Overview

  • Difficulty: Beginner-friendly
  • Best Use: Managing panic episodes, reducing anticipatory anxiety, supporting crisis intervention
  • Time: 15-20 minutes
  • Tools: Phone notes app, printed card, or digital document

Create a panic attack safety plan by writing down specific coping strategies and actions you can use during panic episodes. This planning ahead of time reduces helplessness, grounds your emotions quickly, and reduces anxiety immediately.

Panic attacks strike without warning and trap you in overwhelming fear. Your heart races, your breathing turns shallow, and dread takes over completely. Your thinking brain shuts down during these moments, so you cannot remember helpful strategies. A good safety plan becomes your lifeline during panic episodes and gives you clear steps when fear clouds your thinking.

What to do

  1. Identify your panic warning signs: List physical symptoms like rapid heartbeat, sweating, chest tightness, dizziness, or nausea. Include emotional signs such as sudden dread, feeling detached, or fear of losing control. Write down thought patterns like "I'm having a heart attack" or "I'm going crazy."
  2. Choose immediate grounding techniques: Select 3-4 strategies that work best for you:
  3. Write calming affirmations: Create 5-6 reassuring statements like "This feeling will pass," "I am safe right now," or "I have survived this before." Use present-tense, positive language that feels authentic to you.
  4. Create your step-by-step action sequence:
    • Step 1: Notice early warning signs
    • Step 2: Find a safe, quiet space if possible
    • Step 3: Begin chosen breathing technique
    • Step 4: Use grounding exercises
    • Step 5: Repeat calming affirmations
    • Step 6: Contact support person if needed
  5. List your support contacts: Include trusted friends, family members, therapists, or crisis hotlines. Write names and phone numbers clearly. Consider adding the National Suicide Prevention Lifeline (988) and Crisis Text Line (text HOME to 741741) if you feel they are applicable.
  6. Document medication instructions: If prescribed anti-anxiety medication, note exact dosage, timing, and when to use. Include any specific instructions from your healthcare provider about emergency medication use.
  7. Make your plan accessible: Save it in your phone's notes app, print a wallet-sized card, or use a dedicated mental health app. Ensure you can access it quickly when panic strikes.
  8. Schedule regular reviews: Update your plan monthly or after significant life changes. Remove strategies that don't work and add new techniques you've learned.

When to use

  • For people with recurrent panic attacks - People who experience multiple panic episodes benefit from safety plans because they provide immediate structure when cognitive function becomes impaired. Research shows that prepared coping strategies significantly reduce panic duration and intensity compared to spontaneous responses.
  • During panic disorder treatment - Mental health professionals routinely recommend safety plans as a core intervention for panic disorder. Clinical studies demonstrate that clients with written safety plans show better treatment adherence and faster symptom improvement.
  • When panic attacks feel unpredictable or uncontrollable - People who experience panic as chaotic or overwhelming benefit from safety plans because they provide predictable responses during crisis moments when rational thinking becomes difficult.
  • For people avoiding situations due to panic fear - Those who limit activities or places due to panic concerns can use safety plans to build confidence for gradual re-engagement with avoided situations by knowing they have effective coping tools available.
  • When developing personalized panic management strategies - Safety plans help identify individual-specific triggers, symptoms, and effective interventions, which leads to more targeted and successful panic management approaches.
  • For people preparing for exposure-based treatments - Having a solid safety plan provides essential foundation for exposure therapy by ensuring clients have reliable coping strategies before systematically confronting feared situations or sensations.
  • When panic interferes with daily functioning - People whose panic attacks impact work performance, relationships, or personal goals can use safety plans to reduce panic's interference with meaningful activities and responsibilities.
  • For family members supporting loved ones with panic - Understanding safety plans helps family members provide appropriate support during panic episodes while avoiding well-meaning responses that might accidentally increase anxiety or dependence.

Why it works

Panic attacks trigger your body's fight-or-flight response and flood your system with stress hormones. Your prefrontal cortex shuts down during these episodes while your amygdala takes control.

A predetermined plan works because you skip complex decisions during crisis moments. Research shows that structured coping plans reduce panic intensity and duration by giving you immediate actions when your thinking breaks down.

Grounding techniques in your safety plan turn on your parasympathetic nervous system and fight panic symptoms. Deep breathing exercises control heart rate variability and drop your physical stress within minutes.

Written affirmations challenge the scary thoughts that feed panic attacks. Cognitive research proves that ready-made positive statements stop negative thought cycles and reduce emotional intensity.

Support contacts reduce the isolation that comes with panic episodes. Social support research shows that knowing help exists reduces both panic severity and worry about future episodes.

Easy access matters because panic attacks hurt working memory and slow your thinking. Physical or digital reminders remove the mental work of remembering complex strategies during high-stress moments.

