Panic attacks: what to do now and afterwards

When do you need urgent help?

Call your local emergency service for persistent squeezing chest pain, pain spreading to an arm or jaw, or severe breathing difficulty. Do not assume these signs are panic; a first or unfamiliar episode also needs medical assessment.

What to do during a familiar panic attack: three steps

Use these steps for a familiar episode, alongside any plan already agreed with your clinician. If the place is safe, you do not need to rush away. If you are driving, stop safely before doing anything else.

1. Find support. Sit if convenient, feel the chair and your feet on the floor, and look at one steady object.
2. Let your breathing stay gentle. Use a comfortable rhythm without forced deep breaths, breath-holding or a target number. If focusing on breathing feels uncomfortable, return your attention to the room.
3. Ask for one useful action. “Please stay with me and speak slowly.” You can postpone a non-urgent conversation until later.

You do not have to perform the exercise perfectly. Stop any part that makes you feel worse. If symptoms worsen or you are uncertain what is happening, seek help rather than trying harder.

The institute describes these steps as a Zhiva attention practice: physical support, gentle breathing and a useful next action.

Yav is the present in the institute’s framework: where you are, what you notice and what you can do safely now. Heart racing, trembling and breathlessness describe sensations; they do not establish a diagnosis.

How can someone nearby help?

Ask what the person needs, keep your words short and stay at a comfortable distance. Help them find a safe place without creating a crowd or insisting on touch. If there are warning signs, call emergency services.

• “I am here. Would you like me to stay?”
• “Would sitting here feel more comfortable?”
• “Shall I call someone or help you get medical assistance?”

Avoid arguing about whether the fear is reasonable. Ask before offering an exercise; the person can decline.

What should you do after the episode?

Once you feel ready, leave yourself a short note: where you were, what you noticed first, what you did and what support helped. A few lines are enough. You do not need to reconstruct every sensation.

If attacks recur, restrict daily life or leave you afraid of the next episode, arrange a professional assessment. A clinician can check possible causes and discuss a plan; psychotherapy such as cognitive behavioural therapy can be part of treatment. Follow existing prescriptions and discuss changes with your clinician.

For an overview of signs and possible causes, read the main guide to panic attacks. This page keeps its focus on what to do now and afterwards.

What can make the next step harder?

Sometimes a second fear grows around the episode: “What if it happens again?” That can turn into constant checking of the body and withdrawing from everyday activities. Think of an alarm: repeatedly checking its volume does not explain what set it off.

Feeling frightened does not make you weak. You can ask for help without first finding the right explanation.

What can you explore once you feel ready?

Explore personal patterns after the acute episode, when you want to reflect. Nav means past experience, learned rules and family patterns in Alexander Zharkov’s approach. Ancestral and karmic ideas are the institute’s language of interpretation, not a way to identify a medical cause from a symptom.

• What was happening before the episode, without assuming it was the cause?
• What is hard to allow myself: a pause, disagreement or asking for help?
• Which rule appears: “I must always be in control” or “I cannot show uncertainty”?

How can you make a support plan?

Prav is the direction of future decisions. In the institute’s language, energy sovereignty means recognising your responsibility, keeping workable boundaries and choosing your next action. A practical result is a clearer request for help, not a promise to control every future sensation.

• Keep your professional care plan where you can find it.
• Agree one support phrase with a person you trust.
• Choose a realistic change in daily demands and review it together if needed.

The institute’s 40-day programme explores attention, emotions, thoughts and family patterns over six stages. Consider its format separately from the plan for managing attacks.

Professional care and a participant’s experience

Katerina describes less everyday hurry, clearer thinking and improved sleep after the 40-day programme. She does not describe treatment for panic attacks. Her account is useful for understanding the kind of daily observations a participant makes, not for predicting your outcome.

Watch Katerina’s review ↗

Questions about immediate help and recurrence

What personal situation would you like to explore?

After the acute episode, choose one situation you want to understand: asking for help, a difficult conversation or the urge to control everything. Quantum Diagnostics is a personal exploration using Alexander Zharkov’s framework: Nav for past experience, Yav for present circumstances and Prav for possible decisions.

The institute reports 16 years of practice and 16,000+ clients; its founder has received eight public awards. About Alexander and his work.