A panic attack can feel like a sudden threat to your life: your heart pounds, you struggle to breathe, feel dizzy, your hands go numb, and you think "I am about to die" or "I am losing control". Although a panic attack itself is usually not dangerous, the experience can be so intense that a person begins to fear not only another attack, but fear itself.

This article explains how to recognise a panic attack, what to do during one, when medical help must not be delayed, and when sessions with a psychologist may help break a recurring cycle of panic and avoidance.

At a glance: what to do during a panic attack

  • seek help if symptoms are new, unusual or suggest a medical emergency;
  • if this is a familiar wave of panic, remind yourself that it will pass;
  • place your feet on the floor, slow your breathing and lengthen your out-breath;
  • bring your attention to your surroundings: colours, shapes, sounds and the places supporting your body;
  • do not blame yourself afterwards, and notice whether panic is beginning to restrict your life.

What is a panic attack?

A panic attack is a sudden wave of intense fear or discomfort accompanied by strong physical symptoms. It may begin in a situation where you already feel tense, but can also arrive unexpectedly while sitting quietly, shopping, travelling, working or during the night.

A panic attack usually peaks within a few minutes. For many people it lasts around 5-20 minutes, although tiredness, trembling, sensitivity to bodily sensations or fear that it will happen again may linger afterwards.

Symptoms of a panic attack

Panic symptoms can feel very physical, so people often think of a heart attack, stroke, suffocation or fainting. This is precisely why it is important to consult a doctor if you experience severe or unusual symptoms for the first time.

Bodily sensations

  • a racing or pounding heart;
  • sweating;
  • trembling;
  • a feeling of not getting enough air;
  • chest tightness or pain.

Stomach and head

  • nausea or stomach discomfort;
  • dizziness;
  • weakness;
  • numbness or tingling;
  • hot flushes or chills.

Thoughts

  • fear of dying;
  • fear of losing your mind or losing control;
  • the thought that you are about to have a heart attack;
  • interpreting bodily sensations in catastrophic ways.

Experience

  • a sense of unreality;
  • feeling detached from yourself;
  • an urge to escape;
  • a strong need for reassurance that everything is all right.

When do you need emergency medical help?

If you are unsure whether this is panic or a medical condition, it is better to get checked. In Lithuania, call 112 or seek emergency care if you have any of the following signs:

  • you experience severe chest pain or pressure for the first time, or pain spreading to your arm, jaw or back;
  • you faint, lose consciousness or feel extremely weak;
  • you develop numbness on one side of your body, difficulty speaking, facial asymmetry or a sudden change in vision;
  • breathlessness does not ease, your lips turn blue, or you have severe asthma or another breathing condition;
  • symptoms are clearly different from usual, or began after new medication, substance use or a change in your health;
  • you have thoughts of suicide or self-harm, or it is no longer safe for you to be alone.

What should I do during a panic attack?

During panic, your body acts as though you are in danger: the fight-or-flight response activates, breathing speeds up, your heart works harder and your muscles tense. The aim is therefore not to convince yourself that "I cannot feel anything". It is to help your body learn that you can get through this wave.

1

Name what is happening

Tell yourself: "This feels like a wave of panic. It is very unpleasant, but it passes." Naming the experience can help your mind see the sensations as something recognisable rather than completely unknown.

2

Check that you are safe

If you are driving, pull over somewhere safe. Seek medical help if you have severe chest pain for the first time, fainting, unusual breathlessness or neurological symptoms.

3

Slow your breathing without forcing it

Try breathing in through your nose for a count of 4 and breathing out slowly for a count of 6, if that feels comfortable. Do not force yourself to breathe perfectly. Gentleness and a longer out-breath matter more.

4

Reconnect with your surroundings

Name 5 things you can see, 4 sounds or places where your body is supported, 3 textures, 2 smells and 1 taste, or one fact about where you are. This can help bring your attention back from catastrophic thoughts.

5

Ease tension in your body

Place your feet on the floor, unclench your jaw, lower your shoulders and relax your hands. During panic, your body prepares to flee, so clear signals of safety can help.

6

Let the wave pass

The aim is not to win a fight against panic. A more helpful thought is often: "I can stay with this while my body settles." Give yourself a few minutes to recover after the attack.

What to avoid

Do not force yourself to breathe into a paper bag, use alcohol or sedatives without a doctor’s prescription, or punish yourself for having an attack. Try not to build an ever-longer list of places to avoid. Avoidance may bring short-term relief, but can strengthen fear over time.

How can you help someone having a panic attack?

If someone near you has a panic attack, your calm presence can make a real difference. First, consider whether there may be a medical emergency. If the symptoms are familiar and the person says it is panic, help them reconnect with the present.

What helps

Stay nearby, speak in short sentences, ask "what do you need right now?", suggest placing their feet on the floor, breathe more slowly together and remind them that the wave will pass.

What does not help

Saying "calm down", shaming them, arguing with their sensations, leaving them alone when they are frightened, or overwhelming them with advice. During panic, it is hard to take in a lot of information.

Panic attack or panic disorder?

One panic attack does not mean that a person has panic disorder. Panic disorder is associated with repeated, unexpected attacks and at least a month of worry about another attack or changes in behaviour. For example, a person may stop visiting shops or using public transport, or avoid exercise, social meetings, being alone or anything that reminds them of the attack.

This is how a "fear of fear" develops: a person starts constantly monitoring their heart rate, breathing, dizziness or other bodily signals. The more they check their body, the more sensations they notice, and those sensations may again be interpreted as a threat. If tension persists between attacks, read about why anxiety continues even when everything is calm.

Why do panic attacks recur?

