A panic attack can be a terrifying experience and frightening to watch. With a panic attack, a person experiences the fear of being on the cusp of life or death. There are some essential things to keep in mind when trying to help alleviate the symptoms of a panic attack. Learning the right things to say helps create a calm and safe environment to prevent further stress for the concerned person.
How to Identify a Panic Attack
Panic attacks are short and may only last a few minutes, although they can feel like hours when they occur. However, people can find it difficult to differentiate between panic attacks and anxiety-related episodes and don’t know how long panic attacks last. Panic attacks often are misunderstood by those experiencing them as heart attacks, as they can cause powerful physical sensations.1 They can come out of nowhere and usually get triggered by any situation perceived as overly stressful.
“Panic attacks are simply heightened anxiety. They are temporary and harmless, typically lasting 10-15 minutes. The definition of a panic attack is: the catastrophic interpretation of the normal body sensations of anxiety. This means that the person having the panic attack is interpreting the normal body sensations of anxiety (nausea, heart racing, shallow breathing, sweating, numbness/tingling in extremities, derealization or depersonalization) as dangerous in some way, which drives them up. This causes the spike of anxiety to turn into a panic attack.” – Dr. Andrea Kulberg, PhD, CEDS
It is not clear what cognitive process causes panic disorders. Genetics, acute stress, stress-sensitive temperaments, negative emotional development, and brain functioning are all contributors.2
How to Help Someone With a Panic Attack
It is challenging to keep the presence of mind when you help someone through a panic attack, especially if it is somebody who you know and love. Thankfully, there are a few easy actions you can do, things to help calm people who experience panic attacks.
Here are 15 tips on how to help someone with a panic attack:
1. Remain as Calm as Possible
Panic attack experts recommend staying calm and gently informing the person you think could be having a panic attack.3 Helping someone understand they are experiencing a panic attack, not a heart attack, can reduce tension and panic attack symptoms.
2. Gather Information
Are they aware of a panic attack? Has this happened to them before? What has worked before to offset symptoms? Ask them what you can do to help, and communicate in short sentences.
3. Give Them Space But Stick Around
Oftentimes, the person having a panic attack feels such distress that they don’t even know what to do with themselves. They may feel a whirlwind of uncomfortable sensations and ask for some space. At this point, if they’re not in imminent danger, take a step back and honor their request. However, let them know you’ll stick around in case they need your support. Even if you’re not right next to the person in distress, your presence alone might help them feel safe and protected as they attempt to become more calm.
4. Know the Right Things to Say
Saying the wrong thing can reinforce someone’s feelings of panic. The onset of a panic attack causes extreme anxiety for the person having it and the people around them. Saying “you will be fine” or “this is no big deal” may make the person feel their needs are not getting addressed, as if their feelings are not genuine or intense.
Some suggestions on what to say when someone has a panic attack include:4
- “You can get through this.”
- “I’m proud of you. Good job.”
- “Tell me what you need now.”
- “It’s not the place that bothers you; it is the thought.”
- “What you are feeling is scary but not dangerous.”
5. Understand That Their Panic Might Not Make Sense
You may not comprehend why someone is having a panic attack or think they’re being irrational. But panic attacks are often unpredictable, random, and may not always be linked to something specific. For the person enduring the panic attack, it feels intensely real, and whether they’re aware of what triggered it or not, they can’t control their reaction. It is crucial that you refrain from trying to investigate the cause or make sense of it. Instead, try to be compassionate and validate their experience even if you don’t understand it.
6. Use Grounding Techniques
Grounding is a method that creates a calming effect by using all five senses. It relies on the principle of using nearby objects to help recognize where you are, which can help the brain slow down and focus.
The grounding technique called 5-4-3-2-1 is an excellent example:5
- Five things you see: It could be a pen, a spot on the ceiling, or anything in your surroundings.
- Four things you can touch: It could be your hair, a pillow, or the ground under your feet.
- Three things you hear: These are sounds that could be anything external. Focus on sounds coming from outside of your body.
- Two things you can smell: Maybe you are in your office and can smell a pencil or soap in your bathroom.
- One thing you can taste: What does the inside of your mouth taste like; gum, coffee, or lunch?
7. Focus on Breathing
One of the scariest parts of a panic attack is accelerated breathing and the inability to control it. Coaching a person to take slow, deep breaths and stay present can help them to slow their breathing down and reduce anxiety.
Take these four steps for breathwork:6
- Breathe slowly, deeply, and as gently as you can through your nose.
- Breathe out slowly, deeply, and gently through your mouth.
- Steadily count to five on each in-breath and each out-breath.
- Close your eyes and bring attention and focus on your breathing.
8. Use One Technique at a Time
Continue to use one calming technique at a time. Give it time to work. If you keep rapidly moving from one method to the next, this can instead create feelings of tension for the person having an anxiety or panic attack.
