Panic Attack Coping Skills: Immediate and Long-Term Strategies

Have you ever felt sudden fear that takes over, making it hard to breathe or think? Panic attacks can be scary and leave you feeling helpless. It’s tough when your heart races and you can't calm down.

In this article, you will find easy and effective ways to handle panic attacks right when they happen. You will learn how to breathe better, stay focused, and find calmness quickly. These strategies will help you manage your feelings and feel more in control.

Immediate Coping Strategies

When you have a panic attack, you can use these strategies to manage the symptoms.

Deep Breathing Techniques

You may ask, “How can I reduce my anxiety immediately?”. One effective answer is practicing deep breathing techniques.

Breathing techniques help you control your anxiety during a panic attack. Breathing quickly and shallowly can make you feel even more anxious.

One study showed that deep breathing exercises can reduce anxiety and depression after just eight weeks of practice.

Here are some breathing techniques you can try:

Diaphragmatic Breathing

Also called belly breathing, this technique uses your diaphragm for deeper breaths. To practice:

1. Place one hand on your chest and the other on your belly.
2. Breathe in through your nose, letting your belly rise while keeping your chest still.
3. Purse your lips and breathe out through your mouth, feeling your belly fall.

Studies show this type of breathing can lower anxiety levels. For example, a review of 16 studies found that breathwork helps adults with anxiety feel calmer and more relaxed.

4-7-8 Breathing

This technique can calm your nervous system. Follow these steps:

1. Breathe in quietly through your nose for four seconds.
2. Hold your breath for seven seconds.
3. Breathe out completely through your mouth for eight seconds, making a whooshing sound.

Repeat this cycle up to four times. Regular practice can help you sleep better and reduce anxiety.

Box Breathing

Also known as square breathing, this method can improve focus and relaxation. Here's how:

1. Breathe in through your nose for four counts.
2. Hold your breath for four counts.
3. Breathe out through your mouth for four counts.
4. Pause after exhaling for another four counts.

This method helps stabilize your breathing and reduce panic. A study from Stanford Medicine found that controlled breathing exercises like box breathing can improve your mood and lower anxiety.

Cyclic Sighing

Also called extended exhale breathing, this technique promotes relaxation and reduces anxiety. Here's how:

1. Take a deep breath in through your nose, filling your lungs fully.
2. Breathe out slowly through your mouth, making the exhale longer than the inhale.

Continue this cycle for five minutes. Focus on making each exhale longer and smoother. Practicing cyclic sighing for five minutes daily can make you feel less anxious and happier. A study with 111 volunteers showed that those who did cyclic sighing felt better each day and breathed more calmly.

Grounding Techniques

Grounding techniques help you stay focused on the present moment. These methods make you feel calmer and more in control. Here are some effective grounding techniques:

5-4-3-2-1 technique

This popular method helps you focus on your senses:

1. See five things around you. For example, a blue pen, a green plant, a window, a book, and a chair.
2. Touch four things you can feel, like the smooth surface of your desk, your shoes, a soft blanket, and your smartphone.
3. Listen for three things you can hear, such as a ticking clock, birds outside, or the hum of a computer.
4. Smell two things around you, like the scent of your coffee or a nearby candle.
5. Taste one thing, like the lingering flavor of a mint.

Focus on an Object

Choose something nearby, like a pencil. Look closely at its:

• Color
• Texture
• Shape
• Size

For example, you might notice the pencil is bright yellow, smooth to the touch, long and slender, and about six inches in length. By describing the pencil in detail, you shift your attention to something real and tangible, helping you feel more grounded.

Calming Mantra

Using a calming mantra can help you feel more in control. Repeat a phrase that reassures you, like "This will pass" or "I am safe."

For example:

• When you feel anxious, quietly say, "I am calm and in control."
• If your heart races, say, "My body is just reacting, and I am okay."
• When you feel overwhelmed, remind yourself, "I can take one step at a time."
• If fear takes over, say, "This is temporary, and I will get through it."
• Sometimes, saying, "I am stronger than this," can boost your confidence.

Pick a mantra that feels right for you and repeat it until you feel the tension at ease.

Humming

Humming can help you feel calm. When you hum, it creates vibrations that help control your mood. Try humming your favorite song for a few minutes. You might feel calmer as your body relaxes.

Research shows that humming can reduce stress. In a study with 23 people, humming resulted in the lowest stress levels, even lower than during sleep.

