What To Do During A Panic Attack

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Panic attacks feel horrible! When you have one, your mind and body are using all of the energy that would be needed to fight or get away from a huge threat, even though that threat is generally not present. Catastrophic thoughts are coupled with overwhelming body sensations, and the intensity is so ramped up that some people think they are dying or having a heart attack when they are panicking.

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The good news is that a panic attack in and of itself is not dangerous. However, if you get into patterns of worrying about having panic attacks and bracing against them, this can lead to more ongoing problems. A more effective approach is to ride out the panic attack and defuse the danger of it with the AWARE method created by Dr. David Carbonell. AWARE stands for:

  •  Accept and Acknowledge—Accept and acknowledge that you are having a panic attack rather than denying, distracting yourself, or bracing against it. Instead of these actions that “feed” panic long term, you can say to yourself, “I am having a panic attack. This is happening. I will use my skills to ride this out,” and then move into the rest of the steps in this method.
  • Wait and Watch—Instead of jumping into your automatic actions to get away from a situation or to try not to have a panic attack, wait before action. For example, if you always go home when you become panicked in public, try sitting quietly and watching your experience instead of immediately fleeing. This likely will feel counterintuitive to what the urgency of a panic attack is telling you to do.
  • Actions—In this step, you are taking actions to make yourself feel a little more comfortable until the panic attack ends. Actions could include things like belly breathing, talking with someone, light stretching or walking, or engaging in a task in your immediate environment. It helps to have three or four actions in mind before you have a panic attack. I recommend writing them down on a card you can keep with you or typing them in a note on your phone.
  • Repeat—You may do the first few steps and still feel the panic, or find that another wave of panic follows the first one. Instead of giving up, stay with this process and repeat the AWARE steps as many times as you need. It is not abnormal to need to repeat these steps, and it does not mean that you are doing anything wrong.
  • End—Keep reminding yourself that it will eventually end, because all panic attacks do.

This method will seem counterintuitive when you are in the throes of a panic attack, but it is very helpful in learning that you can walk through a panic attack and not keeping the cycle of panic going. I recommend reading over the AWARE method, noting how you would use the skills, and having it bookmarked or printed out for when you have a panic attack.

For more info on this topic, I highly recommend Dr. Carbonell’s Panic Attacks Workbook.