Benefits

  • Reduces panic attack intensity and duration - Clinical studies show that people with structured safety plans have 40-60% shorter panic episodes than those who rely on random coping.
  • Builds control and confidence - Having concrete action plans boosts your confidence in managing panic symptoms and stops feelings of helplessness.
  • Reduces worry about future attacks - Knowing you have proven strategies reduces anxiety about future panic attacks, which often creates extra anxiety that keeps panic disorder going.
  • Improves therapy success - Therapy research shows that clients with safety plans follow treatment better and improve faster.
  • Strengthens emotion control skills - Using structured coping strategies regularly builds your ability to handle intense emotions in many situations beyond panic attacks.
  • Reduces emergency room visits - Studies show that people with good panic management plans go to emergency rooms much less during panic episodes.
  • Supports long-term recovery - Having reliable coping strategies builds confidence and strength, leading to lasting improvement in anxiety management and quality of life.

Tips

  • Practice during calm periods - Skill rehearsal research shows that techniques practiced when relaxed are more accessible during crisis moments.
  • Keep multiple copies - Store your plan in your phone, wallet, car, and home office. Redundancy ensures accessibility regardless of circumstances.
  • Use simple language - Write instructions as if explaining to a frightened child. Complex language becomes harder to process during panic episodes.
  • Include timing estimates - Note how long each technique typically takes, such as "breathe deeply for 2-3 minutes" to set realistic expectations.
  • Personalize completely - Generic plans are less effective than those tailored to your specific symptoms, triggers, and preferences.
  • Share with trusted contacts - Let close friends or family members know about your plan so they can support you effectively during episodes.
  • Consider environmental factors - Plan strategies for different locations like work, home, car, or public spaces where panic might occur.
  • Track what works - Keep notes about which strategies are most effective in different situations to refine your plan over time.

What to expect

  • Immediate (first few days): Simply having a completed safety plan often provides immediate relief and confidence boost. Many people report feeling more prepared and less anxious about potential future panic episodes just from knowing they have a concrete action plan ready to use.
  • First 1-2 weeks: Creating your first plan may feel overwhelming as you identify your patterns and choose strategies. You might forget to use your plan during real panic episodes, which happens to everyone during this learning phase.
  • Weeks 3-4: You'll start remembering to grab your safety plan during mild to moderate panic episodes. Success rates go up as you build muscle memory for reaching for your planned strategies instead of panic-driven responses.
  • 1-2 months: Research shows that steady safety plan use typically creates measurable improvements in panic management by this time. You'll notice shorter episodes and more confidence in your ability to cope.
  • 3-6 months: Most people report big drops in both panic frequency and intensity. Worry about future episodes often decreases a lot as trust in your coping abilities grows stronger.
  • Long-term (6+ months): Clinical studies prove that ongoing safety plan use creates lasting improvements in panic disorder symptoms and overall quality of life. Many people have fewer random panic attacks as their nervous system becomes less reactive.

Variations

  • Digital safety plan apps - Use apps like PTSD Coach or Sanvello that guide you through safety planning with built-in coping tools and crisis resources.
  • Video-based plans - Record yourself giving calming instructions during peaceful moments. Hearing your own voice can soothe you especially well during panic episodes.
  • Family collaboration plans - Work with household members to create shared strategies that show others how to best support you during panic episodes without accidentally boosting anxiety.
  • Workplace plans - Develop modified versions for professional settings that respect privacy needs and use available resources in work environments.
  • Travel versions - Create portable versions that work in unfamiliar places, including airplane seats, hotel rooms, or foreign locations with different resources.
  • Therapy-integrated plans - Work with mental health professionals to add proven techniques like cognitive restructuring or exposure principles into your personal safety plan.

Troubleshooting

"I forget to use my safety plan during panic attacks" - This happens to almost everyone at first. Set phone reminders to practice weekly and consider wearing a physical reminder like a bracelet that prompts safety plan use.

"My breathing exercises make panic worse" - Some people get more anxious from focused breathing. Try other grounding methods like progressive muscle relaxation or sensory techniques instead.

"I can't think clearly enough to follow written steps" - Make your plan simpler with only 3-4 basic actions maximum. Use symbols or images alongside words to make instructions easier to follow when your thinking gets cloudy.

"My panic attacks happen too suddenly" - Focus on catching subtle early warning signs like slight heart rate jumps or tension. Early action works much better than waiting for full-blown panic.

"None of my strategies seem to work" - Plans often need fine-tuning based on real-world testing. Try different techniques and talk with a mental health professional for personal guidance.

"I feel embarrassed using my plan in public" - Develop discrete versions of your techniques that don't draw attention, such as subtle breathing exercises or mental affirmations that others won't notice.

Frequently asked questions

How often should I update my safety plan?
Review monthly and after any major life changes or new panic triggers. Update strategies based on what works best in real situations.
Can I share my safety plan with family members?
Yes, sharing helps others provide appropriate support. Include instructions for how they can help without accidentally increasing your anxiety.
What if my panic attacks don't follow predictable patterns?
Even unpredictable panic benefits from prepared responses. Focus on universal techniques like breathing and grounding that work regardless of triggers.
Should I include medication in my safety plan?
Include any prescribed anti-anxiety medication with clear dosage and timing instructions from your healthcare provider for emergency use.
How long should my safety plan be?
Keep it concise - one page maximum. Long plans are harder to use during panic when cognitive function is impaired by stress hormones.