How to Stop a Panic Attack in 20 Seconds (Best CBT Technique)

Is it possible to stop a panic attack dead in its tracks, before you feel you can’t breathe, your chest hurts and you think you’re going to die?

I know from personal experience that when panic starts, it sure feels like there’s nothing you can do to stop the terrifying experience.

But that’s not necessarily true.

A panic attack can be stopped dead in its tracks, even while it’s happening.

how to stop a panic attack

It’s a little CBT (cognitive behavioral therapy) trick/exercise that has always worked for me and now I want to share it with you.

How to Stop a Panic Attack – The 20-Second Countdown

immediate relief for a panic attack

When you feel the sensation of a panic attack (a sudden “fit” of terror) building up, do the following:

1. “Talk” to your panic

Tell the panic that it has 20 seconds to manifest fully. 20 seconds and no more.

After the 20 seconds are complete it must stop making empty threats. You are allowing 20 seconds for it to fully manifest but not a second more. Whatever the bodily sensation that you fear is, it must happen within that 220-second time frame.

If your heart is going to explode, it has 20 seconds to do so.

If you are going to lose control, then your mind has 20 seconds to do so.

If you are going to faint – 20 seconds! But absolutely no more time than that.

By setting a specific time frame you establish boundaries of control.

You turn it into a game where you call fear’s bluff. If it were a poker game, you are asking anxiety to show its hand. This works because it establishes a sense of control within your mind and body.

You think to yourself – I am not ready to spend my time worrying about this. I’ve had enough.

I am going to be generous and give it 20 seconds but after 20 seconds and nothing has happened then the opportunity has officially passed and I am going to go back to what I was doing.”

2. Start Counting 

Do it nice and slowly, don’t rattle it off as fast as you can. Really tease it out like you did when you were a child and you never wanted to reach zero.

Teasing it out is key because it allows you to feel generous and that you are giving anxiety every chance possible. Deep down you know there is really nothing to fear.

To really help tease it out, break the last few numbers into fractions. 5………………………….. 4………………………….. 3…………………………… 2…and three quarters… 2…and half……………… 2………………………….. 1…and three quarters… (last chance anxiety) 1…and half……………… (I really can’t wait any longer) 1………………………….. 0. Sorry, too late we’ve reached the end.

By not rushing through the countdown you will feel your confidence rising because you are demonstrating real control and authority over your anxious thoughts and bodily sensations.

You are saying “look, I am really trying to give you all the time I can to unleash X,Y, and Z, I am being very generous here with this countdown.

Count your way to freedom. Count your way to confidence.

How to Stop Night-Time Panic Attacks

For me, the scariest panic attacks happened at night.

When it’s dark, and everyone is sleeping, you are at your weakest mental strength.

I have found a few very helpful ways to get over panic attacks before sleep (or during), and I recommend that you read my post about night anxiety and try them out for yourself.

Before You Go…

I used to suffer from panic attacks for years. That’s why my blog is filled with advice and different remedies for anxiety and panic attacks. Benefit from my trial and error and read my posts about anxiety and panic attacks. They obviously helped, since I am no longer suffering from anxiety disorder (although I am not free from stress, the plague of the western world)

To your health and happiness,


45 thoughts on “How to Stop a Panic Attack in 20 Seconds (Best CBT Technique)”

  1. Wow, your a stress reliever. I tried this technique it almost worked instantly and I will use it again for any other “break-downs.” 3..2..1, the anxiety is done. Poof gone. Also, do you have any techniques for coping with anxiety thoughts, or what triggers your anxiety and how to stay away from it? If you did please leak me that article it would really help.

  2. my wife goes through this sometimes but has trouble describing the symptoms but I believe its anxiety I will share with her this info and will try to get her to read up on this I think your advice is wonderful and if we do this together she will most likely get better thank you

  3. Hello to everybody who is experiencing this horrible disorder. Iv had panic attacks before but didn’t understand that they were attacks. Iv recently had another one in the night and it scared me as much as the previous ones. With me, I wake up in the night, but not only do I have to get up, but I have to get out of the house. I find myself walking the streets trying to calm down. After a while, I go back home, but as soon as i lay down again the attack starts again, so i get up and go out again. It gets better when the sun comes up and it gets lighter, and when there are more people around, but its still there. What gets my back up, is when mental health gets TV and Radio time, and all the Facebook people that just like to follow a trend, are all of a sudden experts. Until someone goes through this illness they can never understand what we go through. It’s nice to find a site like this and know we are not alone. Thanks for reading my waffling, and hang in there guys and girls. I’m sure we can beat this.

