Panic Attack First Aid
Two techniques to use when panic is happening right now. Print this guide so you have it ready when you need it. These tools work with your body to help the wave pass.
Before You Begin
What to know when panic is happening
If you're reading this during a panic attack, know this: What you're feeling will pass. It always does. A panic attack typically peaks within 10 minutes and fades within 20-30 minutes. You're not dying. You're not going crazy. Your body is just having a false alarm.
What You'll Learn
This guide gives you two proven techniques:
- The Dive Reflex — A biological reset button that quickly calms your nervous system
- 5-4-3-2-1 Grounding — A way to anchor yourself when you feel disconnected or unreal
Why only two techniques? During panic, you can't think clearly. Long lists of options make things worse. These are the two most effective, most practical techniques — one for the body, one for the mind. Start with whichever feels right.
If you haven't panicked yet: Read through both techniques now so they're familiar. Practice them when you're calm. Then when panic hits, you'll already know what to do.
Technique 1: The Dive Reflex
A biological reset for your nervous system
This technique uses a real biological response called the mammalian dive reflex. When cold water touches your face, your body automatically slows your heart rate and calms your nervous system. It's involuntary — your body does it without you trying.
Cold Water Method
Best when you have access to cold water
What you need: Cold water (as cold as you can get) and a bowl or sink, OR ice/frozen item and a towel.
Get Cold Water Ready
Fill a bowl or sink with cold water. Add ice if you have it — colder is more effective. If you don't have access to water, grab a bag of frozen vegetables or ice pack and wrap it in a thin towel.
Take a Breath and Hold It
Take a breath in — it doesn't have to be deep. Hold your breath gently. Don't force it. You'll only be holding for about 15-30 seconds.
Submerge Your Face (or Apply Cold)
With water: Bend over and put your face in the cold water. Focus on getting your forehead, eyes, and cheeks wet. The area around your eyes and temples is most important.
With ice pack: Press the cold pack firmly against your forehead and the area around your eyes. Cover as much of your face as possible.
Hold for 15-30 Seconds
Keep your face in the water (or the cold on your face) for 15-30 seconds while holding your breath. You'll feel your heart rate start to slow. This is the dive reflex working.
Come Up and Breathe
Lift your face out, release your breath, and breathe normally. Notice how your body feels. You can repeat this 2-3 times if needed. Most people feel a noticeable calming effect within one or two rounds.
🧊 Quick Reference
If you're panicking right now, here's the short version:
1. Get cold water or ice pack
2. Take a breath and hold it
3. Put cold on your face (forehead, eyes, cheeks)
4. Hold 15-30 seconds
5. Come up, breathe, repeat if needed
Why this works: The dive reflex activates your parasympathetic nervous system — the "rest and digest" system that counteracts fight-or-flight. It's not a mental trick; it's a physical response your body can't help but have. Your heart will slow down.
Technique 2: 5-4-3-2-1 Grounding
Anchoring yourself when you feel disconnected
During panic, you might feel disconnected from reality — like things aren't real, or you're watching yourself from outside your body. This is called dissociation, and it's frightening. Grounding brings you back by focusing your attention on concrete, physical reality.
The 5-4-3-2-1 Exercise
Best when you feel disconnected, unreal, or trapped in your head
This exercise moves through your five senses, finding specific things in your environment. Say each one out loud if you can — hearing your own voice helps ground you further.
Name 5 Things You Can SEE
Look around you. Name five specific things you can see right now. Not just "wall" — describe it: "The white wall with a small crack near the corner." Be specific. Really look.
"I see... the blue mug on the desk. The lamp with the bent shade. The book with the red cover. The window with raindrops. The clock showing 3:42."
Name 4 Things You Can TOUCH
What's touching your body right now? Notice four different textures or sensations. Actually touch things if you can — run your hand over different surfaces.
"I feel... the smooth phone in my hand. The soft fabric of my shirt. The hard floor under my feet. The cool air on my face."
Name 3 Things You Can HEAR
Pause and listen. What sounds are happening around you? Even in silence, there's usually something — a hum, distant traffic, your own breathing.
"I hear... the refrigerator humming. A car passing outside. My own breath."
Name 2 Things You Can SMELL
What do you smell right now? If nothing obvious, get closer to something — your coffee, a candle, your sleeve. If you carry essential oil or perfume, this is a good time to use it.
"I smell... the coffee on my desk. The laundry detergent on my sweater."
Name 1 Thing You Can TASTE
What taste is in your mouth? If you can't identify one, take a sip of water or eat something small — a mint, a piece of gum, a bite of food.
"I taste... the mint from my toothpaste."
⚓ Quick Reference
Say these out loud:
5 things I SEE: _____, _____, _____, _____, _____
4 things I TOUCH: _____, _____, _____, _____
3 things I HEAR: _____, _____, _____
2 things I SMELL: _____, _____
1 thing I TASTE: _____
Why this works: Panic pulls you into your head — into scary thoughts and frightening sensations. Grounding pulls you out by making you focus on external reality. Your brain can't fully focus on panic AND count ceiling tiles at the same time. The more specific you are, the more grounded you become.
If It's Not Working
What to do when the techniques feel hard
These techniques don't make panic disappear instantly. They help you ride the wave until it passes naturally. If they feel hard to do, that's normal — you're in the middle of something intense. Here's what to do if you're struggling.
"I can't concentrate enough to count things."
Start simpler. Instead of 5-4-3-2-1, just find one thing you can see and describe it in detail. Or just press your feet hard into the floor and focus on that sensation. Or just hold a cold object in your hands. Any anchor is better than none.
"I don't have cold water available."
Use whatever cold you can find: run your wrists under cold tap water, hold a cold can from a vending machine, step outside if it's cold out, or even fan yourself vigorously. The goal is any cold sensation, especially near your face.
"The panic is too intense — I can't do anything."
That's okay. Sometimes all you can do is wait. Sit or lie down somewhere safe. Remind yourself: "This will pass. It always passes. I just need to wait." You don't have to do the techniques perfectly. Even attempting them helps.
"I did the techniques but I still feel anxious."
These techniques help you ride the wave, not erase it completely. After the peak passes, you'll likely feel tired, shaky, and still a bit anxious. That's the aftermath, not a new attack. Rest. Drink water. Be gentle with yourself. Full calm will come.
What to Remember
The key takeaways
Key Takeaways
- The Dive Reflex — Cold water on your face triggers a biological response that slows your heart rate
- 5-4-3-2-1 Grounding — Naming things you can sense anchors you to reality when you feel disconnected
- These help you ride the wave — They don't stop panic instantly, but help you get through it
- Panic always passes — Usually peaks in 10 minutes and fades within 20-30 minutes
Remember: You don't need to do these perfectly. Even trying them gives your brain something to do besides panic. And no matter what, the panic will pass. It always does.
Your Next Step
Practice these techniques when you're calm so they're familiar when you need them:
Having panic attacks doesn't mean something is wrong with you. It means your nervous system is sensitive and protective. With practice and support, you can learn to work with it instead of against it. You're already taking steps by reading this.
💜 Bring this back to therapy
Which technique worked better for you — the dive reflex or grounding? What made it easier or harder to use? Did you notice any patterns in when panic hits? These observations help your therapist tailor your work together.
Print this guide now. When panic hits, you won't want to search for techniques. Have this by your bed, in your bag, or saved on your phone.
This resource is intended to support—not replace—your work with a licensed therapist. It provides information and exercises based on evidence-informed approaches, but is not a substitute for professional mental health treatment. If you're in crisis or need immediate support, please contact your therapist or a crisis helpline.