The 60-second panic guide
Save this where you can find it fast. It's short on purpose.
What's happening
A panic attack is a surge of adrenaline, the same chemistry your body releases in real danger. In panic, it fires when there's no real threat. It feels dangerous. It's not. It's intensely uncomfortable, and it always burns out. Adrenaline can't stay high. Every wave peaks and falls.
What makes a wave bigger and longer than it needs to be is the fear you add on top of it. So the goal isn't to stop the wave. The goal is to not feed it.
The 60-second reset
Pause
Stop what you're doing for five to ten seconds. Just enough to break the automatic reaction.
Name it
Say, this is a surge. No explanation needed.
Slow the exhale
For about thirty seconds, make every out-breath longer than the in-breath. Don't gulp air. Long, slow exhales.
Ground
Feel your feet on the floor. Feel your back against something solid. Find one object you can see and rest your eyes on it.
Let the thoughts run
They'll still be there. Let them run in the background. You stay in the foreground.
If it's too intense for all five
Do one thing. Make your next three exhales longer than your inhales. That's enough. A wave you didn't add fear to is a wave that passes sooner.
For the full, psychiatrist-designed version, see the Panic Reset, a step-by-step guide to stopping a panic attack (opens in a new tab) on shrinkMD. shrinkMD is part of The Shrink Network, founded by Shariq Refai, MD.
Over time, panic tends to pull you into avoiding the places and situations where it hit you, which is its own trap. I've mapped that in the avoidance loop, and how the shrinQ system works walks through the four moves I use to interrupt it. When you want the full structure rather than one reset, the shrinQ program is where I teach it.
One honest note
Panic shares symptoms with real medical conditions. If your symptoms are new, sudden, or unfamiliar, get checked by a clinician before deciding it's panic. This guide is for panic that has already been identified as panic. If you ever feel unsafe, in the US you can call or text 988.
Get a printable copy of this guide.
Knowing what to do in the moment is the start. shrinQ, the paid program, is where the moment becomes a skill: a full module on panic, the shrinkMD Reset, and a practice that shrinks the waves over time. Enter your email to get the printable guide and a short series that introduces the program.
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Common questions
A panic attack always burns out, because it runs on a surge of adrenaline and adrenaline cannot stay high. Every wave peaks and falls on its own. What makes a wave bigger and longer than it needs to be is the fear you add on top of it, which is why the reset focuses on not feeding the wave rather than stopping it.
A panic attack is intensely uncomfortable but is not itself physically dangerous. It does share symptoms with real medical conditions, so if your symptoms are new, sudden, or unfamiliar, get checked by a clinician before deciding it is panic. This guide is for panic that has already been identified as panic.
Make your next few exhales longer than your inhales. A slow, extended exhale gives your nervous system the signal to settle, and it is the one step to use if the full five feel like too much. Pair it with feeling your feet on the floor to bring your attention into the room.