  4. I’ve had many traumatic experiences throughout my life and I am afraid it may finally be catching up to me. I used to suffer from anxiety but I seemed to get a handle on it. Now that I’m in my late 40’s, with changes in the body, I feel it may be starting up again. I’m not sure if anyone else feels this way but I feel a surge of adrenaline throughout my body but what bothers me the most is the feeling in my head. The only way I can explain it is a rush of energy through my brain, then the panic starts. I get nervous thinking it may be the start of a nervous breakdown?? Fighting it with breathing exercises. Does anyone else feel this way?
    Thank you

  5. I have been suffering from severe anxieties. ….my first one was when I was six sixteen when I didn’t wanna tell my mom I smoked weed everything would spin I felt like I was in a constant roller coaster ….After long doctors visit one told me is there something bothering u …I said yes I told my mom boom gone….Now I went to the er for hyperventilating myself…I lost my job luckily my new boss is more patient but I to work in sales …and I drive an hour away I have stopped several times I walk but get so close To running inside and saying I’m dying in public areas luckily I havent….idk wat to do anymore I’ve gotten blood work nothing came out…I wanted to visit a specialist but that’s 250 per visit so I don’t wanna add to my anxieties with debt….I need help my social life has gone down the drain ’cause I’m scared ….Just today I went out started feeling bad left as soon as I get to my car I feel ok…The only thing I haven’t done is exercise and diet…I do eat out every day 🙁

  6. Sue-Bee,

    Please don’t give up. The counselor IS going to help you and you can try many of the natural methods to stop your panic disorder.
    Everyone has one thing that works for him/her. You just have to find YOUR one thing.
    You’re not alone. Hang in there.

  7. I have had anxiety and depression for so many years I can’t remember not having it. Tried lots of drugs but never stick with them I hate “needing” drugs. Although by the end of the day I’m so exhausted from fighting through the day I have several beers just to take a break from it. The last year I wake up in a full-blown panic attack’s The last month it’s every night even if I fall to sleep on the couch. I’m going to a counselor tomorrow to see if there is anything I can do about this. I don’t think I’m to the point of being suicidal but if a painless accident happened I’m not sure I’d care except for leaving my wife and Mother. I’m just exhausted

  8. Hello, I’m a 19-year college student who has struggled with panic attacks ever since graduating from high school. I got accepted to one of my dream schools Syracuse University and right before I was supposed to pack up and leave starting my new chapter in life, I backed out. I worked very hard for this opportunity throughout high school and I hated myself for letting it go. I have a second opportunity to attend this fall but I’m praying the same thing won’t happen. I really want to take this chance and chase after my dreams, but once again my anxiety attacks are standing in the way of this dream. Any advice?

  9. Thank you so much for this information. I have medication for my attacks and it works, but sometimes I think it’s also a crutch too. If I forget to bring it, like today, I swear it almost makes me have one.

    I have just started looking into the diet aspects of it. But this technique seems like it would really help. Does anyone else’s panic seem to morph over time to cause and be caused by different things?

  10. I had panic attacks for a whole year about 3 years ago. I feel it started from a stomach bacteria (H.Pylori). The major attacks went away after treating the bacteria. Now the panic attacks have returned, it started the day I ate shrimp, my body became very cold and my heart pounding. I had mussels about 2 weeks after that and I went into a full-blown attack, ended up in the hospital. My doctor thinks I’m allergic to shellfish which might have caused the attack. I’ve since become vegan and started taking vitamins. I’m desperate, I’m still getting them, I feel like my life was thrown out the window and that I’m just a walking zombie. Pls, help.

  11. I will try this the next time I have one of those dreadful things… I hate the feeling and I’m crying as I type this because that feeling of dying is so very real and I can’t see anything but blackness and stars when I have a panic attack …do you know if there are any support groups for this?

