In one of the last articles devoted to Panic attacks and Drugs, I promised to describe in more detail practical techniques and strategies in order to deal with panic attacks, in fact. I’m fulfilling my promise.

What Happens During a Panic Attack?

What Happens During a Panic Attack?

A panic attack is a sudden episode of intense fear or anxiety that triggers severe physical and emotional reactions, even when there is no apparent danger. The body’s “fight or flight” response is activated, releasing adrenaline and other stress hormones. This can lead to symptoms like rapid heartbeat, shortness of breath, trembling, and a feeling of impending doom.

Mechanisms Involved in Panic Attacks

Fight or Flight Response: The body’s “fight or flight” system is activated, releasing adrenaline and other stress hormones. This is an evolutionary mechanism designed to prepare the body for immediate action in the face of danger.

Increased Heart Rate: The heart pumps faster to circulate blood more quickly, which can lead to palpitations or a pounding heart.

Rapid Breathing (Hyperventilation): The rate of breathing increases to supply more oxygen to the muscles. This can lead to a feeling of breathlessness.

Muscle Tension: Muscles may tense up as the body prepares for rapid action, which can cause shaking or trembling.

Digestive Changes: Blood is diverted away from the digestive system, leading to nausea or abdominal distress.

Sensory Sensitivity: Some people report heightened senses, such as vision and hearing, during a panic attack.

Cognitive Effects: The mind may go into a state of hyper-vigilance, where you’re excessively aware of your surroundings, or you may experience feelings of unreality or detachment.

Immediate Actions

Immediate Actions

Recognize That You’re Having a Panic Attack
Recognizing that you’re having a panic attack rather than a life-threatening medical condition can help you focus on coping strategies. Awareness allows you to activate coping mechanisms more quickly, reducing the duration and severity of the attack.
When you feel a panic attack coming on, remind yourself that it is temporary and that you have the tools to manage it.

Find a Safe Space: If possible, go to a quiet and safe environment.

Reach Out: If you’re comfortable, call or text a trusted friend or family member to talk you through the panic attack.

Avoid Caffeine and Sugar: These can exacerbate symptoms, so avoid consuming them during a panic attack.

Stay Still: Try to sit down and stay still until the panic attack passes. Moving around can increase your heart rate and exacerbate symptoms.

Seek Medical Help: If the symptoms do not subside or if this is your first experience with a panic attack, seek immediate medical attention to rule out other potential causes.

Breathing Exercises for Panic Attacks

Breathing Exercises for Panic Attacks

Breathing exercises can be a powerful tool in managing panic attacks. They work by counteracting the body’s “fight or flight” response, which is activated during a panic attack. Controlled breathing helps to slow down the heart rate, reduce muscle tension, and promote relaxation.

Mechanisms in the Human Body

Oxygen-Carbon Dioxide Balance: Controlled breathing helps maintain a balanced level of oxygen and carbon dioxide in the blood, which can be disrupted during hyperventilation.

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Parasympathetic Activation: Deep breathing stimulates the parasympathetic nervous system, which helps to calm the body.

Reduced Adrenaline: Slowing down your breathing can help reduce the release of stress hormones like adrenaline.

4-7-8 Technique

Inhale: Through the nose for 4 seconds

Hold: The breath for 7 seconds

Exhale: Through the mouth for 8 seconds

Repeat: 3-4 times

Box Breathing

Inhale: Through the nose for 4 seconds

Hold: The breath for 4 seconds

Exhale: Through the mouth for 4 seconds

Hold: The breath for 4 seconds

Repeat: 3-4 times

Diaphragmatic Breathing

Inhale: Deeply through the nose, filling the diaphragm (not just the chest)

Hold: For a moment

Exhale: Slowly through the mouth

Repeat: As needed

Pursed Lip Breathing

Inhale: Through the nose for 2 seconds
Exhale: Through pursed lips for 4 seconds
Repeat: As needed

Practice Regularly: The more you practice, the more natural these techniques will feel.

Seek Professional Help: If panic attacks are affecting your quality of life, consult a healthcare provider for a comprehensive treatment plan.

Grounding Techniques

Grounding Techniques

Close Your Eyes

If you find yourself in a situation where a panic attack is triggered by overwhelming stimuli, try closing your eyes and focusing on your breath. Closing your eyes can help reduce stimuli that may be exacerbating your panic attack. By reducing sensory input, you can more easily focus on your breathing and other coping mechanisms.

