The first time it happened I thought something was physically wrong with me. Heart hammering, can't get a full breath, hands buzzing, a total certainty that something terrible was about to happen right now. Then, after a while that felt like an hour, it drained away and left me shaking and embarrassed.
I've had enough of those since to learn a few things. I'm not a doctor, and this isn't a substitute for one. But here's the plain answer first.
How do you stop a panic attack? You mostly can't switch it off like a light. What you can do is stop pouring fuel on it. The NHS says to stay where you are if you can, breathe slowly and deeply, and remind yourself that the attack will pass and can't hurt you. It also says most panic attacks last between 5 and 20 minutes. That number helped me more than any trick. It ends. It always ends.
First, a safety thing
If you've never had a panic attack before and you have chest pain, pain going into your arm or jaw, or you feel faint, don't assume it's panic. Call 911 or go to the emergency room. Being told "it was panic" by a doctor is a fine outcome. Guessing wrong about a heart is not.
Once you've been checked and you know what your panic feels like, the rest of this post applies.
What helps me in the moment
None of this is magic. Some days it works and some days I just ride it out.
Name it. I say it in my head, sometimes out loud. "This is panic. This is adrenaline. It peaks and then it drops." Panic feeds on the fear that this time it's something else. Naming it takes a bit of that away.
Slow the breath, especially the out-breath. Panic makes you breathe fast and high in the chest, which makes the dizzy, tingly feelings worse, which makes the fear worse. I breathe in through my nose and let the breath out longer and slower than it came in. Not a perfect count. Just slower out than in.
Stay put. Every cell is screaming to get out of there. Leaving brings relief, and that relief teaches the brain the place was dangerous. The NHS advice to stay where you are, if you can, is the part I resisted most and the part that mattered most. Over time it's how places stopped being "the store where it happened".
Give the senses something real. I'll count things in the room. Blue things. Corners. Or hold something cold. It drags attention out of the spiral in my chest and back into the room.
Don't fight it. This is the strange one. The harder I try to make it stop, the longer it lasts. When I let it crest, almost like watching a wave, it passes faster.
The game that taught me something about breathing
This sounds odd on a mental-health blog. There's a video game called Celeste, a hard little platformer about a young woman climbing a mountain while her anxiety follows her up, almost as a second character. At one point she has a panic attack and another character talks her through it by asking her to imagine a feather and keep it floating with slow, steady breaths. It's simple. It also happens to be a decent picture of what slow breathing should feel like.
Nobody should call a game treatment. But it takes anxiety seriously, and it reminded me that the people who made it had clearly been there.
What treats panic for good
The in-the-moment stuff gets you through an attack. It doesn't stop the next one. If you're having attacks again and again, or you've started avoiding places because of them, that's worth real help.
The main treatment is cognitive behavioural therapy. The UK's NICE guideline for panic disorder puts CBT at the centre, with medication as an option. A big part of CBT for panic is learning, by doing it, that the body sensations aren't dangerous, and slowly going back to the places you've started avoiding. Medication is a conversation with your doctor, and I won't name any.
Avoidance is the trap to watch. Panic attacks in a certain place can grow into agoraphobia, a fear of being anywhere you can't easily escape. I wrote about why I got scared to leave the house and about agoraphobia after 40.
In Québec, public mental-health care is free: start with your doctor, a CLSC, or call 811 and choose option 2. Phobies-Zéro runs self-help groups for anxiety and panic, including virtual ones. HereToHelp BC has solid plain-language info on anxiety disorders. And if you want to understand the therapy options, I wrote about CBT, DBT and ACT in plain words.