  12. I just laughed so hard now that it made my attack go away. No offense to anyone of course.
    I’ve been having daily anxiety attacks every single day for a month now. What triggered mine after almost 2 years without one, was the death of two friends in freak accidents. one died in January and the other one died recently. I started thinking about death, of how one can die any minute due to disease, accident, etc., and ended up in the ER. Even though I know I am not going to die, the terror I feel i wouldn’t wish it to my worst enemy. I have been prescribed meds, but I refuse to take them. Instead, I tried to meditate, pray, spend time with family, do things that make me feel good, like my old young self when I didn’t have any worries in life. I exercise, eat well, and I’m also trying to give up alcohol because it raises my blood pressure which results in an anxiety attack. I also try to be around people because I get it when I am alone. I am no psychologist, but i do have a BA in psychology. in those 4 years of college, i took many classes, so I am familiar with all these types of mental disorders. the mind is very powerful and during an attack, it can make us believe that we are going to die. I know this, still, i get so scared for my life every time. But i know i am getting better, and now I just realized that there are so many people that are going through the same problems as i am. The reason why I laughed was because i get exactly all those symptoms described by the readers, if I don’t get them all, i get most. And it seems silly because here i am now, drinking tea and typing this note with a smile in my face… alive. Because i see that there is hope. my heart beat went back to normal and the sun is shining even brighter outside. I’m thinking of all the times I’ve scared people, family, friends and strangers, thinking how silly i look every time i have an attack made me laugh more than anything, the pacing the sweating, the crying etc…
    Maybe an alternative to private therapy, a supporting group or group therapy would be something that can help many. Like AA , talking about the problems with people in a similar situation may work and it can help us feel better, to know that we are ok that there is hope. And Laugh! it just worked for me. ( hopefully, it will work every time) find things that make you happy and laugh.

    I still think everyone should get a physical exam, visit a cardiologist, get blood tests, etc. once you know you are healthy and that nothing is wrong with you, it will be easier to deal with the anxiety.

    I love my life, my job, my family and friends and i don’t want this to ruin it.

    I wish everyone a healthy recovery.

    with love,

  13. Hi I’m lady-al, I had panic attacks in the past. 4yrs ago I was afraid to come out my house, or drive to the corner store, or socialize, driving on the highway forget it, it wasn’t happening and stop drinking alcohol. I had my son to drive me everywhere I needed to go for a year. I was always in the E.R, I felt so bad, all-time at nite. I know he was frustrated with me, I wore him out, til his hair started comin out in patches yes ball spots. When we part ways, I was scared and I went to go live with my daughter. She said to me, mom you have to beat this or you will be like this and on meds for the rest of your life. And I was always the strong one, honey I started thinking about what my daughter said to me. I started praying to God and going to church and praying, and praying and praying. I started getting back out there, with baby steps, and Jesus by my side every step of the way, with No Meds, Jesus is my Meds, Know im out and go where ever I want to go, alone! With no by my side, but Jesus. Thank you, Jesus. You can do it through Christ Jesus. You got to try hard, with prayer, it works, trust. Good luck to all of you. Lady-al

  14. Lynn,

    Just listen to your instincts because they are right! This is a reaction to medication and nothing more. Just don’t take medication as much as you possibly can and you will prevent this from happening again.

    Don’t be scared! You’ll be fine!

  15. Yesterday I took medicine for a spine problem I have been treating. And I started feeling the chest, anxiety, though I was going to die. I went to the ER.
    These symptoms always happen every time I take medicines. It started when I was pregnant just w a simple medicine as Zofran, Phenergan, unison.
    During my labor, they gave me other nausea medicine that had other components and I had the reactions. I did not see my baby being born I was hallucinating as the docs said.
    I thought it was normal, maybe I had allergies to those medicines. Then now it happens again and after we were at the ER last night the dr came with the discharge papers saying: anxiety and panic attack.
    I am scared very much.
    It means that I am having panic attacks since pregnancy and even during labor. But it just happens if I take any medicine.
    I do not know what to do.