Find a Focus Object

Having a focus object can help you ground yourself during moments of high stress or anxiety. Focusing on a physical object can divert your attention from stressors, helping to deactivate the “fight or flight” response. Choose an object that has personal significance or calming properties, like a smooth stone or a small trinket, and focus on it when you feel overwhelmed. Or hold onto something with a distinct texture, like a piece of ice, a soft blanket, or a stress ball.

The scent of lavender has been shown to reduce stress and anxiety. Mechanism
Lavender activates the olfactory nerve, which sends signals to the brain that can induce a state of relaxation. Keep a small vial of lavender essential oil or a sachet of dried lavender to inhale when you need to relax.

5-4-3-2-1 method

To ground yourself in the present by identifying

  • 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.

Progressive Muscle Relaxation

Start from your toes and work your way up, tensing and relaxing each muscle group for 5-10 seconds.

It can help you become more aware of physical sensations, aiding in stress and anxiety management. Practice progressive muscle relaxation regularly to improve your body awareness and manage stress more effectively.

And More Grounding

Counting: Count backward from 100 by 7s or simply count objects around you.

Alphabet Game: Think of a category (like fruits, animals, etc.) and try to name something in that category for each letter of the alphabet.

Temperature Change: Splash cold water on your face or hold onto a cold object.

Visual Grounding: Focus on a non-triggering image or object, describing its shape, color, and texture in detail.

Auditory Grounding: Listen to calming music or nature sounds.

Movement: Simple movements like tapping your feet or snapping your fingers can also help ground you.

Sedative Substances

Sedative Substances

Sedative substances aim to calm the nervous system by affecting neurotransmitters like GABA, which inhibits nerve activity, thereby reducing symptoms of panic.

Natural Sedatives

Examples: Valerian root, Lavender, Chamomile, Passionflower, Lemon Balm

Mechanism: These herbs have natural calming effects.

Usage: As teas or supplements.

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Caution: Efficacy varies; consult a healthcare provider for proper usage.


Examples: Benadryl (Diphenhydramine)

Mechanism: Blocks histamine receptors, which can have a mild sedative effect.

Usage: Short-term relief for mild symptoms.

Caution: May cause drowsiness; not suitable for long-term treatment of panic disorder.


Examples: Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam)

Mechanism: Enhances the effect of GABA, a neurotransmitter that inhibits brain activity.

Usage: Short-term relief from acute symptoms.

Caution: Risk of dependency and other side effects like drowsiness.

Always consult a healthcare provider for a proper diagnosis and treatment plan, which may include medication, cognitive-behavioral therapy, or a combination of both.

Sedative substances can have side effects like drowsiness, dependency, and interactions with other medications. Always read the label and consult a healthcare provider for proper usage.

Overuse or misuse of sedative substances can lead to severe health issues, including dependency and overdose.

Keep track of how effective the medication is in managing your symptoms and report any concerns to your healthcare provider.

Consider combining medication with other forms of treatment like therapy for a more holistic approach to managing panic attacks.

Long-Term Strategies to Prevent Panic Attacks

Long-Term Strategies to Prevent Panic Attacks

Cognitive Behavioral Therapy (CBT): This form of therapy can help you understand the triggers and thought patterns that lead to panic attacks. CBT is one of the most effective forms of treatment for managing panic attacks. It works by helping you identify negative thought patterns and beliefs that contribute to your anxiety. It then teaches you to replace these with more rational and positive thoughts. If you experience frequent panic attacks, consider seeking professional counseling. A qualified therapist can provide you with coping strategies tailored to your needs.

Knowing My Body Helps: Being aware of your body’s signals and sensations is crucial for maintaining a balanced life. This heightened awareness can help you manage stress, improve mental health, and even detect health issues at an early stage. Here are some advanced strategies to help you become more in tune with your body.

Regular Exercise: Light exercise like walking or stretching can improve both your physical and mental well-being. Exercise releases endorphins, which are natural mood lifters. It also helps you become more aware of your body’s capabilities and limitations. Incorporate light exercise into your daily routine to improve body awareness and overall health.

Mindfulness and Relaxation Techniques: Mindfulness involves being fully present and engaged in the moment, which can significantly improve your body awareness. Mindfulness practices train your brain to focus on the present moment, allowing you to better recognize bodily sensations, emotions, and thoughts. Start with simple mindfulness exercises, such as mindful breathing or body scan meditation, to become more aware of your body’s signals.

