10 Ways to Help Someone Having a Panic Attack
Don’t freak out that they’re freaking out.Last month, I had my first panic attack in front of two of my closest friends and my dad. My heart rate skyrocketed, my chest went all stress ball, and I swore I wasn’t getting enough oxygen. My body just didn’t feel like my own, and if you told me I was slowly dying, I would’ve believed you. The worst of it didn’t last too long, but I was drained, disoriented, and really fucking disturbed for the rest of the night (and, to be honest, I’m still anxious about it).
If you’ve never had one, a panic attack basically feels like a “surge of intense fear or intense discomfort” that peaks in minutes, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). These can come out of nowhere or be triggered by something you’re scared of, per the DSM-5-TR. When it happened to me, I knew my health anxiety was the culprit. For other people, things like social anxiety might kick off an attack before they speak in public, or a fear of bugs might set one off when their apartment’s pet cockroach comes out to play, explains clinical psychologist Terri Bacow, PhD, author of Goodbye, Anxiety: A Guided Journal for Overcoming Worry. This is all to say that panic attacks can be sparked by anything, and you might not even know the reason.
Panic attacks can make you sweaty, shaky, and dizzy and ramp up your heart rate. They can also cause shortness of breath, chest pain, tingling, numbing, and a choking kind of feeling. And all of that can come with an overwhelming fear of losing control or dying, per the DSM-5-TR.
Yeah, it’s a pretty disturbing experience, but if you’re trying to be there for someone having a panic attack, it might not always be obvious that it’s happening. Sometimes people hyperventilate or look super unwell, but a lot of it is internal chaos, notes Dr. Bacow. During my attack, I was too scared to say anything at its peak. My friends said they noticed I was quieter than usual—that something was wrong—though they had no clue what was going down until I told them.
Whether you know someone who's prone to panic attacks or want to be prepared just in case, we spoke to mental health pros and people who’ve been there about how to handle these situations in the moment. So the next time you notice your partner or even a stranger sitting near you on a plane potentially experiencing a panic attack, you’ll know exactly what to do.
How to help someone having a panic attack.
1. Try to confirm they’re really having a panic attack.
Like we said, it’s not always clear if your bestie or that lady in Target’s frozen aisle is, in fact, panicking. They might look a little off or they could appear to be having a medical issue—and either of those things might be true.
So, one of the surest ways to figure out if someone is having a panic attack is to ask them. For example, if Target lady looks like she’s hyperventilating, ask, “Do you think you’re having a panic attack?” or just, “Are you OK?” would work, Dr. Bacow says.
It’s very possible that they can’t get the words out to confirm/deny or they might even say they’re having a heart attack, Dr. Bacow notes. So, yeah, this isn’t fail-proof. When it’s unclear what’s going on, you can ask them if they’d like you to call 911, or just do it to be safe. When in doubt, getting medical help is the safest option, says psychiatrist Shreya Maniar Nagula, MD.
2. Choose your words wisely.
Saying the wrong thing might make someone having a panic attack more anxious or annoyed. If you say, “Everything is fine,” or, “You’re OK,” it can feel dismissive of their physical and mental experience, explains Dr. Bacow. And telling them to “calm down” isn’t helpful because they might not know how to do it, says Dr. Maniar Nagula. “We would love to calm down, but saying the words does nothing,” notes Julia, 32, who says she feels like she’s suffocating when she’s having a panic attack.
Instead, you should speak kindly (duh) and focus on validating words that encourage them to work through what they’re feeling, says Dr. Bacow. “A sample script [might be], ‘This will pass in a few minutes. Staying calm will make it go away faster, and I can help you ride this out,’” she suggests. You can also say things like, “I’m here with you,” or, “You’ll get through this,” suggests Dr. Maniar Nagula. And, if you know them, remind them of the other panic attacks they survived as proof they’ll get through this one, Dr. Maniar Nagula says.
3. Remain calm.
Staying chill in front of someone who isn’t helps a lot, says Dr. Bacow. That’s because how other people react rubs off on how we react (see: co-regulation). Like when, as little kids, our parents were scared of something so we got scared too, she explains. Basically, not freaking out helps reassure the person having a panic attack that things maybe aren’t as terrifying as they seem (even if the panic attack is), she says. Emily T.* says her S.O. talks to her in a gentle and kind tone that feels soothing. If he was panicking or annoyed, it would probably make her even more anxious, she says.
