Reviewed by Lauren Vilar, LCSW, LCAS — trauma and addiction therapist with 12+ years of clinical experience
A panic attack can make you feel as if your body has suddenly taken over. Your heart may race, your breathing may change, and a wave of fear can hit before you fully realize what is happening. Even if you are used to managing anxiety, the physical sensations of a panic attack can catch you by surprise. You may not immediately connect what you are experiencing with anxiety and instead feel like you are dealing with a medical emergency, such as an asthma attack or even a heart attack.
When panic feels this physical, it makes sense that your mind starts searching for an explanation. In the middle of an attack, though, it can be difficult to think your way through what is happening because your body is already in alarm mode. That is where a few simple physical and grounding strategies can help. They can give your attention something concrete to focus on while your nervous system has a chance to slow down.
There are several ways to do this, and different strategies will feel more helpful to different people. You do not have to remember everything at once. Start with one technique that feels manageable and see how your body responds.
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Change Your Temperature
One simple way to interrupt the intensity of panic is to change what your body is feeling.
Try placing a cool washcloth or cold pack on your cheeks or face for about 30 seconds. You can also splash cool water on your face or hold something cold in your hands. That change in sensation can give your attention somewhere else to go while the panic eases.
Use a temperature that feels safe and tolerable. The idea is to create a noticeable physical change without making yourself uncomfortable.
You can also change your surroundings. Step into a cooler room, go outside for fresh air, or take a shower. Sometimes a small physical shift is enough to help you feel more connected to your body and your environment.
Slow Your Breathing Down
Panic often changes your breathing before you even realize it. You may start to breathe faster and more shallow, which can make the physical sensations feel even stronger. The key is to interrupt your current breathing pattern.
Try taking a gentle breath in through your nose and letting it out slowly. You do not need to follow a complicated pattern or count perfectly. Focus on making the exhale a little slower and more relaxed than it was a moment ago.
If paying attention to your breathing makes you feel more anxious, choose another strategy instead. Grounding works best when it gives you something that feels manageable to focus on.
Bring Your Attention Back to the Room
Panic can pull almost all of your attention inward. You become focused on your heartbeat, your thoughts, or the feeling that something is about to go wrong or that you are in immediate danger.
Grounding shifts some of your attention back toward what is actually around you. Feel your feet against the floor. Notice the chair supporting your body. Look around the room and choose one object to focus on.
You might notice its color, shape, or texture. Giving your brain something specific and concrete to pay attention to can help loosen panic’s grip on your attention.
Remind Yourself What Is Happening
The symptoms of panic can become frightening very quickly. As you feel the panic building, it can help to stop for a moment and acknowledge what is happening. You do not need to figure out why it is happening. Simply recognizing, “This is panic,” can give your brain a brief pause and create a small opening to respond in a way that helps slow things down.
Try giving yourself a simple reminder:
I am having a panic response. This feels intense, and it will pass.
You do not need to force yourself to feel calm. The goal is to name what is happening and remind yourself that the intensity will ease, even if it does not feel that way in the moment.
Give Your Body Something Simple to Do
Sometimes sitting still leaves you paying even more attention to every sensation in your body. Gentle movement can give some of that nervous energy somewhere to go.
Try walking slowly around the room or stretching your shoulders. You can rock your body or sway. You can also press your feet firmly into the floor and notice the pressure beneath them.
Keep it simple. During a panic attack, a long list of techniques can quickly become one more thing to manage. One small action is enough to give yourself somewhere to focus while the intensity begins to come down.
What If You Feel a Panic Attack Starting?
Over time, you can learn to recognize some of the early signs that panic is building. Maybe your chest starts to tighten, or your thoughts suddenly speed up. You might notice that you feel restless or unusually aware of your breathing.
Those early signals can become your cue to respond before the panic becomes more intense. Move somewhere quieter if you can. Try the strategy that tends to work best for you and give yourself a moment to reconnect with where you are.
You can respond to panic before it reaches its peak.
What If Panic Attacks Keep Happening?
When a panic attack happens more than once, it is natural to begin thinking about how to keep the next one from happening. You may start paying closer attention to where you are, what you are doing, or what was happening before the last attack.
One common response is to avoid situations you worry might trigger another panic attack. At first, that can feel like a good way to protect yourself. If you avoid the crowded store, the long drive, or the place where you had an attack before, you may feel some immediate relief.
Over time, though, avoidance can begin to reinforce the fear. The more situations you avoid, the more your world shrinks around the possibility of panic. And because panic attacks can sometimes happen without an obvious trigger, avoidance cannot give you complete control over whether another one will occur.
Therapy can help you break that cycle. You can learn to recognize the patterns around your panic, build confidence in your ability to respond when anxiety rises, and gradually feel more comfortable returning to situations you have started avoiding.
The goal is to help panic take up less space in your life, so your choices are guided less by fear of the next attack and more by what matters to you.
Therapy for Panic Attacks and Anxiety in Wilmington, NC
If panic or anxiety is interfering with your sleep, relationships, work, or ability to enjoy your life, support can make a difference. At LMV Counseling, we work with people who feel overwhelmed by anxiety and are tired of always waiting for the next wave of worry or panic.
Our therapists provide personalized care in a warm, compassionate environment. We offer in-person therapy in Wilmington and online therapy throughout North Carolina.
You can speak with our client care coordinator, who can help match you with someone who fits your needs and accepts your insurance.
Important: Panic attacks can cause physical symptoms that may also have other medical causes. If your symptoms are new, severe, unusual for you, or you are unsure whether anxiety is causing them, seek appropriate medical care.
Frequently Asked Questions About Panic Attacks
How Long Does a Panic Attack Last?
Panic attacks usually come on quickly, although they can feel much longer when you are in the middle of one. The strongest symptoms often begin to decrease as your nervous system starts to settle.
You may still feel tired, shaky, or unsettled afterward. Give yourself some time to recover before expecting yourself to immediately return to everything you were doing.
Can a Panic Attack Happen for No Reason?
Yes. Sometimes there is an obvious trigger, while other panic attacks seem to come out of nowhere.
That unpredictability can make panic especially frightening. You may start wondering when it will happen again or paying close attention to every physical sensation that could signal another attack.
Therapy can help you recognize patterns when they exist and change the way you respond to the sensations and thoughts that come with panic.
What Should I Do When I Feel a Panic Attack Starting?
Choose one simple strategy rather than trying several things at once. You might cool your face, slow your breathing, or focus your attention on something in the room.
The goal is to give your mind and body something manageable to focus on while the panic begins to pass. Once you find a strategy that feels helpful, it can become easier to return to it the next time you notice panic building.
How Can I Help Someone Who Is Having a Panic Attack?
Stay calm and keep things simple. Let the person know you are there, and ask what would feel helpful.
Try to avoid giving them several instructions at once. Sitting nearby, helping them move somewhere quieter, or bringing them some water may be enough.
Your calm presence can help make the moment feel less overwhelming.
When Should I Consider Therapy for Panic Attacks?
It may be worth reaching out if panic attacks are happening repeatedly or if you spend a lot of time worrying about another one. You may also notice that fear of panic is starting to affect the choices you make.
You can seek support even if the attacks happen only occasionally. If panic is frightening, disruptive, or making your world feel smaller, therapy can give you a place to work through what is happening and find strategies that fit you.
Reviewed by Lauren Vilar, LCSW, LCAS
Lauren is the founder of LMV Counseling and Go Inward. Her advanced training includes ketamine-assisted psychotherapy and MDMA-assisted therapy through MAPS, Fluence, and Polaris Insight Center.