Page 24 of the book, in Pranayama
Breathing for Panic Attacks: A Wallet Card You Can Print
A calm, step-by-step plan for riding out a panic attack, with a printable wallet card, the breathing that helps most, the mistakes that make it worse, and when to get help.
During a panic attack, the most helpful thing you can do is slow your breathing down, especially your out-breath, and remind yourself that the attack will peak and pass. Panic attacks feel terrifying, but they aren't dangerous in themselves. Below is a simple plan you can follow in the moment, and a card you can print and keep in your wallet so you don't have to remember anything when your mind is racing.
What's happening in a panic attack
A panic attack is a sudden surge of intense fear that usually peaks within minutes. It often comes with a pounding heart, shortness of breath, dizziness, shaking, tingling, chest tightness, nausea, and a feeling of losing control or impending doom. Many people breathe fast and shallow without noticing, which can make dizziness and tingling worse and fuel the fear.
Panic attacks can happen to anyone. When they keep recurring and you live in fear of the next one, it may be panic disorder, which affects about 2.7% of US adults in a given year, according to the National Institute of Mental Health. It's very treatable.
The three-step plan
- Name it. Say to yourself: "This is panic. It feels awful, but it will pass." Naming it breaks the cycle of fearing the symptoms.
- Slow the out-breath. Breathe in gently through your nose, then out slowly through pursed lips, as if blowing through a straw. Make the exhale longer than the inhale. If you can, add a second small sip of air at the top of the in-breath before the long exhale; this is cyclic sighing, the pattern with the best early evidence for calming.
- Come back to the room. Look around and name five things you can see, four you can hear, three you can touch. Press your feet into the floor.
Repeat steps two and three until the wave passes. Most attacks ease within minutes, even though it may feel much longer.
Your printable wallet card
Print this section, cut out the card and keep it with your ID or phone.
| If panic hits | |
|---|---|
| 1. Name it | "This is panic. It will peak and pass." |
| 2. Breathe out slow | In through the nose, a small top-up sip, then a long slow breath out through pursed lips. Repeat. |
| 3. Ground | 5 things I see · 4 I hear · 3 I touch. Feet on the floor. |
| 4. Wait it out | Don't fight the feelings. Let them rise and fall. |
| If chest pain is new or severe | Call 911. It's always okay to get checked. |
What to avoid
- Big, fast gulps of air. Over-breathing can increase dizziness and tingling. Keep the in-breath gentle.
- Long breath holds. Holding your breath can feel suffocating during panic. Skip them.
- Fighting the feelings. Trying to force panic away often intensifies it. Letting the wave rise and fall works better.
- Breathing into a paper bag. This old advice isn't recommended and can be risky, especially if the symptoms turn out to have a medical cause.
- Escaping immediately, every time. Leaving can bring relief, but routinely avoiding places after panic can make the fear grow over time. A therapist can help with this.
Panic or a heart problem?
Panic attacks and heart attacks can share symptoms like chest pain, breathlessness and sweating. You can't always tell them apart on your own.
Getting help for repeated panic attacks
If panic attacks keep happening, or you're changing your life to avoid them, talk to a doctor or licensed therapist. Cognitive behavioral therapy (CBT) is a highly effective treatment for panic disorder, and certain medications can help too. A doctor can also rule out conditions like thyroid problems or heart rhythm issues.
Myths and facts
| You may have heard | What's actually true |
|---|---|
| Take big deep breaths to calm down | Gentle in-breaths and long, slow out-breaths work better; big gulps can worsen dizziness |
| Breathe into a paper bag | This isn't recommended and can be risky |
| A panic attack can make you pass out or go crazy | Panic feels terrifying but doesn't cause madness, and fainting from panic alone is uncommon |
| If it's panic, you never need a doctor | New or different chest pain should always be checked; panic and heart problems can look alike |
| Panic disorder is something you just live with | It's very treatable, especially with CBT |
Common questions
How long does a panic attack last?
Most peak within about ten minutes and then begin to ease, though you may feel shaky or tired afterward.
Can breathing exercises stop a panic attack completely?
They can make an attack less intense and easier to get through. They aren't a cure for panic disorder on their own, which is why therapy matters if attacks recur.
Why does focusing on my breath sometimes make it worse?
For some people, paying attention to the body increases alarm. If that happens, focus on the room instead: count objects, describe colors, or hold something cold.
Related guides
- Cyclic sighing vs box breathing vs 4-7-8
- Yoga for anxiety: what it can and can't do
- Calming your nervous system: what works
Sources
- National Institute of Mental Health: Panic Disorder — symptoms and treatment
- National Institute of Mental Health: Panic Disorder statistics — US prevalence
- Balban MY et al. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 2023 — exhale-focused breathing
- 988 Suicide & Crisis Lifeline — call or text 988 in the US