  16. Hello. I have been suffering from anxiety ever since I was a young girl. In fact, I am having one now, which is why I have been looking up methods to relieve this. It is the worst feeling not being able to sleep, eat, or concentrate in school. I constantly have this fear gnawing at my insides, and I am considering if I should ask my mom to take me to a doctor. I have a question about your method. While I was counting down it was scary to let it overwhelm me. When I reached one it still wouldn’t go away, and I have been having this attack since yesterday afternoon. How do you be more assertive when doing this?

  17. My first major panic attack was about a month ago, i have had several since then and even rang the ambulance as the fear of passing out and dying terrified me soo much, my doc has put me on valium but its only a short term fix and I’m back to being a nervous wreck when it wears off and I’m on my last pill and am dreading what to do next with no pills left any suggestions? i feel like I can’t cope with my kids as im continuously agitated and frustrated about feeling this way 🙁

  18. hi,
    I have been dealing with anxiety/panic disorder for about 4 years. I tried therapy, a lot of medications (which I do not like) and I can pretty much control my panic attacks now, but ever since I had my daughter in December my anxiety has been a full force. I find it hard to breathe all the time, worry about everything (mostly my health or something bad happening to me or my children). I have also been having major stomach issues and GERD since all of this..The 10 step process you have written about, can all those be taken when nursing? And do you have any advice on how I can control just the all-day anxiety? And did anyone ever tell you why you just developed your anxiety or panic out of nowhere?

  19. Thank you, meital James
    It means a lot that someone put there is capable of helping us with our problems, ladies we are strong and we all seem to be on the same page here! I get weak get hot out of nowhere and sometimes start to sweat I get light-headed like I’m going to faint and sometimes I feel like I cannot breathe and I feel like I’m going to die. It’s a horrible thing to go through I experience them daily. It’s hard to get through them, but lately, I have been experiencing a different type of anxiety, where I feel there Is something in my throat I get a weird sensation and it makes me really sad, I’m giving up smoking cold turkey maybe that might help me. I’m scared that my life is going downhill but I know I can get through this I have faith, any other advice?

  20. I have a severe case of anxiety but my mom would not let me use medication. I am so happy to have found this because you must have gone thru or experienced something similar to this in order to compile these thoughtful and helpful tips.

    Thank you so much!!!

  21. Hi Meital James

    I had hyperventilation last march 20, after that I was experiencing it plus an anxiety attack ( fear for so many ways ) but I had survived that hyperventilation by drinking too much water. okay.

    after I have cured that anxiety, I feel something weird in my heart ( sometimes it’s heavy, abnormal heartbeat-like it’s normal sometimes. sometimes it’s fast, and sometimes I feel pain in it 🙁 ) like I have a feeling of having a heart attack. or scared of death. then I have panic disorder after that feeling like I’m not comfortable in myself I feel crazy, numb, sweating, tingling, cold hands and feet, chest pain and neck, shortness of breath. and about the fears, I fear so many people around me ( public places ) like I don’t want to go outside anymore. it’s completely destroying my life. >_<
    I am taking exercises like walking after waking up in the morning and drinking too much water, and relaxing in our backyard of the house feeling and smelling the fresh air and eat moderately. .<) My therapist told me to push my nerves in the palm ( left hand in the middle of the finger at the palm ) to help me relax of feeling pain in my heart it works but sometimes it keeps coming back. do you think a have a heart problem? or this panic disorder and anxiety are just making this bad feeling and worst.

    please make a reply 🙁

    I really need to cure myself :'(

  22. I would just like to say thank you for this. My anxiety likes to hit when I am trying to go to sleep or when I am just waking up. In the mornings I am ok because I meditate pray and read my Bible. But it is the nighttime where I struggle. I HATE the way medication makes me feel. I would rather deal with the panic attack before taking meds. I just took some meds tonight and now you see me still awake feeling more crazy because of the side effects.
    But I needed this technique to use as well as the chamomile tea suggestion just to help me to relax about to go make a cup now. Thank you so much again. Because I hate medications.

  23. I was skeptical. It really helped!! I was able to realize my feelings were swirling above me like a tornado, and not actually in me. Then I was able to detach from them somewhat (enough that my stomach stopped convulsing so hard).
    Thank you!

