What is the best breathing exercise for a panic attack?

One with no breath hold and a long exhale. Start with a physiological sigh, two inhales through the nose and one long exhale through the mouth, then breathe out slowly for six and let the inhale take care of itself, in for four. Count the exhales, not the seconds. Six of them is a minute, and most attacks begin to turn inside two or three.

Why do I feel like I cannot breathe during a panic attack?

Because you are breathing too much, not too little. Panic speeds the breath up and moves it into the chest; that blows off carbon dioxide, which narrows blood vessels and produces the tingling, the lightheadedness, the tight chest and the feeling of air hunger. The instinct is to gulp more air, which makes every symptom worse. Slowing the exhale lets carbon dioxide come back up and the symptoms fade with it, usually within a couple of minutes.

Should I hold my breath during a panic attack?

No. Box breathing and 4-7-8 are good exercises at other times, but a hold when you already feel short of air adds to the fear and often breaks the rhythm. Use patterns with no hold: the sigh and the 4-6 breath. Holds can come back once you are calm, and for daily practice.

Does breathing into a paper bag help a panic attack?

It was meant to raise carbon dioxide, which is the right idea, but it is not recommended any more: it is hard to do safely, it can drop oxygen too far in anyone with a heart or lung condition, and it looks alarming. Slow exhales do the same thing without the bag. Breathing out through pursed lips, as if through a straw, is the modern version.

How long does a panic attack last if I breathe through it?

Most peak within ten minutes and fade over twenty to thirty, whatever you do; slow breathing tends to shorten the peak and take the edge off the worst of it within two or three minutes. If the breathlessness or chest pain arrives without any anxiety, does not ease with slow breathing, or comes with pain spreading to the arm or jaw, treat it as a medical emergency, not a panic attack.

Can breathing exercises prevent panic attacks?

They lower the baseline they start from. Five minutes a day of slow breathing reduces resting arousal and the tendency to over-breathe, and people who practise daily report fewer and milder attacks. Breathing retraining is one component of the cognitive behavioural therapy used for panic disorder; the other components, understanding the symptoms and stopping avoidance, are the reason to see a therapist if attacks are frequent.

Is there an app to help with panic attacks?

Braele, for iPhone, starts the physiological sigh from a widget or the app icon in one tap, then paces the 4-6 breath with a voice that calls the counts and haptics you can follow with your eyes closed, which is what you need when reading a screen is too much. Box breathing and the sigh are free forever; no account, no ads, works offline.

Breathing exercises for panic attacks

No holds. Breathe out. Count the exhales.

If it is happening now: you are not short of air, you have too much of it. Breathe out slowly through pursed lips and let the in-breath happen on its own. Start the first timer below; it counts for you so you do not have to. If you are reading this calmly, the rest of the page explains why that works and how to make the next one shorter.

Tap one and breathe along right here. Free, no download needed.

Right now

The first three minutes

1
Breathe out first
Through pursed lips, as if through a straw, slowly, all the way. Do not try to take a big breath in; the in-breath will come by itself, smaller than you expect, and that is correct. The feeling of air hunger is carbon dioxide being too low, and the out-breath is what fixes it.
2
One physiological sigh
In through the nose, a second short sip on top, then one long exhale through the mouth. It re-opens the small air sacs that shallow breathing collapses, which is what makes the chest feel tight, and it gives the body its own signal that the emergency is over.
3
Count exhales, not seconds
In for roughly four, out for roughly six, and count each out-breath: one, two, three. Seconds need a clock and attention you do not have; exhales you can feel. Six is a minute. Keep going until you lose count, which is the sign it is working.
4
Name what is happening
Tingling fingers, a pounding heart, a sense of unreality: these are what over-breathing does, they are not dangerous, and they are already fading as the exhale lengthens. Saying that in your head, while the breath does its work, is the part that makes the next attack shorter.