Panic may recur more often when someone has lived with tension for a long time, sleeps poorly, experiences relationship or work stress, uses a lot of caffeine, alcohol or other substances, or has health anxiety, traumatic experiences or a more sensitive nervous system. Medical factors, such as thyroid problems, blood sugar changes, breathing conditions or heart rhythm problems, can also intensify symptoms resembling panic, so ruling out physical causes matters too.

Psychologically, panic can be maintained by interpreting bodily sensations catastrophically. A pounding heart after coffee or climbing stairs, for example, may be taken as a sign that "something is wrong". This thought triggers more adrenaline, the bodily sensations intensify, and the cycle begins.

When can a psychologist help?

Psychological support is worth considering if panic attacks recur, recovery takes a long time, you begin avoiding situations, or your life increasingly revolves around "what if it happens again?". It is also worth seeking help when panic is linked to wider anxiety, stress, burnout, relationship tension or traumatic experiences.

Understand the panic cycle

Panic is often maintained by a cycle: a bodily sensation, a catastrophic thought, more fear, and an even stronger bodily sensation. Recognising this pattern can give a person more choice in how they respond.

Work with catastrophic thoughts

Principles of cognitive behavioural therapy can help you examine thoughts that feel like facts during panic: "I am about to die", "I cannot cope", "everyone will notice".

Reduce avoidance

When a person begins avoiding shops, travel, exercise, social meetings or being alone after an attack, their life becomes more restricted. Sessions can help develop a safe, gradual plan for returning to these activities.

Find ways to regulate that suit you

Breathing helps some people; others benefit from movement, grounding, changes to daily routines, better sleep or working with underlying anxiety. What matters is finding what suits the individual.

Iveta Litvinienė offers online sessions via Teams in Lithuanian and English for adults and teenagers aged 16 and over. Sessions can address anxiety, fear of panic attacks, avoidance, self-regulation skills and deeper emotional patterns. You can choose an appointment on the booking page, and read more about the format on the online psychological consultation page.

A practical plan after a panic attack

In the first 10 minutes

Sit down, drink some water and let your body settle. Avoid trying to analyse everything straight away while adrenaline is still high.

Later that day

Briefly note what happened before the attack: sleep, coffee, stress, conflict, hunger, an enclosed space or thoughts. Look for patterns rather than blame.

Over the following week

Notice whether you have started avoiding places that matter to you. If avoidance is spreading, this is a reason to seek help sooner rather than waiting for panic to "go away on its own".

Where can you find help in Lithuania?

When panic attacks recur, getting help often involves two steps: first ruling out other causes of the physical symptoms, then learning to break the cycle of panic and avoidance. Free support can also be a starting point.

Your family doctor

If severe symptoms have occurred for the first time, or you are unsure whether they really are panic, speak to your family doctor. They can assess whether tests are needed to rule out other causes.

A mental health centre

Lithuania’s National Health Insurance Fund advises contacting your mental health centre as a first step when you experience psychological difficulties. It is often part of the same primary care facility where you are registered. For registered patients covered by compulsory health insurance in Lithuania, these services are free, no referral is needed, and urgent help is provided without joining the usual queue during the centre’s opening hours.

Emotional support by phone

If you need to talk now, the Vilties linija adult helpline is available around the clock in Lithuania on 116 123, as is Jaunimo linija on 0 800 28888. Other helplines and their opening hours are listed on the Pagalba sau website.

Emergency help

In Lithuania, call 112 if symptoms suggest a heart-related or other medical emergency, breathlessness does not ease, you lose consciousness or you have thoughts of suicide.

Support contacts checked on 28 September 2026.

Frequently asked questions about panic attacks

Is a panic attack dangerous?

A panic attack itself is usually not life-threatening, although it can feel very frightening. Its symptoms can resemble heart, breathing or other medical conditions, however, so seek medical help if you experience severe chest pain, fainting, breathlessness or unusual symptoms for the first time.

How long does a panic attack last?

A panic attack usually peaks within a few minutes and lasts around 5-20 minutes, although symptoms may last longer for some people, and exhaustion can linger afterwards.

What should I do during a panic attack?

If there is no medical emergency, it can help to name what is happening as a wave of panic, place your feet on the floor, slow your breathing, lengthen your out-breath, focus on your surroundings and remind yourself that the attack will pass. Try not to fight the sensations or rush to suppress them with alcohol or medication that has not been prescribed by a doctor.

How is a panic attack different from panic disorder?

One or several panic attacks do not necessarily mean you have panic disorder. Panic disorder involves repeated, unexpected attacks and at least a month of worry about another attack or changes in behaviour, such as avoiding places, activities or bodily sensations.

Do breathing exercises always help?

Breathing may help, but it should not become a battle with panic. The aim is not to force symptoms to stop, but to give your body a greater sense of safety by breathing more slowly and gently, with a longer out-breath. If a breathing exercise makes you feel worse, return to grounding yourself in your surroundings.

When is it worth seeing a psychologist about panic attacks?

Consider seeking help if attacks recur, you begin to fear panic itself, avoid places or activities, frequently check your body, struggle to sleep, work or travel, or find that anxiety is limiting your life.

Are online sessions with a psychologist suitable for panic attacks?

Yes, many people can work on panic in online sessions. Sessions can help you understand the panic cycle, practise grounding, work with catastrophic thoughts and gradually reduce avoidance. An acute medical emergency or suicide risk requires immediate help, rather than an email or a later appointment.

Sources and guidance

Panic attacks are not a sign of weakness.

They are an intense nervous-system response to a perceived threat. Although panic attacks can be very frightening, it is possible to understand them better and gradually learn to manage them. If they recur and begin to limit everyday life, it is worth seeking support before avoidance becomes your usual way of coping.

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