  24. Hi, my name is Tanisha. I think I’ve had anxiety for about 4 years now. Had my first one when I was 16. I’m 20 years old now. I used to be able to control it by walking around, listening to music, talking on the phone, etc. Now it’s to the point where I cant get out of bed sometimes without worrying about my health (dying). I’m an emotional rollercoaster so all I can do whenever I get panic attacks is just cry, and hope that I’m going to be okay. I just had a bad one a couple of minutes ago. My heart was pounding like crazy, my legs wobbly, my head was hurting, felt like straight death coming my way, and I was scared! I’m so tired of this. And I need relief, because this is not like me to just lay in bed, and worry. The last thing I want is to be dosed up on meds like I’m Some crazy person.

  25. Katie,

    Wow, 7 years is a long time.

    You’re not going to die from this.

    I wish you told me about the methods you’ve tried to deal with this so far – Any dietery changes? lifestyle changes? Did you check your Magnesium leveles? Did you try CBT?

    Here’s my article about the best natural methods to overcome panic attacks, I think it can really help you:

    As for the deprssion, it’s a side effect of the panic disorder. Once you’re able to reduce the panic attacks, your mood will be lifted and the depression will vanish.

    Hang in there, you sound like a very strong woman.

  26. I Have been dealing with panic attacks for about 7 yrs and they are very harsh I have negative thoughts daily from the attacks I’m starting to think it’s turning into mild depression I think I’m going to die over everything it hurts because I’m an outgoing person who enjoys life! I need help im scared.

  27. Hi,

    I have had a severe panic disorder since 2009 when I ended up in the emergency room. I was on SSRIs and it seemed to not only make me feel like I was on an emotional rollercoaster but it made me gain 30 pounds. I stopped taking them and it seemed to get better. Now in the last year, I have landed in the ER twice and have panic attacks every day. I went to a cardiologist because the heart palpitations and dizziness were so severe. I feel hopeless since I work in sales and spend most of my days with clients. What other natural and behavioral techniques are there?

  28. Angeline,

    I know it’s the worst feeling and it’s very scary. But, if you want to prevent your next panic attack you must do what ever you can to stop thinking about it, and especially fearing the bext panic attack.

    I suggest you immediately start with some breathing exercises to help you relax, calm down and get some sleep.

    Here are some of the best breathing exercises, do them at least 3 times a day. They are very effective:

  29. Just had my first panic/anxiety attack.. it’s the worst feeling! Thought I was gonna die n more can’t sleep help

  30. After going 3 years with no panic what so ever it had returned after one day of drinking too much coffee. I now can not get control of this to save my life it is actually ruining it all over again. I am at a point where I feel like nothing is working and there is no way to stop this beast called panic disorder. I have tried what seems like everything and luck. The part I don’t get is I know I am not going to die from these attacks but they still happen. I hate drugs and refuse to go down that road I have done it before and it’s horrible. Things got out of control and drugs are not the way to go they change you as a person. I wish there was something else I could try that actually had success. This post is true and does work only for the initial attacks but that’s all. I need some advice on how to beat this disorder. My family needs their dad and husband back.

  31. I’ll definitely be trying this next time I have one! It’s the worst feeling in the world, having an anxiety attack! It’s been troubling me for a while now. I’m staying positive to beat it and enjoy life! Especially with how young I am! I’m 22 and I’ve been living every day worrying about when my next attack is going to happen and if it is going to be somewhere in public! I’m tired of feeling this way! I’ve had enough of it and ain’t going to let it bother me! Thanks for sharing this!!!

  32. I’ve been having panic attacks for about 4 weeks (if that long). I’ve been doing the deep breathing exercises and it helps temporarily. But in ready to put this to an end. It comes and goes and when I do have them the symptoms are not as bad as they were in the beginning. Is that a sign that it’s fading away because I got to the root of my problem and why I’m experiencing this ???? I need help

  33. I’ve been suffering from major anxiety attacks and panic disorder for well over a year I’m on meds but they only seem to mask my symptoms. How do I figure out what is causing these attacks? I’m so over it. It is driving me mad and ruining my family life.


  34. I had two attacks today one of the scariest things I’ve ever experienced. your articles and ideas made me feel better. I hope that I do not have to feel that way again but I’m definitely trying this & the breathing exercises.

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