Anxiety Attack: What to Do in the First 5 Minutes

An anxiety attack, often called a panic attack, can be one of the most frightening experiences of your life. Your heart pounds, your chest feels tight, your hands tingle, and a wave of dread tells you that something is terribly wrong. Here is the first thing to hold on to: an anxiety attack is not dangerous in itself, it peaks, and it passes. This guide gives you a simple plan for the first five minutes, and one firm safety rule you must never skip.

What an anxiety attack feels like

A panic attack is a sudden surge of intense fear along with strong physical symptoms. People commonly feel a racing or pounding heart, shortness of breath, a tight chest, sweating, shaking, dizziness, tingling in the hands or face, a churning stomach, and a strange sense of unreality. Some people also feel a fear of losing control or even of dying, which sounds dramatic but is a very normal part of how an attack tricks the mind. Because these feelings are so physical, many people are certain they are having a heart attack. That fear is completely understandable, and it is exactly why the safety rule below matters so much.

Why it peaks and passes

An anxiety attack is your body's alarm system firing when there is no real danger. The surge of adrenaline that causes all those sensations cannot keep rising forever. In most cases the peak comes and then fades, usually within about ten to twenty minutes, even though it can feel much longer while you are in it. Your body simply cannot sustain that level of alarm. Nothing you feel during the attack, however intense, can harm your heart or your body on its own. Knowing this, that the wave always breaks, is itself a powerful tool.

Your first 5 minutes plan

When an attack hits, try these steps in order. You are not trying to force it away. You are riding it out safely.

• Slow your breathing out. Breathe in gently for a count of four, then breathe out slowly for a count of six or more. The long, slow exhale is what calms your body. Repeat it.
• Ground yourself with 5-4-3-2-1. Name five things you can see, four you can hear, three you can touch, two you can smell, and one you can taste. This pulls your mind out of the fear and into the room.
• Do not fight the wave. Tell yourself plainly: this is a panic attack, it is uncomfortable but not dangerous, and it will pass. Fighting it only feeds it.
• Splash cold water on your face, or hold something cold. A cold sensation can gently settle the body's alarm.
• Stay where you are safe. Do not rush to drive or run. Sit down, keep your feet on the floor, and let the wave rise and fall.

Most attacks ease within a few minutes of this. Be gentle with yourself afterwards, as feeling drained or shaky for a while is completely normal.

The chest pain rule you must never ignore

This part is not negotiable. An anxiety attack and a heart problem can feel alike, and you should never simply assume. If this is your first ever episode of chest pain, or the chest pain feels different or unusual for you, especially if it comes with heavy sweating, breathlessness, pain spreading to the arm, jaw or back, or a feeling of collapse, treat it as a possible heart emergency. Call 108 straight away and get the heart checked first. It is always safer to be examined and reassured than to talk yourself out of an emergency. Ruling out the heart comes before anything else.

When recurring attacks deserve treatment

One or two anxiety attacks during a very stressful patch of life are common. But if attacks keep returning, if you start avoiding places or situations for fear of another one, or if the worry is eating into your sleep, work or relationships, please treat that as a clear signal to get help. Recurrent panic attacks and anxiety disorders are common and very treatable. Talking therapies, simple breathing and lifestyle work, and where needed prescribed medicines can all help. Any medicine here is a decision for a doctor, and you should never start or stop one on your own.

You do not have to manage this alone

Anxiety can feel very isolating, but support is close by. If you are struggling and want to talk to someone right now, you can call iCall, a free and confidential emotional support helpline, on 9152987821. Reaching out is a sign of strength, not weakness.

When you feel ready for a calm, unhurried conversation, our psychiatry team is here for you. We offer strictly confidential consultations at Prudent International Health Clinic, DNK Square, Viman Nagar, Pune 411014, open all 7 days, 9 AM to 9 PM. Call or WhatsApp +91 70287 22200.