Before you understand what to do during an anxiety attack, it’s essential to know what’s actually happening in your body and mind. An anxiety attack is an intense response of the body to situations of stress, fear, or insecurity. During an episode, the body activates the fight-or-flight response, releasing hormones like adrenaline and cortisol that trigger symptoms such as a racing heartbeat, shortness of breath, trembling, and a sense of losing control (Harvard)1
Understanding What an Anxiety Attack Is
A clinical study indicates that recognizing and accepting the episode—without resistance—helps the brain restore physiological and emotional balance (AAFP)2.
“Calm isn’t the absence of fear, but the ability to handle it.” — Dr. Lisa Damour
Step 1: Notice the Signs and Accept the Moment
The first move is to acknowledge that you’re having an anxiety attack—without self-blame and without fighting what you feel. Denying what’s happening can intensify symptoms. Accepting the moment means telling yourself: “I’m anxious, and that’s okay. This will pass.”
Common Signs of an Anxiety Attack
| Physical symptom | Emotional symptom |
|---|---|
| Racing heartbeat | Intense fear |
| Shortness of breath | Sense of losing control |
| Tremors | Catastrophic thoughts |
| Sweating | Irritability and mental fog |
Labeling and acknowledging what’s happening reduces fear and tells the brain there’s no real danger. This simple act can significantly shorten the episode’s duration (PMC)3.
Step 2: Breathe Intentionally to Regain Control
Breathing is a powerful tool for interrupting an attack. When you slow your breath, the body understands the danger has passed. One of the most effective techniques is 4-7-8, developed by Dr. Andrew Weil.
How to Practice the 4-7-8 Technique
- Inhale through your nose to a count of 4.
- Hold for 7 seconds.
- Exhale slowly through your mouth to a count of 8.
- Repeat for 4 cycles.
This technique lowers heart rate, normalizes oxygenation, and activates the parasympathetic nervous system. Multiple studies confirm that mindful breathing techniques significantly reduce symptoms of anxiety and stress (PMC).
Step 3: Use Sensory Focus to Anchor in the Present
During an attack, the brain is flooded with fear-based thoughts. To break the loop, you need to anchor your mind in the present. An effective technique is the 5-4-3-2-1 method, which helps reconnect your senses to reality.
5-4-3-2-1 Method — Bring Yourself Back to the Present
| Step | Action |
|---|---|
| 5 | Name five things you can see. |
| 4 | Touch four things you can feel. |
| 3 | Listen for three sounds around you. |
| 2 | Identify two smells. |
| 1 | Taste something or imagine a pleasant flavor. |
This technique—known as grounding—has proven results in reducing the physical and mental symptoms of anxiety. It creates an immediate sense of safety and helps the brain step out of hyper-arousal (NIH) (Counselling)4.
Step 4: Change Your Environment and Use Positive Affirmations
Changing your physical environment signals to the brain that the threat has passed. Go to a well-ventilated space, sit or lie down comfortably. Then repeat positive affirmations such as:
- “I am safe right now.”
- “My body knows how to calm down.”
- “This feeling will pass.”
This blend of self-compassion and cognitive reframing helps interrupt automatic negative thoughts and restore emotional balance. Studies show that using positive affirmations reduces the recurrence of panic episodes and improves self-control (AJP)5.
Step 5: Seek Support and Tend to Your Lifestyle
After an anxiety attack, it’s essential not just to recover from the episode, but also to seek emotional and therapeutic support to understand the causes and develop preventive strategies. Science shows that ongoing psychological support and lifestyle changes are fundamental pillars of long-term emotional stability.
Research indicates that psychotherapy, especially Cognitive Behavioral Therapy (CBT), significantly reduces the frequency and intensity of anxiety attacks, promoting greater emotional control and self-understanding (PubMed)6. Psychoanalysis and other relational approaches help individuals identify unconscious patterns and repressed emotions that often sustain anxious symptoms (ResearchGate)7.
In addition, studies show that lifestyle interventions—such as regular physical activity, balanced nutrition, quality sleep, and reducing caffeine and alcohol—are associated with lower cortisol levels and less activation of the amygdala—the region involved in fear and anxiety responses (PMC)8. These changes support the balance between body and mind and strengthen emotional regulation.
Long-Term Habits That Reduce Anxiety
| Self-care strategy | Evidence-based effect |
|---|---|
| Do light physical activity daily | Lowers cortisol and improves mood (NIH) |
| Sleep 7–8 hours per night | Regulates stress-related neurotransmitters (Harvard Health) |
| Reduce caffeine and alcohol intake | Prevents spikes in anxiety and irritability (Mayo Clinic) |
| Schedule breathing breaks and leisure moments | Reduces muscle tension and improves focus (PMC) |
| Attend psychotherapy regularly | Strengthens emotional resilience (APA) |
These practices not only reduce the risk of new episodes, they also promote emotional autonomy. Caring for body, mind, and emotions is an act of prevention and psychological maturity.