Why it feels like you cannot breathe

Panic speeds the breath up and moves it into the upper chest. Fast breathing blows off carbon dioxide, and low carbon dioxide narrows the blood vessels to the brain and the hands: that is the lightheadedness, the tingling, the tight chest and the sense that the air is not going in. The body reads those sensations as proof of danger and breathes faster still. It is a loop, and the exhale is the only place it can be cut, because a slow out-breath lets carbon dioxide rise and switches the alarm off from the inside. The vagus nerve page explains the second half of the mechanism.

What not to do

Do not hold your breath: box breathing and 4-7-8 are good exercises at other times, but a hold when you already feel short of air adds to the fear. Do not take big deep breaths; deep here means slow and low, not large. Do not breathe into a paper bag; the idea was right, the method is out of date and unsafe for some people. And do not fight to stop the attack: the aim is to let it pass with a slower breath, and it will, usually within ten minutes at the peak and half an hour in all.

Making the next one shorter

Five minutes a day of coherent breathing lowers the resting breathing rate and the tendency to over-breathe, which is the ground panic grows from, and people who practise report fewer and milder attacks. Breathing retraining is one part of the cognitive behavioural therapy used for panic disorder; understanding the symptoms and going back to the places you have started avoiding are the other parts, and a therapist is the right help for attacks that are frequent. The Braele app starts the sigh from a widget in one tap for the moment, and keeps the daily five minutes for the long run.

Questions

What people ask

What is the best breathing exercise for a panic attack?: One with no breath hold and a long exhale. Start with a physiological sigh, two inhales through the nose and one long exhale through the mouth, then breathe out slowly for six and let the inhale take care of itself, in for four. Count the exhales, not the seconds. Six of them is a minute, and most attacks begin to turn inside two or three.
Why do I feel like I cannot breathe during a panic attack?: Because you are breathing too much, not too little. Panic speeds the breath up and moves it into the chest; that blows off carbon dioxide, which narrows blood vessels and produces the tingling, the lightheadedness, the tight chest and the feeling of air hunger. The instinct is to gulp more air, which makes every symptom worse. Slowing the exhale lets carbon dioxide come back up and the symptoms fade with it, usually within a couple of minutes.
Should I hold my breath during a panic attack?: No. Box breathing and 4-7-8 are good exercises at other times, but a hold when you already feel short of air adds to the fear and often breaks the rhythm. Use patterns with no hold: the sigh and the 4-6 breath. Holds can come back once you are calm, and for daily practice.
Does breathing into a paper bag help a panic attack?: It was meant to raise carbon dioxide, which is the right idea, but it is not recommended any more: it is hard to do safely, it can drop oxygen too far in anyone with a heart or lung condition, and it looks alarming. Slow exhales do the same thing without the bag. Breathing out through pursed lips, as if through a straw, is the modern version.
How long does a panic attack last if I breathe through it?: Most peak within ten minutes and fade over twenty to thirty, whatever you do; slow breathing tends to shorten the peak and take the edge off the worst of it within two or three minutes. If the breathlessness or chest pain arrives without any anxiety, does not ease with slow breathing, or comes with pain spreading to the arm or jaw, treat it as a medical emergency, not a panic attack.
Can breathing exercises prevent panic attacks?: They lower the baseline they start from. Five minutes a day of slow breathing reduces resting arousal and the tendency to over-breathe, and people who practise daily report fewer and milder attacks. Breathing retraining is one component of the cognitive behavioural therapy used for panic disorder; the other components, understanding the symptoms and stopping avoidance, are the reason to see a therapist if attacks are frequent.
Is there an app to help with panic attacks?: Braele, for iPhone, starts the physiological sigh from a widget or the app icon in one tap, then paces the 4-6 breath with a voice that calls the counts and haptics you can follow with your eyes closed, which is what you need when reading a screen is too much. Box breathing and the sigh are free forever; no account, no ads, works offline.

One tap when it starts

Braele starts the sigh from a widget or a long-press on the icon, calls the counts out loud, and taps each phase on your wrist and palm so you can close your eyes. Box breathing and the sigh are free forever on the App Store.

Downloadon the App Store