Top 10 Strategies to Manage Panic Attacks

Panic attacks are sudden surges of intense fear paired with powerful physical symptoms such as racing heart, shortness of breath, dizziness, and a sense of losing control. While panic feels dangerous, it is not — it is the body’s alarm system firing when no real threat exists. Cognitive Behavioral Therapy (CBT) is the gold-standard psychological treatment for panic disorder because it directly targets the fear-of-fear cycle that keeps panic alive. Lifestyle habits also play a powerful role because panic is deeply tied to how the nervous system is regulated. Below are 10 evidence-based strategies that combine CBT and biology-based lifestyle changes.

1. Reinterpret Panic Sensations

CBT starts by changing how you interpret physical symptoms. Panic worsens when normal stress sensations are misread as dangerous (“My heart is racing — I’m having a heart attack”). This activates the amygdala, which releases adrenaline, intensifying symptoms. Learning to label symptoms as “safe but uncomfortable” prevents the brain from escalating the alarm.

2. Use Interoceptive Exposure

CBT purposely recreates panic sensations (spinning to create dizziness, running to raise heart rate, breathing through a straw). This teaches the brain that these sensations are not dangerous. Repeated exposure causes habituation in the amygdala, reducing fear conditioning and stopping panic from being triggered by bodily sensations. 

3. Stop Avoidance and Safety Behaviors

Avoiding places, carrying “just in case” items, or constantly checking pulse teaches the brain that panic is dangerous. CBT reverses this by gradually re-entering feared situations without escape behaviors. Avoidance strengthens fear memory through negative reinforcement. Facing feared sensations weakens it through exposure - allowing the body a chance to regulate it self.

4. Slow Your Breathing

Panic causes rapid, shallow breathing that lowers carbon dioxide levels, leading to dizziness and tingling. Breathing exercises such as slow breathing (4–6 breaths per minute) restores blood gas balance. Higher CO₂ levels signal safety to the brainstem and reduce panic physiology.

5. Exercise Regularly

Cardio exercise (brisk walk, running, swimming, biking) exposes you to increased heart rate, breathing, and sweating — the same sensations that trigger panic — but in a safe context. Exercise retrains the brain to interpret these sensations as normal, while increasing GABA and serotonin, which reduce anxiety sensitivity. Engaging in cardio for 30 minutes 3-4 times per week is optimal for the production of hormones that the body needs to regulate.

6. Reduce Caffeine and Stimulants

Caffeine increases adrenaline, heart rate, and jitteriness — identical to panic symptoms. Caffeine stimulates the sympathetic nervous system and can directly provoke panic in vulnerable individuals. Caffeine can also prevent REM sleep, which is restorative and allows for the production of hormones that help with self-regulation.

7. Improve Sleep Consistency

Practising sleep hygiene such as sleeping and waking at similar times, avoiding naps, turning phone notifications off, not looking at your phone or the time if you wake, and no big meals prior to bed.  Poor sleep increases amygdala reactivity and lowers emotional regulation. Sleep deprivation increases cortisol and reduces prefrontal control over fear circuits, making panic more likely.

8. Practice Acceptance Instead of Control

Trying to stop panic paradoxically increases it. CBT teaches you to allow sensations to rise and fall without resistance. Resistance activates threat circuits. Acceptance engages the parasympathetic nervous system, allowing the panic wave to pass.

9. Eat Stable, Regular Meals

Low blood sugar can cause shakiness, dizziness, and palpitations that mimic panic. Glucose instability activates stress hormones, which can trigger panic-like sensations.

10. Work With a CBT Therapist

CBT is the most researched psychological treatment for panic disorder, with long-term success rates higher than medication alone. CBT changes neural pathways through exposure and cognitive restructuring, leading to lasting reductions in panic sensitivity.

Panic attacks are not a sign that something is wrong with you — they are a nervous system that has learned to overreact. With CBT and the right lifestyle habits, your brain can relearn safety, and panic can fade into the background.

To access cognitive behavioural therapy in Toronto, specializing in men’s mental health, please contact the Men’s Wellness Clinic to book a free 15-minute consultation through their website or by phone at 416-834-2080. For women, please visit Psychology Today, which provides a list of psychotherapists who practice cognitive behavioural therapy.