Small breaths out, slowly, through pursed lips, longer than the breaths in, and no breath-holds of any kind. Panic is partly a carbon-dioxide problem: you are breathing more than you need, CO2 drops, and the tingling and dizziness that follow feel like proof something is wrong. A long, unforced exhale lets CO2 come back toward normal and the alarm quiets.
The steps
- Sit or lean against something. You are not going to faint from this, but your legs may not believe that yet.
- Breathe in through the nose, small, for about three counts.
- Breathe out through pursed lips for about six, as if cooling soup. Do not force the lungs empty.
- Keep going. Count the exhales to ten and start again.
- Say one factual sentence to yourself: this is a panic attack, it peaks and passes, I have had this before.
- When it passes, do not sprint back into the day. Three more slow exhales, then move.
When not to, and when to get help instead
No box breathing, no 4-7-8, no breath-holds; a held breath raises CO2 fast and in a sensitive alarm system that reads as danger. Not while driving. If this is your first attack, if it comes with crushing chest pain, or if attacks are recurring, that is a doctor, then very likely a therapist; panic disorder is one of the most treatable conditions there is, and breathing is a tool inside that treatment, not a substitute for it.
What the research says
Trials of breathing training in panic disorder from Alicia Meuret’s group found that what tracked improvement was carbon dioxide returning to normal, not breathing rate as such. In the largest, 41 patients did four weeks of either breathing training with a CO2 monitor or cognitive training; both helped about equally, and only the breathing arm corrected the CO2. That is why the instruction is “breathe less, out slowly” and not “breathe deep.” The book’s CO2 Alarm chapter is the physiology in plain words.
Other methods people use
Grounding (name five things you can see, four you can touch) helps when you feel unreal or far away; it is a different job from breathing and I keep them separate. Cold water on the face triggers the dive reflex and slows the heart for some people. Cognitive behavioral therapy for panic has the strongest evidence of all, and the breathing above is a small piece of what it teaches.
Questions people also ask
Should I breathe into a paper bag during a panic attack?
No. It was once standard advice because it raises CO2, but it can be dangerous if the problem is not panic (asthma, a heart issue). Slow, small exhales do the same job safely.
Why does holding my breath make panic worse?
A held breath raises carbon dioxide, which is exactly the signal a sensitized alarm system treats as suffocation. Skip every hold in every technique.
In the book
Techniques
Rooms
Two rules, no exceptions
Never practice any technique on this site while you are driving, operating machinery, or doing anything that needs your full attention. The slow ones can make you drowsy, faster than you’d expect. And never practice a breath-hold, bellows breath, or any vigorous breathing in or near water. Read Before you begin for the doctor’s list and the rest.
More in “Right now”
- How do I calm down fast when anxiety spikes?
- How do I stop shaking when I'm nervous?
- How do I breathe when I'm angry and about to say something I'll regret?
- How do I breathe after bad news?
Written by Eric Bradley. Last reviewed October 2026. One performer’s craft, offered for general information; not medical advice, mental health treatment, or a substitute for care.