I keep having panic attacks, what should I do?

First, know that a panic attack, frightening as it is, passes, usually within minutes, and you are not alone: many people have them. Book a GP appointment, especially if they keep coming or you have chest pain or breathlessness that has not been checked. Many people also find that talking therapy and learning calming skills help them feel more in control, and a good practitioner will tell you if another route is better first.

What to do during a panic attack

1. Remind yourself what this is. Say it to yourself: this is a panic attack, it is horrible but it will pass.
2. Slow your breathing. Breathe in gently through your nose for about four, and out through your mouth for about six. Longer out-breaths help your body settle.
3. Ground yourself. Press your feet into the floor and name five things you can see, four you can touch and three you can hear.
4. Stay where you are if it is safe. Fighting it or rushing away often makes it feel worse. Let the wave rise and fall.
5. Be kind afterwards. Have a drink of water and rest. You may feel tired or shaky for a while.

When to see your GP

Please book a GP appointment if panic attacks are happening more than once or twice, if they are new, or if they are changing how you live, such as avoiding places or things you used to do. Panic can feel like a heart problem, so it is sensible to have chest pain, a racing heart, dizziness or breathlessness checked, especially if you have not had them looked at before. Your GP can rule out other causes and talk through options on the NHS, which often include talking therapies such as cognitive behavioural therapy (CBT), self-help and sometimes medication. Please don't stop or change any medicine without speaking to your doctor.

How counselling can help

A counsellor gives you regular, private time to talk about what is going on, what tends to happen just before an attack and what worries sit underneath. Many people find that understanding the pattern makes panic feel less mysterious and less frightening. Some counsellors also teach practical ways to calm your body and thoughts. Sessions usually last 50 minutes to an hour, in person, by phone or on video, and many people start with a short block and review how it feels.

Other things that can help

• Hypnotherapy. Guided relaxation and calm imagery can help you learn to settle, and many people use it to feel steadier between attacks.
• Yoga, breathing and relaxation classes. Slow movement and practised breathing help many people feel more at ease in their bodies.
• Everyday habits. Regular sleep, movement, meals and less caffeine can help you feel less on edge.

Roughly what does it cost?

Private counselling in the UK is commonly from £45 a session, and often more in big cities. Hypnotherapy is commonly from £50 a session too. Some counsellors offer lower-cost places or a sliding scale, and many offer a free first chat. Check the length of a session and the cancellation terms before you book.

Who this might not suit

Private therapy is not a substitute for medical care. If your panic comes with thoughts of harming yourself, very low mood, or you are already under a mental health team, tell them and your GP, and let any practitioner know too. If you would find it hard to talk about feelings at first, say so. A good counsellor will go at your pace.

If you need to talk to someone now

• Samaritans on 116 123: free, any time, day or night.
• NHS 111 for urgent help when it is not an emergency.
• 999 or A&E if you or someone else is in danger, or if you have severe chest pain or cannot breathe.

This page is general information, not medical advice. If you have symptoms that haven't been checked, or you are under medical care, please talk to your GP as well.

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