9. See If They Need to Move
Ask the person having a panic attack if they want or need your help. If they ask for help and the panic attack happens in a busy or loud place, encourage them to move into a quiet space. Eliminating noise and other distractions can help them focus on techniques to help manage their panic episodes.
10. Give Them Water
Water can have calming qualities when people tend to sweat and feel warm when anxious. For those prone to them, a panic attack can start from a physical trigger like being dehydrated, then skyrocket until someone feels like they’re dying.7 Cold water triggers the parasympathetic nervous system, which helps to calm the body. Plus, drinking cold water helps to focus on the sensation of swallowing the cold water. Putting their hands in water or cold water on a cloth and placing it on your face or neck can also feel soothing. It’s a pleasant distraction from the overbearing thoughts they may have.
11. Ask If They Need to Sit
Help them find a comfortable chair and sit down so they can have a literal grounding effect. Having feet relaxed on the floor, and the sensation of having a chair for support can have a healing impact. Sitting also helps when doing deep breathing exercises more comfortably.
12. Check for Medications
Find out if the person has any medications for anxiety or panic attacks and if they have taken them that day. If possible, help them to take medicine. Medication can help to get the panic episode under control. It can also help the person who is panicking feel that they have more quick control over their attack.
13. Be Supportive, Compassionate, & Reassuring
Be present without judgment and speak to them in a supportive manner. Let the person struggling with a panic attack know that you will remain with them as long as they need you to be there. Your ability to offer reassurance goes a long way to helping to remind them that they are not alone.
14. Don’t Guess or Surprise Them
By guessing what someone having a panic attack might need, you may create more triggers for them and only create more anxiety. It’s important not to make assumptions about what someone needs. Communication is vital, so be sure to ask, be predictable, and avoid surprises.(8
Tell them you will help them with their breathing before you start giving instructions. If you do something without warning, they may react by getting more stressed and anxious.
15. Respect What They Say They Need
If your friend or loved one tells you that they’re having a panic attack, they are essentially exposing their vulnerability. This may prompt you to come to their “rescue” and do or say things that could make them feel more anxious. You may be tempted to give them advice, investigate what triggered their panic attack, or try to minimize what they’re feeling. Don’t let your good intentions backfire—instead show kindness, and simply ask what exactly it is that they need right at that moment. And whatever this may be, respect their wish.
16. Find a Pet
If a pet is nearby, get them and bring them to the anxious person. Not only does petting an animal give them something to focus on, but it can also increase dopamine and serotonin hormone levels, which help relax the body. Service dogs are frequently used to help people who suffer from anxiety or recurring panic attacks.
17. Know the Warning Signs
Learn about the early warning signs of panic attacks which commonly start with an intense physical reaction including heart palpitations, shortness of breath, and shakiness. These symptoms can resemble a serious medical condition which may cause you to confuse it with something else, make you panic and stress the person even more. Knowing the specific warning signs from the person you care about can help you become better equipped to offer support and relief early on should a panic attack emerge in your presence.
18. Get Them Educated
Encourage someone you care about to get educated about their panic attacks. Information is fundamental in helping people understand why and what is happening. Researchers recommend that having a thorough education about panic disorder and understanding that their symptoms are not life-threatening can be incredibly helpful. By being taught about the different treatments and the need for compliance, people can be taught to recognize the triggers and avoid them.9
19. Encourage Counseling
If recurring panic attacks continue to be a problem for someone you care about, encourage them to seek counseling. Counseling can help the person recognize possible triggers leading to an emotional response. A therapist will also teach coping techniques and reframe negative thinking so they can independently manage an episode when it occurs. These skills can help them address panic episodes early so they don’t escalate. It is crucial for those suffering from these types of scenarios to find a therapist specializing in anxiety and panic attacks.
How to Help Someone Having a Panic Attack Over Text
It can feel frightening when a friend or loved one tells you over text that they’re having a panic attack, but in a calm and gentle manner there are ways to help from afar.
Here are some things to say to someone over text that can be helpful:
- “I am glad you decided to reach out to me.”
- “I am here for you, and we’ll get through this together.”
- “You may be feeling terrified right now, but you’re safe and your intense discomfort will pass.”
- “How can I help you right now?
- Don’t assume you know what they need. Instead ask something like, “Would you be willing to try some techniques to help you through this?”
What Not to Do When Assisting Someone With a Panic Attack
It’s noteworthy to know there are specific things you should not do when trying to help someone you care about getting through a panic attack. Saying something wrong could make the panic attack worse or last longer.
Here are some things to avoid when helping someone with a panic attack:
- Do not repeatedly suggest different things to try and reduce their panic attacks. It’s important to try one thing at a time. Give it time to work.
