urge to make any resolutions this new year? Perhaps you’d like to understand yourself and God better, learn some new skills, or get a better handle on this thing called life.

If so, we’ve designed this new series just for you. We know there are a lot of things going on in your life that aren’t easy to accept or manage. Every day, we meet with clients who struggle with unanswered prayer, stress, difficult relationships, how to know God’s will, and much more.

These episodes will be practical espresso shots full of wisdom that will leave you with a greater sense of confidence to handle all that life is throwing at you. And since we often see clients who struggle with panic attacks, this is a good way to start our series.

What is a panic attack?

If you’ve had a panic attack, you know what it is—or at least, how it feels. However, there’s something about explicitly defining things that brings greater levels of clarity and understanding in the moment.

A panic attack is a sudden, intense surge of fear or discomfort with abrupt and overwhelming anxiety that comes on quickly, often without a clear or immediate danger. It brings an overall sense that something is terribly wrong.

Panic attacks are usually accompanied by physical and cognitive symptoms:

• Increased heart rate

• Shortness of breath

• Dizziness, light-headedness

• Nausea

• Sweating, shaking, or chills

• The feeling that you are having a heart attack, or are going to die

After seeing this list of symptoms, you might wonder what, if anything, can be done to manage a panic attack. But there are some strategies that can help.

5 Steps to Manage Panic Attacks

Step 1: Controlled breathing for at least two minutes.

Specifically, breathe in for a count of 3, hold it for a count of 3, exhale for a count of 4, hold for a count of 4. This is called ‘box breathing’.

As you breathe, you can cross your arms over your chest or put your hands on your belly to feel yourself breathing. Push your belly out as you breathe in. I’ll explain why in a second. You may wonder, why start with breathing? When you’re in the middle of a panic attack, the only thing you can control is your breathing.

A panic attack means your body is on high alert and feels an imminent danger is present. Telling yourself cognitive truths like “I’m fine” or “I can do all things through Christ who strengthens me” (even though it’s an excellent Bible verse) won’t help, because the part of your brain responsible for explicit thought, analysis, and evaluation is offline. The emotional part of your brain is now in charge.

When you sense a panic attack coming, or are in the midst of one, your adrenal glands have poured adrenaline and cortisol into your body, which gives you a shot of energy and allows you to be on high alert for a perceived threat.

Your blood leaves your arms and legs and heads to go to your core, giving your heart more oxygen to work with. If you’ve ever gotten sweaty palms in a panic attack, this is the blood leaving your arms. Your heart starts beating faster. You’re in fight or flight mode.

But when you breathe slowly and consistently, your diaphragm pushes against your adrenal glands. This is essentially the off-switch. Adrenaline and cortisol will stop flowing. Your heart will begin to slow down, your blood will return to your limbs, and your thinking brain will go back online in 5-10 minutes. When these things happen, you’ll be able to move on to Step 2.

Step 2: Notice (also called ‘grounding’).

Play the 5-4-3-2-1 game. This exercise is all about engaging your senses to anchor yourself in the present. So, notice:

• 5 things you see around you

• 4 things you feel with your body

• 3 things you hear around you

• 2 things you smell

• 1 thing you taste

Step 3: Movement.

Breathing is a good start to calm you down, but you also might still have a lot of adrenaline and cortisol left over in your system. Some suggestions:

• Go outside

• Walk down the hall or around the block

• Do some pushups

• Jog in place

Step 4: Eat and drink.

Drink water, Gatorade, or juice; not alcohol, coffee, or an energy drink. Eat a snack. Ideally something with protein like nuts or trail mix, but anything is better than nothing. Something with sugar may help stabilize your blood sugar if that has dropped.

Don’t try to eat during the panic attack, as your throat may constrict and you might choke. Instead, eat after you’ve controlled your breathing, done the 5-4-3-2-1 exercise, moved around, and have calmed down.

Step 5: Get a hug.

If you have someone that you feel comfortable hugging, their presence can be the calm in the storm. Feeling the sturdy, consistent, quiet presence of a safe person helps calm the parts of your brain and body that think that you are in crisis.

If you’re getting the hug, focus on trying to match the other person’s breathing. If you’re giving the hug, concentrate on breathing nice and slow.

Managing the Moment, Exploring the Why

The more you practice all of these steps, the more natural they become. If you practice intentional breathing, noticing, and moving on a regular basis, then when you sense a panic attack is coming, you’ll be able to handle it more effectively.

These strategies are meant to help you with the downstream issue of a panic attack. They will not help you discover the upstream source of why your panic attacks are happening in the first place. If you want to figure that out, you’re going to need to do some deeper reflecting and searching, with a trusted friend, mentor, or counselor.

Remember that Jesus knows you are anxious. He isn’t expecting you to live an anxiety-free life. Instead, he wants you to bring those anxieties to him. As 1 Peter 5:7 says, “Cast all your anxieties on him, because he cares for you.”