Just 10-15 minutes of humming daily can improve your focus, mood, and heart health.

Counting backward

No, how can you distract yourself during a panic attack? Counting backward is a simple but powerful solution to that. Start counting backward from 100 to one. For example, count slowly and focus on each number.

Researchers at Stanford University found that this method helps you concentrate on your breathing and distracts you from worries, keeping you in the moment and reducing anxiety.

Pet Therapy

If you have a pet, spending time with them can be very soothing. Cuddle your dog or cat and feel their warmth and softness.

Studies show that petting animals can decrease cortisol, the main stress hormone, helping you feel more relaxed and happy. This simple act provides a comforting distraction from your anxious thoughts.

Listening to Music

Listening to music is another great way to soothe yourself. Choose your favorite songs or make a playlist of calming tunes.

Research shows that listening to music can shift your body out of the "fight or flight" mode and bring a sense of calmness.

For example, playing soft instrumental music while you sit quietly can help you feel more present and less stressed.

Progressive Muscle Relaxation

Feeling tense and anxious can make it hard to stay calm. Progressive Muscle Relaxation (PMR) is a great technique to help reduce the physical tension that comes with panic attacks.

One study examined the effects of different interventions on physical exertion. Although the study primarily focused on how music tempo affects exercise performance, it showed the importance of relaxation techniques in managing perceived exertion and heart rate.

The research found that participants experienced a 6.5% decrease in the rating of perceived exertion (RPE) during high-intensity exercises and an 11% decrease during endurance exercises when using relaxation strategies compared to no intervention.

This means that techniques like PMR can help lower how hard you feel you’re working and reduce your heart rate, making you feel more relaxed and less stressed.

Now, let's learn how to do PMR:

1. Start with Your Feet

Begin by focusing on your feet. Squeeze the muscles in your feet tightly for five seconds. Imagine all the stress leaving your feet as you do this.

Then, relax them completely for ten seconds. Feel the difference between the tension and the relaxation.

For example, wiggle your toes tightly and then let them loosen. This simple action can help start releasing the stress in your body.

2. Move Up Your Body

After your feet, move up to your calves. Tense the muscles in your calves for five seconds and then relax them for ten seconds.

Next, focus on your thighs. Squeeze your thigh muscles for five seconds, then relax. Continue this process, moving through your abdomen, arms, face, and neck.

For instance, tighten your fists and hold for five seconds before letting go and feeling the calm spread through your hands.

3. Focus on Sensations

As you relax each muscle group, pay close attention to how your muscles feel. Notice the warmth and looseness as you release the tension.

For example, after relaxing your shoulders, you might feel a wave of relief spreading through your neck. This awareness helps you become more in tune with your body, making it easier to spot and release tension in the future.

Long-Term Management Strategies

To manage panic attacks over time, use these strategies to reduce how often and how strong they are.

Cognitive Behavioral Therapy (CBT)

You may ask, “How can I stop waves of panic attacks?”. Note that CBT does not remove panic attacks completely. Instead, it teaches you how to control them and make them less disruptive in your life. Studies show that CBT is very good for treating anxiety, panic attacks, and depression.

CBT focuses on three main things:

1. Changing Thoughts: CBT helps you find and change thoughts that are not realistic and that make you anxious or panic. For example, if you often think, "I can’t handle crowded places," CBT helps you challenge and change this thought.
2. Facing Fears: CBT helps you face your fears slowly. Instead of avoiding things like buses or busy areas, CBT teaches you to approach them little by little until you feel less anxious.
3. Building Skills: You learn useful tools to control anxiety. These tools include breathing techniques or exercises that stop negative thoughts, helping you prevent future panic attacks.

Research shows that CBT works well for different mental health issues. A study that examined 12 trials found that computer-based CBT gave good short-term results for anxiety and depression. For example, in some cases, computer-based CBT was better than waiting for treatment for people with panic disorder. Also, people with social phobia did better with computer-based CBT than with group discussions.

For older adults, a study from 2014 found that CBT helps people over 60 with panic disorder and fear of open spaces. Older people showed more improvement in avoiding fears than younger people. The study also found that only 6% of older patients stopped therapy, compared to 22% of younger patients. This shows CBT is good for seniors.

CBT is not only effective but also affordable. The same above study found that computer-based CBT saved about 5,500 Swedish kronor in lost productivity compared to traditional therapy. The cost for each quality-adjusted life year was around 17,000 kronor, showing that CBT is good for both money and health.