Therapy—whether through psychology, psychoanalysis, or integrative approaches—offers tools to understand emotional triggers and rebuild a sense of inner safety. This therapeutic prevention is one of the most effective ways to keep anxiety from becoming chronic.
However, if symptoms persist or worsen, it’s best to seek help from a medical specialist, such as a psychiatrist or primary care physician, for a thorough evaluation and, if needed, supervised medication. The combination of medical follow-up and psychotherapy has proven to be the most effective strategy for long-term control of anxiety disorders (Harvard Medical School)9.
Anxiety doesn’t have to be an enemy. It can’t be eliminated completely, but it can be kept at healthy levels—and, more than that, it can become a call to transformation and care.
The balance between body and mind sustains emotional control. Daily self-care has a direct impact on preventing relapse and improving mental health (Mayo)10.
How to Apply These Steps Day to Day
The five steps above can be woven into your routine with small, practical actions that make a real difference.
At Work
Take short breaks, breathe deeply, and avoid overload. Before important meetings, use the 4-7-8 technique to steady your body and clear your mind (PMC).
In Relationships
Communicate your feelings with authenticity and kindness. Anxiety tends to decrease when there’s space for safe emotional expression (Harvard).
In Personal Life
Set aside time for leisure, meditation, and relaxation. Keep an emotional journal and notice your triggers. Small self-care rituals, such as walking or listening to calm music, reduce accumulated stress (NIH)11.
These practices strengthen self-esteem and create a positive cycle of well-being and emotional stability.
FAQ – Frequently Asked Questions
1. What should I do during an anxiety attack when I’m alone?
Breathe deeply, practice the 5-4-3-2-1 method, and repeat calming affirmations. The episode is temporary and will pass.
2. How long does an anxiety attack last?
On average, between 10 and 30 minutes. The duration may vary based on stress intensity and the use of regulation techniques.
3. Can I prevent an anxiety attack?
Yes. With healthy habits and psychological support, it’s possible to reduce the frequency and intensity of episodes.
4. Is it dangerous to have many anxiety attacks?
Repeated episodes can cause emotional and physical wear, calling for professional support.
5. Does breathing really help control anxiety?
Yes. Conscious breathing activates the parasympathetic system, slows heart rate, and reduces stress.
6. Can I use medication during an attack?
Only under medical prescription. Treatment must be supervised by a psychiatrist.
7. Does nutrition influence anxiety?
Yes. Reducing sugar and caffeine and increasing whole, natural foods supports emotional regulation.
8. Do children and adolescents also have anxiety attacks?
Yes. Welcoming, listening, and seeking professional support are essential for healthy emotional development.
Conclusion
Knowing what to do during an anxiety attack is an act of self-compassion and emotional maturity. Applying these five steps—recognize, breathe, anchor, change the setting, and seek support—is a safe path to regaining balance.
Remember: anxiety doesn’t define who you are; it simply signals that something needs attention and care.
Question for Reflection:
“Are you willing to practice, today, one small act of self-care that could change how you handle your anxiety?”
Recommended Scientific / Theoretical References
- Harvard – Managing Panic and Anxiety. https://www.health.harvard.edu/mind-and-mood/panic-attacks-recognizing-and-managing-panic-attacks-and-preventing-future-attacks ↩︎
- AAFP – Generalized Anxiety Disorder and Panic Disorder in Adults. https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html ↩︎
- PMC – Clinical Practice Guidelines for the Management of Anxiety and Panic Disorder. https://pmc.ncbi.nlm.nih.gov/articles/PMC5310105/ ↩︎
- Counselling – Grounding for Anxiety: Evidence-Based Practice. https://www.counsellingconnection.com/index.php/2023/02/20/grounding-for-anxiety/ ↩︎
- AJP – Psychotherapies for Generalized Anxiety Disorder. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2810866 ↩︎
- PubMed – Cognitive behavioral therapy for anxiety and related disorders. https://pubmed.ncbi.nlm.nih.gov/23796855/ ↩︎
- ResearchGate – Evidence-Based Psychodynamic Treatments for Anxiety Disorders: A Review. https://www.researchgate.net/publication/283314004_Evidence-Based_Psychodynamic_Treatments_for_Anxiety_Disorders_A_Review ↩︎
- PMC – Healthy Lifestyle Interventions Augmenting Psychotherapy in Anxiety and PTSD. https://pmc.ncbi.nlm.nih.gov/articles/PMC10561983/ ↩︎
- Harvard Medical School – Social anxiety disorder. https://www.health.harvard.edu/mind-and-mood/social-anxiety-disorder-treatments-and-tips-for-managing-this-challenging-condition ↩︎
- Mayo – Anxiety Disorders: Symptoms and Treatment. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961 ↩︎
- NIH – Mindfulness Exercises and Physiologic Stress. https://pmc.ncbi.nlm.nih.gov/articles/PMC11519409/ ↩︎
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