A panic attack usually comes on suddenly, often without a clear trigger, which is why it is important to recognize it quickly. Symptoms such as a racing heartbeat, shortness of breath, or the feeling that you cannot take a full breath can resemble a life-threatening emergency. In many cases, however, they result from activation of the sympathetic nervous system, which puts the body into a “ready for danger” state.
During this surge, you may notice tightness in the chest, sudden waves of heat or chills, intense sweating, trembling in the hands or throughout the body, dizziness, nausea, or pressure in the stomach. Some people describe their legs as feeling “like cotton,” as if they might give out.
Psychological symptoms can be just as intense. You may feel detached from your body or surroundings, as if everything is happening next to you rather than to you (a sensation known as depersonalization). This can be accompanied by overwhelming fear, a sense of losing control, and the conviction that you are about to faint, have a heart attack, or die. It is common for people to say afterward that the fear felt completely real.
Panic attacks do not follow a fixed pattern and can vary from person to person. Some people experience a single episode that never returns. Others have attacks repeatedly or several within a short period. Over time, you may notice certain places, situations, or activities that make them more likely—for example, before a stressful appointment, an important conversation, or in specific public spaces.
A typical attack lasts from a few minutes to several tens of minutes—most often about 5 to 20 minutes—and can build very quickly. Symptoms usually peak within the first 10 minutes and then gradually fade. In some cases, a lingering feeling of anxiety and physical discomfort may persist, either because another attack follows or because the body remains in a heightened state of tension.
Although a panic attack is a very distressing experience, there are practical ways to get through it and regain a sense of control. During an attack, try to focus on your breathing: breathe slowly and evenly, for example, counting to five on the inhale and to five on the exhale. You can also take a few deeper breaths, gently holding each one for a couple of seconds before releasing it.
Many people find grounding techniques helpful—bringing attention back to the senses and the body. This might involve noticing the taste of mint gum, touching a cool surface, or focusing on the pressure of your feet against the ground. If you feel unreal or detached, try naming objects around you or placing your hands under cold running water.
There are also two common approaches to managing an attack mentally. One is rationalizing: reminding yourself that these symptoms are caused by anxiety, are not dangerous, and will pass, even if they feel severe. The other is allowing the wave to pass through you: you might cry, sit somewhere quiet, and give yourself time rather than resisting every sensation. Which strategy works best often depends on the individual and may be discovered through experience or with the help of a therapist.
Some people keep a paper bag on hand because panic can lead to hyperventilation—breathing too quickly and shallowly. One method to help manage this is consciously slowing breathing, sometimes by breathing into a paper bag. The goal is not to increase oxygen intake but to reduce excessive loss of carbon dioxide. Breathing air with a higher concentration of CO₂ may help restore balance, calm the body, and lower the risk of fainting.
After symptoms ease, take care of yourself: rest, drink water, and eat something light. It can also help to talk to someone you trust and describe what happened. Saying it out loud can help organize the experience and reinforce an important fact: despite how real the symptoms felt, the body was overreacting to stress rather than responding to an immediate danger.
If you witness a panic attack in someone close to you—or even a stranger—your response matters. The most important thing is to remain calm. If you also become anxious, the tension can escalate and make the situation harder to manage. Start by helping the person shift attention away from escalating fear and toward something concrete.
A gentle but steady physical presence can help—such as holding a hand or placing a supportive arm around the shoulders—if the person is comfortable with it. Another effective approach is to ask simple, concrete questions about time and place: their name, where they are, what day it is, or what the weather is like. This can help them regain orientation and reconnect with reality.
Your words are just as important. Avoid minimizing the experience with phrases like “nothing’s wrong” or “you’ll be fine in a second,” because for the person, the fear is real and overwhelming. Instead, try: “I’m here with you,” “You’re not alone,” “I’ll stay as long as you need.” Supportive reassurance can reduce fear without dismissing what they are feeling.