Mindfulness

Mindfulness and meditation can help you stay focused on the present and handle stress better. When you practice regularly, it can lower feelings of anxiety, depression, and even physical pain.

For example, a method called mindfulness-based stress reduction (MBSR) often uses body scan meditation. Studies show that MBSR can reduce how much pain you feel by a noticeable amount after eight weeks. This is especially helpful for people who have long-term pain or stress-related problems.

Guided meditation is great if you are just starting or if you want some structure. Following a guided session can help you focus and feel calm. Harvard studies have found that mindfulness meditation can greatly reduce the symptoms of generalized anxiety disorder. People who practice it report that they have better control over unwanted thoughts.

Additionally, programs like mindfulness-based cognitive therapy (MBCT) can lower the chances of depression coming back for those who have had it before. This shows that mindfulness has long-term benefits for mental health.

If you are new to mindfulness, you can start with apps or local classes. There are some recommendations to help you get started.

For Mindfulness and Meditation apps:

• Headspace: Offers guided meditations for reducing stress, improving focus, and helping you sleep better. It’s easy to use, making it great for beginners.
• Calm: Provides many meditation sessions, sleep stories, and relaxation techniques to help your mind feel better.
• Insight Timer: Has a large library of free meditations, music tracks, and talks from mindfulness experts. It’s good for both new and experienced users.
• Smiling Mind: A free app with mindfulness programs for different ages, including kids and adults. It helps people of all ages feel better.
• Breethe: Offers guided meditations, sleep stories, and classes to help you manage stress and sleep well.

Here are some local Mindfulness and Meditation classes in the US:

• The Mindfulness Center: Located in Bethesda, Maryland, this center offers classes in meditation, yoga, tai chi, and more. They also have training programs and workshops to help you stay healthy in mind and body.
• Transcendental Meditation (TM) Centers: Found across the US, TM centers offer courses in Transcendental Meditation. You can find a certified teacher near you through their website.
• Copper Beech Institute: Based in West Hartford, Connecticut, this institute focuses on mindfulness, compassionate action, and social justice. They offer retreats, workshops, and courses to support your mindfulness journey.
• Mind Oasis: An online meditation community that provides guided meditation sessions, workshops, and courses you can access from anywhere. It makes meditation easy no matter where you are.
• Art of Living Foundation: Offers meditation and breathing workshops, both online and in-person, in many locations across the United States. Their programs help you manage stress and feel better overall.

If you keep practicing, you will feel less stress, have stronger emotions, and enjoy a better life. More and more scientific studies support these methods, showing that mindfulness is a powerful tool for both your mind and body.

Lifestyle and Dietary Adjustments

Lifestyle and dietary changes can help you manage anxiety and reduce panic attacks. These adjustments work well with professional care to improve your mental health and make you feel better.

Here’s what you should think about:

Regular Exercise

Exercise is one of the best ways to boost your mental health. Being active can lower anxiety and stress, especially for women and people with depression or heart disease.

Even walking for 30 minutes every day can lift your mood. It increases your serotonin and endorphin levels and lowers cortisol, the stress hormone.

Activities like yoga and tai chi are also very helpful. In fact, according to one study, regular physical activity can lower the risk of developing depression by up to 18%.

Balanced Diet

What you eat is very important for managing anxiety. Eating foods like whole grains, fruits, vegetables, and lean proteins gives your brain the nutrients it needs to make chemicals that control your mood.

Studies show that not getting enough magnesium or zinc can make anxiety worse. However, certain foods can help reduce anxiety symptoms.

Foods high that are in magnesium include:

• Spinach
• Swiss chard
• Legumes
• Nuts
• Seeds
• Whole grains

Zinc-rich foods include:

• Oysters
• Cashews
• Beef
• Liver
• Egg yolks

Additionally, fatty fish such as salmon, mackerel, and sardines are rich in omega-3 fatty acids, which have been shown to reduce anxiety. Probiotic-rich foods like yogurt, kefir, sauerkraut, and pickles may also help, as they support gut health and serotonin production.

Asparagus, which has anti-anxiety properties, and foods with B vitamins, like avocados and almonds, further contribute to reducing anxiety. Including these "feel-good" foods in your diet can significantly support mental health.

