Panic attacks are abrupt episodes of severe fear or discomfort accompanied by other symptoms. While panic attacks have significant symptoms—such as chest pain, sweating, difficulty breathing, and a fast heartbeat—they are usually not physically harmful.

Panic attacks can occur in the context of several mental health and other conditions, including panic disorder. Breathing exercises can slow your heart rate and breathing and help you calm down.

This article discusses breathing exercises you can use during a panic attack and how to perform them.

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Breathing Exercises for Panic Attacks

There are a variety of breathing exercises you can employ during a panic attack to slow your breath and calm down.

4-7-8 Breathing

Dr. Andrew Weil developed the 4-7-8 breathing technique to help ease anxiety and help with stress-related health issues. Perform this exercise while seated in a comfortable position.

  1. Touch the tip of your tongue to the roof of your mouth, just behind your upper teeth. Keep your tongue in this position throughout the exercise.
  2. Breathe out through your mouth, emptying all the air from your lungs. Make a "whoosh" sound as you exhale.
  3. Close your mouth and breathe in through your nose for a count of 4.
  4. Hold your breath and count to 7.
  5. Breathe out through your mouth for a count of 8, making a "whoosh" sound as you exhale.
  6. Repeat this cycle for three to four breaths. Over time, work your way up to eight breaths—this is the maximum recommended by the creator of this breathing technique.

Lion’s Breath

Lion's breath is a type of yogic breathing known as pranayama. Perform this exercise while seated comfortably in a chair or on the floor.

  1. Breathe in deeply through your nose, allowing your belly to expand as you fill your lungs with air.
  2. When you can't breathe in more air, open your mouth wide and stick your tongue toward your chin.
  3. Breathe out forcefully through your mouth while making an "Ahh" sound.
  4. Repeat for several breaths.

Alternate Nostril Breathing

Alternate nostril breathing is an effective way to slow breathing during a panic attack. It can also temporarily decrease blood pressure.

  1. Sit in a comfortable position.
  2. Place your right thumb on your right nostril and your right ring and pinky finger on your left nostril.
  3. Close your right nostril with your thumb and breathe out through your left nostril.
  4. Breathe in through your left nostril.
  5. Release your right nostril and close your left nostril with your right ring and pinky finger.
  6. Breathe out through your right nostril.
  7. Breathe in through your right nostril.
  8. Close your right nostril and breathe out through your left nostril.
  9. Continue this pattern for several breaths.

What to Expect During Breathing Exercises

Early on, breathing techniques for panic attacks can cause lightheadedness. If this happens to you, breathe normally for several minutes between cycles of breathing exercises. Gradually decrease the number of normal breaths until you can perform the breathing exercises as recommended.

Additional Ways to Treat Panic Attacks

In addition to calming breathing exercises, there are other strategies you can use to decrease your symptoms during a panic attack.

Relax Your Muscles

Muscle tension often occurs during a panic attack. Progressive muscle relaxation is a technique you can use to help reduce symptoms of stress and anxiety. This technique involves tensing and relaxing muscles throughout the body in a specific order, from the top down or the bottom up.

Recognize What Is Happening

When you start to have a panic attack, take a break from whatever you are doing. Remind yourself that your body and brain are overreacting to the actual circumstances of your situation.

Recognize irrational thoughts that might be contributing to your panic attack. For example, your racing heartbeat might make you think you will die. However, focusing on your breath and practicing calming techniques in these moments can help your heartbeat slow down.

Try Grounding Methods

Grounding techniques can help shift your focus back to the present during high anxiety, such as a panic attack.

The 54321 grounding exercise is one way to engage all five senses. Look around your environment and find:

  • Five things you can see
  • Four things you can feel
  • Three things you can hear
  • Two things you can smell
  • One thing you can taste

Preventing Panic Attacks

Panic attacks can't always be prevented. Most occur without a clear trigger, and they can even happen while you're relaxing or after falling asleep.

However, for some people, tracking symptoms can help identify potential triggers. Keep a journal and write down the environment where your attacks occurred, the circumstances, and what you felt.

Panic Attack or Heart Attack?

Symptoms of a panic attack and heart attack can be similar. Both conditions can cause difficulty breathing, sweating, dizziness, nausea, chest pain, tingling in the arms, and a sense of "impending doom."

If you are experiencing chest discomfort, seek medical attention to rule out a potentially life-threatening condition. Once you've been diagnosed with panic attacks or anxiety, you will be better able to discern the cause of your symptoms if they occur again.

Summary

Panic attacks are sudden, often unexpected episodes of intense fear accompanied by many uncomfortable physical and emotional symptoms. Breathing exercises can help calm your mind and reduce these symptoms during a panic attack. Examples include 4-7-8 breathing, Lion's breath, and alternate nostril breathing.

Other techniques, such as progressive muscle relaxation and grounding techniques, can also be used during panic attacks. If you suspect you are having a panic attack but have not been given a diagnosis, seek medical attention to rule out serious medical causes of your symptoms, such as a heart attack.

A Word From Verywell

While panic attacks are not life-threatening, they can significantly interfere with your daily life. If you aren't finding relief from breathing exercises or other self-help methods to manage symptoms, talk to your healthcare provider about other treatment options, such as medications and psychotherapy.

Frequently Asked Questions

  • What's the 54321 method for panic attacks?

    The 54321 grounding exercise can help decrease anxiety during panic attacks or other stressful situations. It engages all five senses by finding these things in your environment: five things you can see, four things you can feel, three things you can hear, two things you can smell, and one thing you can taste.

  • How can I stop panic attacks forever?

    Unfortunately, there's no magic cure for panic attacks. Sometimes they resolve on their own, while other times they continue to occur. However, treatments such as medications and psychotherapy can help reduce the frequency of panic attacks and help you manage your symptoms.

  • How many times a day should you do breathing exercises?

    While there's no set rule for performing breathing exercises, practicing two or three times per day for a few minutes will make it easier for you to use these techniques during a panic attack.


By Aubrey Bailey, PT, DPT, CHT

Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living. 

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