- Don’t compare normal fear and stress to a panic attack. Normal fear or stress is a typical response to an identifiable real/perceived problem which usually dissipates once resolved. While a panic attack doesn’t necessarily involve an actual reason, it may spurt out of nowhere, without warning and with extreme physiological symptoms.
- Don’t say things like “Just calm down,” “you are overreacting,” or “you’re acting crazy.” Words have so much power during a panic attack; these statements could sound like ridicule and imply that their struggle isn’t a priority to you. Please don’t dismiss the severity of their symptoms, and utilize the techniques discussed in tip eight to be empathetic, non-judgmental, and supportive.
- Don’t jump in and make assumptions about what they need to do. As suggested in Tip 10, communication is crucial. Ask what they need from you to offer the best support to reduce the panic attack symptoms they are experiencing.
- Don’t offer caffeine, alcohol, or non-prescribed medications not used to treat anxiety/panic symptoms. This action is ill-advised and can increase the likelihood of physical triggers that could lead to an additional panic attack.
- Don’t let them ignore the problem. Avoiding feared situations and places can reinforce the disorder, so encourage them to face their fears, but with help and support.10
When to Seek Medical Attention
You should seek medical attention if a panic attack does not subside or gets worse or more frequent. Breathing issues associated with a panic attack can also turn into hyperventilation which can lead to an increase in heart rate called tachycardia. When this happens, the heart is pumping so quickly that it may not be able to move blood throughout the body.
Because of these physical responses, the line between a panic attack versus a heart attack is difficult to distinguish. It is good to learn the differences between the two in case you may need to receive more serious medical attention. For either, immediately seeing a doctor is the best choice to avoid worsening medical conditions.
Preventing Future Panic Attacks
Dr. Kulberg advises, “Go back to all the places you have had surges of anxiety or panic attacks, and invite the harmless body sensations to come forth. Tell yourself to accept whatever risks and uncertainties go with this. Accept that, like all humans, you may have a panic attack at any time, and learn to be alright with that. Once you are good at moving toward anxiety at lower levels and are no longer interpreting it as dangerous to your body or mind, you will no longer turn the sensations of anxiety into a panic attack.”
Understanding Panic Disorder
It’s normal to feel nervous or panicky when faced with a stressful or new situation. A person may even have a panic episode but never develop panic disorder. Panic disorder occurs when someone experiences recurrent, unexpected, sudden panic attacks making them extremely preoccupied about having future ones. People with panic disorder will often change their behavior to avoid situations that might provoke potential panic attacks. Panic disorder can be a debilitating condition that can worsen if left untreated.11
Encouraging Your Loved One to Seek Help for Panic Attacks
While assisting someone with a panic attack in the short term can still be helpful, getting them the long-term care they need is what can actually change their life and prevent future anxiety issues.
Offer to Go With Them to a Doctor Appointment
Because many of the physical symptoms of a panic attack resemble a medical illness, those who experience these episodes often think they have a chronic health condition. Thus, seeing their primary care provider can help to establish if there is an underlying physical concern or reassure them of the absence of one. Discussing symptoms and stressful experiences with a healthcare professional regarding panic attacks can help shed light onto what may be really happening.
Offer to Help Them Find a Therapist & Take Them to Sessions If Needed
Therapy has proven to be effective in helping with panic attacks. Cognitive Behavioral Therapy (CBT) is a frequently used psychotherapy for panic disorder. CBT for panic attacks helps people unravel how their thinking contributes to their panic episodes. Changing thoughts can change behavior in healthy ways.
The main goals of therapy for panic attacks include:
- Identify the sources of anxiety and fear
- Learn to exist in situations that would have evoked a panic attack
- Develop new ways of thinking about negative feelings
- Use coping skills to offset panic-related symptoms and behaviors
You can find a therapist with expertise in anxiety and panic disorders by asking for a referral from a doctor or by using an online therapist directory.
Offer to Help Them Find a Support Group or Group Therapy
People who struggle with a mental health condition often feel like they don’t belong, or that others can’t relate to what they’re going through. Having this in mind, you can encourage them to join a support group or seek group therapy which can help them feel less alone and connect with others via shared experiences.12
Consider offering your assistance in searching for a group, or sharing appropriate resources or organizations such as Anxiety.org or the Anxiety and Depression Association of America. There are also online support groups that can be especially helpful for people with limited mobility or who live in more rural areas.
Final Thoughts
Experts on the subject share that panic attacks and panic disorder represent a “fear of fear.” It feels frightening for the observer and the person suffering the panic attack. Knowing what to say and what to do is critical in getting these symptoms under control and creating a more calm and safe environment for all concerned. Give them what they need and get their focus back on the present so they can let go of the thoughts that led to their panic.
How to Help Someone Having a Panic Attack Infographics