Online meditation platforms offer guided sessions that can help you practice mindfulness more effectively. These platforms often provide a variety of meditation styles and lengths, allowing you to choose what best suits your needs and schedule.
Explore apps or websites that offer guided mindfulness meditations. Many offer free trials or free basic versions. If you know good ones, please share in comments

Healthy Diet: Eating a balanced diet rich in nutrients can have a positive effect on your mental health.

Avoid Drugs That Stimulate Your Brain: I didn’t specifically write just “stimulants”. Because not only classical stimulants like caffeine, nicotine and amphetamines can potentiate the development of panic attacks. But also euphoretics, psychedelics and even cannabis. Especially modern hybridized cannabis. If you have experienced a panic attack, or you have a tendency to such conditions or a confirmed diagnosis, in my opinion, you should give up substances that have an activating effect on the central nervous system.

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Sleep Hygiene: Lack of sleep can exacerbate anxiety. Aim for 7-8 hours of quality sleep per night.

Social Support: Having a strong support network can help you manage stress and reduce the frequency of panic attacks.

Pharmacotherapy: Medications like antidepressants or anti-anxiety medication can be prescribed to prevent panic attacks. Medications can help regulate neurotransmitters in the brain, reducing the frequency and severity of panic attacks.
Consult your healthcare provider for a diagnosis and a tailored treatment plan, which may include medication.

When to Seek Medical Help

When to Seek Medical Help

During a panic attack, the body’s “fight or flight” response is activated, leading to a range of physiological and psychological symptoms. While panic attacks are generally not life-threatening, they can mimic symptoms of other serious conditions, making it crucial to seek medical help in certain situations.

Indicators for Seeking Medical Help:

First-Time Experience: If you’re experiencing a panic attack for the first time, it’s essential to seek immediate medical attention to rule out other potential causes like heart issues.

Severe Symptoms: If symptoms are extreme, such as intense chest pain, severe shortness of breath, or fainting, seek emergency medical care.

Prolonged Duration: Panic attacks typically last for a few minutes. If symptoms persist for an extended period (more than 20-30 minutes), seek medical help.

Frequency: If you’re experiencing frequent panic attacks that interfere with your daily life, consult a healthcare provider for a proper diagnosis and treatment plan.

Unresponsive to Self-Help Techniques: If grounding techniques, deep breathing, or other self-help methods are not effective in managing your symptoms, consult a healthcare provider.

Co-Existing Medical Conditions: If you have other medical conditions like heart disease, asthma, or diabetes, it’s crucial to consult a healthcare provider as panic attacks can exacerbate these conditions.

Medication Interactions: If you’re already on medication for other conditions, consult a healthcare provider to ensure that there are no adverse interactions between your medication and treatments for panic attacks.

Mental Health Concerns: If panic attacks are accompanied by other mental health symptoms like depression or suicidal thoughts, seek immediate medical help.


Panic attacks

Panic attacks trigger the body’s “fight or flight” response, leading to a surge of adrenaline and other stress hormones. This results in a range of physiological and psychological symptoms like rapid heartbeat, shallow breathing, and heightened anxiety. Understanding this mechanism can help demystify the experience and make it less frightening.

Key Strategies:

  1. Immediate Actions: Utilize grounding techniques, deep breathing exercises, and other immediate actions to manage acute symptoms.
  2. Sedative Substances: Consider the use of natural or over-the-counter sedatives, always consulting a healthcare provider for proper diagnosis and treatment.
  3. Long-Term Management: Cognitive-behavioral therapy (CBT), medications like SSRIs or benzodiazepines, and lifestyle changes like regular exercise can help in long-term management.
  4. Seek Medical Help: If you experience severe symptoms, frequent episodes, or if this is your first panic attack, seek immediate medical attention.
  5. Holistic Approach: A combination of medication, therapy, and lifestyle changes often provides the most comprehensive approach to managing panic attacks.


  1. Be Prepared: Keep a list of grounding techniques and emergency contacts accessible for immediate reference during a panic attack.
  2. Educate and Inform: Educate yourself and your close ones about the symptoms and triggers of panic attacks to better manage them.
  3. Consult a Healthcare Provider: For frequent or severe panic attacks, consult a healthcare provider for a proper diagnosis and treatment plan.
  4. Practice Self-Care: Regular exercise, adequate sleep, and stress management techniques like mindfulness can help in reducing the frequency of panic attacks.
  5. Stay Informed: Keep up-to-date with the latest research and treatment options for panic attacks.

Understanding the mechanisms behind panic attacks and having a well-rounded approach to managing them can significantly improve your quality of life. Always consult a healthcare provider for a tailored treatment plan that suits your needs.