4. Try to distract them.
The thing about panic attacks is that people can start freaking out over the physical stuff, like their heart pounding, chest hurting, and the choking sensation, often making those symptoms worse, says Dr. Bacow. So thinking about something not related to what a panic attack feels like gives their nervous system a chance to cool off, she says.
Maybe ask if they’re up for counting backward from 100 by two, suggests Dr. Bacow. Or you can ask what they see around them, what they hear, or what they can touch to ground them, suggests Dr. Maniar Nagula. Whatever the exercise, the goal is to get them focused on what’s happening around them instead of the chaos in their brain.
While distractions are great, you should also reassure them that you understand what they’re going through and that you’re taking it seriously. Again, we don’t want anyone to feel like we’re dismissing their very real experience, ya know?
5. Walk them through deep breathing.
Sometimes, deep breathing can ease people’s chest tightness, fast heart rate, and shortness of breath when they’re having a panic attack, which, in turn, helps them feel less anxious, says Dr. Maniar Nagula. So take long inhales and exhales with them or count to five each time they breathe in and out, she suggests. Doing it together lets them follow your lead when they’re not sure how to do it themselves.
For example, when Julia is mid-panic attack, she and her husband do box breathing together: inhaling for four seconds, holding for four seconds, exhaling for four seconds, and holding for four seconds. That little exercise slows her breathing and her racing thoughts, she explains.
That said, if the person having a panic attack can’t seem to breathe deeply and slowly with you and starts taking more shallow breaths, it could make them more panicked, says Dr. Bacow. When that happens, move on to another kind of distraction, like what’s going on around them, she suggests.
6. Ask if you can touch them.
Though physical touch is great for some, others might feel more worked up by it, Dr. Maniar Nagula says. So, ask them if it’s OK to touch their shoulder or arm to calm them, she suggests.
When you’re in freakout mode, having another person hold your hand or rub your back can calm your stress response. It makes you feel like someone is there for you, says Dr. Maniar Nagula. For Julia, her husband will hold her tight, like being wrapped in a weighted blanket, she says.
How to help someone after a panic attack.
7. Ask them what they need.
Panic attacks are scary, so it’s common for people to have residual feelings of anxiety when it’s over, says Dr. Maniar Nagula. To guide them through the aftermath, the best thing you can do is ask them what they need—not everyone will want the same thing. When it looks like someone’s symptoms are calming down, try something like, “Do you want water?” or “Do you want a hug?” or “Should we go get some food?” suggests Dr. Bacow. A simple, “What do you need right now?” may be helpful too.
8. Chat about what led up to the panic attack.
Sometimes people want to talk about what happened and sometimes they don’t. But if the person you’re with is up for it, getting into what happened before the attack can enable them to find long-term solutions—I know it did for me.
To be fair, they might not know what led up to this panic attack, but rehashing what’s been on their mind lately can clue them in. Say their panic attack came after a week of crappy sleep and intense work deadlines—which Dr. Bacow says happens—maybe they’ll realize that they need to take some time off, practice better pre-bed habits, or even find a new job. Sometimes the next step is finding a mental health professional to get to the bottom of it, Dr. Bacow adds. No one needs to make decisions like that with you, but you can still encourage them to consider their options.
9. Ask (and listen to) how the panic attack made them feel.
Discussing what the panic attack was like can support people as they regulate their emotions and process what happened, says Dr. Bacow. So, again, if they’re open to it, you could start with something like, “Seems like that was really scary for you.” Then, let them take it from there.
Assist them as they work through that debilitating experience by reflecting back whatever they say, Dr. Bacow suggests. If they’re like, “OMG I felt like I was dying,” you could respond with, “That sounds really terrifying!” In my experience, having my friends and my dad there to listen as I cried made me feel supported and heard.
10. Find out what helped them come down from the attack.
When you’re aware of what’s most useful in a moment of panic, you learn how to self-soothe. And verbalizing that with another person can solidify it in your brain.
If you’re helping someone, encourage them to write down what worked so they can better manage a future attack on their own, suggests Dr. Maniar Nagula. Bonus points if they screenshot that list and set it as their phone background, she says. It’s great to be there for them, but they shouldn’t rely on you, she explains.
That said, this is still good intel for you as a support person. Julia says now that her husband knows what’s most effective, he feels more confident helping her get back to baseline.
*Name has been changed.
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