Panic attacks: what to do in the moment and how they are treated

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A panic attack is one of the most frightening experiences a person can have — and one of the most misunderstood. It often comes from nowhere: the heart races, breath disappears, the chest tightens, the hands tingle, and a terrifying sense sets in that something dreadful is about to happen, that you are going to lose control or even die. People experiencing it for the first time frequently go to A&E, convinced they are having a cardiac problem.

The truth is reassuring, though hard to believe in the moment: a panic attack, however intense, is not dangerous to the body and always passes. It is a false alarm response — the body's defence system firing when there is no real danger.

What to do during a panic attack

In the moment the aim is not to force it to stop (that usually makes it worse), but to get through it safely until it passes. These strategies help:

• Slow breathing. Breathe in through the nose for a count of 4, hold for 2, breathe out slowly through the mouth for a count of 6. A longer out-breath than in-breath helps switch off the alarm.
• Ground yourself in the present (the 5-4-3-2-1 technique). Name 5 things you can see, 4 you can hear, 3 you can touch, 2 you can smell, 1 you can taste. It brings the mind out of "what if" and back to now.
• Remind yourself: "This is a panic attack. It is unpleasant, but it is not dangerous. It has passed before and it will pass now."
• Do not flee the place. Running out teaches the brain that the place was dangerous. Staying (where it is safe to do so) shows it the opposite.

Why they happen — and why living abroad can raise the risk

Panic attacks appear when the stress system has been overloaded for too long. That is why they are so common in demanding phases — and living abroad is one of them: permanent alertness, uncertainty about the future, accumulated exhaustion, the absence of a support network nearby and the pressure to "just cope" create ideal conditions. Often the first attack arrives precisely when everything appears to be fine — because the body discharges the tension it has been storing.

How they are treated

The good news is that panic disorder is among the conditions that respond best to treatment. Cognitive Behavioural Therapy has strong evidence: it helps you understand the panic cycle, stop fearing your own bodily sensations and reduce the avoidance that keeps the problem going. Hypnotherapy can help regulate the alert response at a deeper level. In some cases psychiatric support and medication may be appropriate — always an individual decision.

When to seek help

If you have had more than one attack, if you live in fear of it returning (the so-called "fear of fear"), or if you have started avoiding places and situations, it is worth seeking support. With proper care, most people regain control and freedom. Online, that support reaches you wherever you live.