A panic attack can feel as if it arrives out of nowhere and leaves you literally shaking, frightened and feeling like you have been through the wars. I’ve already spoken about my first panic attack and, in hindsight, I could have done with some help on what to do afterwards, which is why I am wiring this article now.
I want this to be the page you can read after the attack, not three weeks later when you are feeling more rational. The aim today is not to analyse your entire life. It is to get through the next 24 hours in a way that helps calm your nervous system without accidentally teaching your brain that panic itself was dangerous.
When I had my first full-blown panic attack, I ended up in hospital because I was convinced I was dying. The tests were reassuring, but the fear did not simply disappear the next morning, in fact I had my second panic attack later that day. What mattered afterwards was learning what had happened in my body and, just as importantly, what to do next.
First: decide whether this needs medical attention
Panic can cause chest tightness, breathlessness, dizziness, trembling, nausea, sweating, tingling and a racing heart. Those symptoms can overlap with medical problems.
If this was your first episode, symptoms were different from your usual panic, you have severe or persistent chest pain, fainting, weakness, confusion, severe breathlessness, injury, or you simply are not sure, seek appropriate medical advice. In Ireland that may mean your GP, out-of-hours GP service, emergency department or 112/999 depending on severity.
Appropriate medical assessment is not “giving in” to panic. The difficulty begins when familiar panic sensations are repeatedly treated as fresh emergencies after reasonable medical checks.
The first hour: let the alarm cycle finish
After a panic attack, your body may still feel activated. The urge is often to escalate: Google symptoms, call several people, check your pulse, replay every second, or decide never to return to the place where it happened.
For the next hour, do the opposite. Sit somewhere reasonably calm. Loosen anything tight. Let your breathing settle rather than forcing enormous breaths. Do something ordinary and low-demand while your body comes down.
“My body has had an alarm response. I do not have to solve it while the alarm is still ringing.”
Do not make permanent avoidance decisions today
The frightened brain can sound very convincing: “I can never drive that road again”, “I have to leave this job”, “I cannot go back to that shop”, “I need to cancel college tomorrow”.
For the first 24 hours, make a rule: no major avoidance decisions solely because of the panic attack. Rest if you need to. Slow the day down. Seek medical advice if appropriate. But avoid teaching the brain that the situation itself had to be removed from your life.
How one panic attack can become a smaller life
The recovery alternative
Appropriate medical check if needed → understand the panic cycle → return gradually → reduce safety behaviours → new learning
Write a short panic record, not an essay
Once you are calmer, use five lines:
- Where was I?
- What did I notice in my body?
- What did I think was going to happen?
- What did I do to cope or escape?
- What would I like to practise next time?
Panic thrives on forensic investigation, so resist writing pages. You are looking for the pattern, not a perfect explanation.
Deal with the shame early
People often tell me they are as upset by what the panic attack “says about them” as by the physical sensations. They worry that they looked weak, unstable or out of control.
I understand that shame. I was working as a psychologist when I developed panic disorder, and at the time I felt deeply embarrassed that I was struggling with something I thought I should be able to understand. Panic does not care what job you do. Knowing psychology did not make the sensations feel less frightening while they were happening. As a full blown panic attack does not feel like a panic attack – the first time. Once you have had your first panic attack, then you know what it feels like and can recognise it the second time. My professional knowledge of panic attacks did not prepare me for what it felt like.
A more useful description is simply: “I had a panic attack. My nervous system produced a very strong alarm. I can learn a different response to that alarm.”
After more than 20 years working with anxiety, one of the most important shifts I see is when the attack stops being treated as proof that the person cannot cope and starts being understood as a pattern that can be changed.
Do one normal thing before the day ends
Your brain pays attention to what happens after the attack. If the rest of the day becomes scanning, cancelling and hiding, the message is “panic changed everything”.
Choose one small normal action: answer one work message, shower and get dressed, walk to the gate, sit in the car, go into a small shop, make dinner, or attend part of something you planned.
The aim is not heroics. It is to show your brain that panic does not get to erase the rest of the day.
The next morning: watch for the panic hangover
You may wake tired, tender or hyper-alert. The danger is interpreting this as further evidence that something is wrong and withdrawing more.
Sometimes rest is sensible. But if the main reason for staying home is fear of another attack, keep at least one small anchor in your routine: breakfast, getting dressed, a short walk, standing outside, one phone call or a reduced version of your normal day.
Was this a one-off or is a pattern starting?
Ask yourself:
- Am I now frightened of having another attack?
- Am I avoiding places because panic might happen?
- Am I monitoring my body more closely?
- Am I seeking repeated reassurance?
- Is my world beginning to shrink?
If yes, it is worth addressing the pattern early. You may also find my guide to panic attacks, my explanation of exposure for panic, and the article on graded exposure useful.
Getting help in Ireland
Your GP is a reasonable starting point when symptoms are new or you are unsure. CBT for panic generally focuses on understanding the panic cycle, changing catastrophic interpretations of bodily sensations, reducing safety behaviours, and gradually approaching feared sensations and situations.
If you want a structured way to work on panic attacks
My self-paced Panic Attack Course brings this practical CBT work together in one programme. It helps you understand the panic cycle, change catastrophic interpretations of physical sensations, reduce avoidance and safety behaviours, and practise gradual exposure using CBT-based skills.
I created the course from the same understanding I use clinically and the understanding that changed my own response to panic.
A panic attack is frightening. It does not have to become the point where your life starts getting smaller.