Panic and Frightening Thoughts Right Now: Get Help

Right now: ride the wave

A panic attack can make you feel like something is terribly wrong, but it is your body's alarm misfiring — and it will pass. Try this:

• Breathe slowly. In through your nose for 4, hold for 4, out through your mouth for 6. Longer exhales calm the alarm. Repeat.
• Ground yourself. Name 5 things you see, 4 you can touch, 3 you hear, 2 you smell, 1 you taste.
• Cool down. Splash cold water on your face or hold something cold — it can interrupt the surge.
• Tell yourself the truth. "This is panic. It feels awful, but it is not dangerous, and it will pass."

Panic attacks usually peak within minutes. You are getting through it.

Reach out — you don't have to do this alone

If frightening thoughts about dying come with the panic, please talk to someone now:

• Call or text 988, the Suicide & Crisis Lifeline. It is free, confidential, and available 24/7, and a trained counselor will stay with you and help you steady 1Ref 1Substance Abuse and Mental Health Services Administration (SAMHSA) (2024).988 Suicide & Crisis Lifeline.988 provides free, confidential, 24/7 crisis support through a national network of local crisis centers..
• Text HOME to 741741 (Crisis Text Line) if texting feels easier.
• If you are thinking about hurting yourself, or are in immediate danger, call 911.

Reaching out is not weakness — it is exactly the right move. Talking openly about these thoughts does not make them worse; being heard helps relieve the pressure 2Ref 2National Institute of Mental Health (NIMH) (2024).5 Action Steps to Help Someone Having Thoughts of Suicide (Ask, Be There, Keep Them Safe, Help Them Connect, Follow Up).Talking openly about thoughts of suicide does not make them worse; being heard helps..

Why does panic bring scary thoughts?

During a panic attack, a racing heart, tight chest, and dizziness can trick your mind into thinking you are dying. That terror can spin into frightening thoughts. It does not mean something is medically wrong in this moment, and it does not mean you have to act on any thought. These thoughts are a symptom of the panic, and they fade as the panic settles.

If the physical symptoms are new, severe, or you are unsure, it is reasonable to get checked — but the immediate step is to slow your breathing and reach out for support.

How can a clinician help with panic?

Once you are steadier, a clinician can help these episodes happen less and feel less frightening. A clinician can:

• Check for medical causes of panic-like symptoms (like thyroid or heart issues) so you know your body is okay, and screen for what's underlying using validated tools designed for young people, such as the ASQ for safety 3Ref 3Horowitz LM, Bridge JA, Teach SJ, Ballard E, Klima J, Rosenstein DL, Wharff EA, Ginnis K, Cannon E, Joshi P, Pao M (2012).Ask Suicide-Screening Questions (ASQ): A Brief Instrument for the Pediatric Emergency Department.The 4-item ASQ has high sensitivity for identifying suicide risk in youth aged 10-21..
• Teach evidence-based skills — cognitive behavioral therapy (CBT) is highly effective for panic, helping you respond to the alarm without fear.
• Build a safety plan with you — a brief, evidence-informed best practice listing your warning signs, coping steps, and people to reach when a hard moment hits 4Ref 4Stanley B, Brown GK (2012).Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk.The Safety Planning Intervention is a brief, evidence-informed best practice for mitigating acute crises..
• Coordinate ongoing care and, when appropriate, discuss treatment options and connect with your school or family so support continues 5Ref 5Shain B; AAP Committee on Adolescence (2016).Suicide and Suicide Attempts in Adolescents.Clinicians should identify and manage at-risk youth and coordinate ongoing care..