One study even found that taking omega-3 supplements helped lower anxiety in medical students. Eating probiotics, such as yogurt or fermented foods, can also support your gut health, which affects serotonin production.

It’s also important to limit sugar and sweetened drinks. Research shows that drinking four or more sugary beverages each day can increase the risk of depression by 30%. On the other hand, eating antioxidant-rich foods like berries, kale, and walnuts can help ease anxiety by reducing oxidative stress, which is linked to poor mental health.

Adequate Sleep

Getting 7–9 hours of good sleep each night is crucial for reducing anxiety and depression. Poor sleep can disrupt the replenishment of neurotransmitters, making your mood worse.

One study found that people who don’t get enough sleep are more likely to see neutral images in a negative way, which can heighten anxiety. Keeping a regular sleep schedule and having calming bedtime routines can improve both your sleep quality and your overall mental health.

Making the Connection

These lifestyle changes are not just small tweaks; they are important parts of a complete approach to mental health. They help improve conditions like panic attacks, depression, anxiety, and stress by affecting brain pathways, regulating your body’s stress response, and enhancing communication between your gut and brain.

Start with small steps—walk every day, eat healthy foods, and make sure you get enough rest. Over time, these habits can lead to big improvements in your mental health and how you feel overall.

Creating a Panic Attack Toolkit

Having a panic attack toolkit can help you feel prepared and more in control when anxiety strikes. Here are some essential items to include, supported by evidence from studies and expert recommendations:

List of Coping Strategies

Include techniques like the immediate coping strategies mentioned above (deep breathing, grounding exercises, and progressive muscle relaxation)These methods help calm your body’s stress response.

Emergency Contacts

Keep a list of trusted friends, family members, or mental health professionals you can call during an attack. Knowing that support is just a phone call away provides a sense of security.

Having this accessible during a panic attack can significantly reduce feelings of helplessness.

Comfort Items

Carry items that soothe you or help redirect your focus. Examples include:

• Stress ball
• Scented essential oil like lavender or citrus
• Small journal for jotting down your thoughts or doodling to release nervous energy.

A favorite stuffed animal can provide a comforting presence, while an ice pack can help calm your body by quickly reducing physical tension. Additionally, items like mints or sour candies, such as lemon drops or Warheads, can refocus your mind through sensory stimulation.

Coloring books and crayons can also serve as a calming outlet for creativity, allowing you to channel anxiety into a focused activity. Including these items ensures you have versatile tools to support you during moments of distress.

Physical items like a weighted blanket can provide a calming sense of security, while sensory objects like slime or putty help redirect nervous energy.

Additional Tools to Consider

You might also want to include:

• Headphones: Listen to calming music or guided meditations during an attack.
• Ice Pack: Applying cold to the skin can help "reset" your nervous system.
• Coloring Book and Crayons: Engaging in simple creative activities can be a calming distraction.
• Tissues and a Small Mirror: For moments when you need to compose yourself and regain confidence in social settings.

Final Words

Use breathing and grounding techniques to calm yourself when you feel scared. Long-term strategies like Cognitive Behavioral Therapy, mindfulness, and healthy habits can help reduce anxiety over time.

Make a panic attack toolkit with things that soothe you, like a favorite scent or a stress ball. By practicing these methods, you will feel more in control and less anxious. Remember to stay active, eat well, and get enough sleep to support your mental health.

Frequently Asked Questions

How can I tell if I’m having a panic attack?

Look for signs like chest pain, dizziness, trembling, or a fear of losing control. It may feel like a heart attack but isn’t life-threatening.

What are grounding exercises?

Grounding brings you back to the present. For example, name 5 things you see, 4 you can touch, 3 you hear, 2 you smell, and 1 you taste.

How can deep breathing help?

Deep breathing slows your heart rate and calms your nervous system. It helps counteract the body’s stress response.

When should I seek professional help?

If panic attacks interfere with your daily life or you can’t manage them on your own, consider seeing a psychologist or psychiatrist for therapy or medication.

What is progressive muscle relaxation?

It’s a technique where you tense and relax different muscle groups. Start with your toes and work up to your head, releasing tension as you go.

Are panic attacks dangerous?

No, they aren’t life-threatening, but they can feel overwhelming. Understanding your symptoms helps reduce fear during an attack.

What is a panic attack toolkit?

It’s a personalized set of resources, like calming strategies, grounding exercises, and emergency contacts, to help manage panic attacks quickly.