How to deal with panic attacks (when they keep coming back)

If you are in immediate danger, having thoughts of suicide, or feel unsafe, please call 999 or go to your nearest A&E. For urgent mental health support, call NHS 111 and select the mental health option. Samaritans (116 123, free, 24/7) and Shout (text 85258) are always available.

This is not about stopping one panic attack

If you need help right now, mid-attack, read our guide on how to stop a panic attack. That article covers what to do in the moment. This one is different.

This is for people who have had more than one. People who are starting to organise their lives around the possibility of the next one. People who avoid certain places, turn down invitations, or carry a low-grade dread that it could happen again at any time. That pattern is common, it is well understood, and there are things you can do about it.

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Why panic attacks come back

A single panic attack is your body's threat response misfiring. Unpleasant, but not necessarily a pattern. When panic attacks start repeating, something else is usually going on underneath.

The NHS describes a cycle that looks roughly like this: you have a panic attack, you feel frightened by it, you start watching your body for signs of the next one, and that hypervigilance itself creates the conditions for it to happen again. The fear of the attack becomes the trigger for the attack. Mind and Anxiety UK both describe this self-reinforcing cycle as the mechanism behind recurring panic.

For some people, the attacks cluster around specific situations: driving, supermarkets, public transport, social events. For others there is no obvious pattern at all, which can feel even more unsettling because there is nothing to avoid. Either way, the cycle works the same. It is not about the place. It is about the brain learning to treat its own alarm system as a threat.

What keeps the cycle going

Two things tend to make recurring panic worse over time. Both are completely understandable responses, and both are the wrong ones.

Avoidance

If a panic attack happened at Tesco, the logical instinct is to stop going to Tesco. If it happened on the train, you start driving instead. If it happened in a meeting, you find reasons not to attend. This makes perfect sense in the short term. The problem is that every time you avoid a situation, your brain files it as "that place was dangerous, good call avoiding it." The list of avoided places quietly grows. Your world shrinks. The NHS and NICE both identify avoidance as the primary behaviour that turns occasional panic attacks into panic disorder.

Safety behaviours

These are the things you do to feel safe without fully avoiding: sitting near the exit, always having water, checking your heart rate, needing someone with you, Googling symptoms afterwards. They feel helpful. They are helpful in the moment. But they work the same way as avoidance. Your brain learns "I was okay because I sat near the exit" rather than "I was okay because panic attacks are not dangerous." The relief stays attached to the behaviour instead of being learned as a general truth.

Mind describes safety behaviours as a subtle form of avoidance that maintains anxiety rather than reducing it.

What actually helps with recurring panic attacks

These approaches are drawn from NHS guidance, NICE clinical guidelines (CG113), and information published by Mind and Anxiety UK.

Understand what a panic attack actually is

This sounds too simple to be useful, but it is one of the most effective long-term tools. A panic attack is your nervous system's threat response firing without a real threat. The heart racing, the breathlessness, the dizziness, the sense of unreality: all are adrenaline doing what adrenaline does. The NHS confirms that panic attacks, while extremely unpleasant, are not physically harmful and are not a heart attack, no matter how much one can feel like one.

Understanding this does not stop the fear overnight. But over time, knowing what is happening in your body changes your relationship with it. "My body is doing the adrenaline thing again" is a very different thought from "something is seriously wrong with me." That shift matters.

Stop the avoidance (gradually)

This is the hardest part and also the most effective. NICE guideline CG113 recommends graded exposure as a core component of treatment for panic disorder. That means gradually, at your own pace, returning to the situations you have been avoiding.

If supermarkets are the problem, start by sitting in the car park for five minutes. Then walk in, buy one thing, and leave. Then stay longer. If meetings are the problem, attend one for ten minutes. You are not trying to eliminate the anxiety. You are teaching your brain that the anxiety can be there and nothing bad happens.

This is uncomfortable by design. The discomfort is how your brain updates its threat map. But it should be gradual. Throwing yourself into the deep end is not what the guidance recommends.

Drop the safety behaviours one at a time

Pick one. If you always sit near the door, try sitting one row further in. If you always carry water, leave it in the car once. If you always check your heart rate, delete the app for a day. Small experiments. The goal is to prove to your brain that you are safe without the prop, not to remove all comfort at once.

Build a regular breathing practice

Not just during panic attacks, but as a daily habit. The NHS recommends slow breathing techniques (in for 4, out for 6, out-breath longer than in-breath) as a way to lower baseline anxiety over time. Practising when you are calm makes it easier to use when you are not.

Track patterns without obsessing

Keep a brief note after each attack: where you were, what you were doing, how you had slept, what you had eaten or drunk. Over a few weeks, patterns often emerge. Common amplifiers include poor sleep, caffeine, alcohol, and periods of high stress. None of these cause panic attacks on their own, but they lower the threshold. Addressing them will not cure anything, but it reduces the frequency.

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When panic attacks become panic disorder

The NHS distinguishes between occasional panic attacks (which many people experience at some point) and panic disorder, where attacks are recurrent and the fear of having another attack starts affecting daily life. If you are regularly avoiding situations, if the dread of the next attack is always with you, or if your life is getting smaller because of panic, that is worth taking seriously.

Panic disorder is one of the most treatable anxiety conditions. NICE guideline CG113 recommends cognitive behavioural therapy (CBT) as the first-line treatment. In England, you can self-refer to NHS Talking Therapies without needing a GP referral. In Scotland, Wales, and Northern Ireland, your GP is the route in. Waiting times vary.

If the wait is too long, or the idea of committing to a full course of therapy feels like too much right now, there are lower-commitment options. Private therapists registered with the BACP or UKCP offer shorter-term work. On-demand platforms like WOD let you describe what is happening and get practical input from a qualified therapist without booking a course.

When to see your GP

Book an appointment if:

• Panic attacks are happening regularly and affecting your work, relationships, or daily routine
• You are avoiding more and more situations
• You are using alcohol or other substances to manage the fear
• You want to rule out physical causes for your symptoms (this is a reasonable thing to do and a good GP will not dismiss you for it)

Your GP can also refer you directly to specialist services if needed.

The honest bit

Dealing with recurring panic attacks is not a quick fix. It is not a matter of learning one breathing technique and being sorted. It involves doing things that feel counterintuitive, like walking towards the situations that frighten you, and it takes time. But panic disorder responds well to the approaches above, and most people who get support see a real change.

You do not have to be at crisis point to get help. Getting support earlier usually means needing less of it.

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Sources and further reading

• NHS: Panic disorder overview and self-help (nhs.uk)
• NICE Guideline CG113: Generalised anxiety disorder and panic disorder in adults (nice.org.uk)
• Mind: Panic attacks (mind.org.uk)
• Anxiety UK: Understanding panic (anxietyuk.org.uk)
• NHS Talking Therapies self-referral (England): nhs.uk/talk
• Samaritans: 116 123 (samaritans.org)
• Shout: text 85258 (giveusashout.org)

This article is for information only and does not replace advice from a qualified medical professional. If you are unsure whether what you are experiencing is a panic attack, please speak to your GP or contact NHS 111. If you are in crisis, please call 999 or go to A&E.