A panic attack is a brief but intense rush of fear.
These attacks involve symptoms similar to those experienced when facing a threat, including:
- intense fear
- a sense of doom
- sweating or chills
- pounding heart
- difficulty breathing
- head and chest pain
Panic attacks differ from a typical fear response because there’s no actual threat involved.
“The body is saying there’s danger, when in reality there’s none present,” explains Sadie Bingham, a clinical social worker who specializes in anxiety and provides therapy in Gig Harbor, Washington.
Panic attack triggers aren’t always easy to identify, so people who have one attack often worry about having more, especially in public.
Panic attacks usually feel very uncomfortable and cause significant distress. Many people believe they’re experiencing a heart attack or other life-threatening issue.
If you know someone who experiences panic attacks, there are several things you can do (and avoid doing) to help them in the moment.
Keeping your cool is one of the best ways you can help.
Panic attacks usually don’t last long. “The most intense feelings tend to last between 5 and 10 minutes,” Bingham explains.
But someone having an attack may not have much concept of time as it happens. They might feel terrified or think they’re about to die.
Even if you feel a little afraid yourself, stay calm. If your voice seems to help (and they haven’t asked you to keep quiet), talk to them in a calm voice.
What to say
- reassuring them you won’t leave
- reminding them the attack won’t last long
- telling them they’re safe
Most people who experience panic attacks or live with other types of anxiety have their own go-to coping methods. When offering support, keep in mind your loved one knows best when it comes to what will help most.
During an attack, however, they might find it harder to communicate this. Consider asking in advance how you can offer assistance if they experience an attack around you.
During an attack, it’s okay to calmly ask what you can do to support them. Just prepare for the possibility of a short or curt response.
The fight-or-flight stress response can affect the ability to think and behave logically, according to Bingham. “Try to remain neutral, and don’t take their response personally,” she recommends.
What if they want me to leave?
As long as they’re not in immediate danger, take a few steps back and give them some space. Stay nearby so you can still keep an eye on things, and let them know that should they change their mind, you’ll come right back.
If you haven’t already, take some time to familiarize yourself with the early signs of a potential panic attack.
Panic attacks commonly begin with:
- a feeling of terror or dread
- hyperventilation or shortness of breath
- feelings of choking
- a pounding heart
- dizziness and shaking
Not everyone experiences panic attacks in the same way, so it’s best to ask what signs they tend to experience.
The sooner you realize what’s happening, the faster you can help them get to a more private place, or wherever they need to feel more comfortable.
A soothing, familiar voice helps some people, but try to avoid repeatedly saying things like “don’t worry” or asking them if they’re alright over and over.
Of course you mean well, but your words may not have much benefit in the moment. They can also make the situation more stressful, since your loved one may believe they’re doing something wrong by not being alright.
How to make your words more actionable
Take action with your words by:
- asking if they want to leave the room and go somewhere else
- reminding them to keep breathing
- engaging them in light conversation, unless they say they don’t want to talk
Panic attacks can be confusing as well as scary. People generally can’t predict them and there’s often no clear cause. They can happen in stressful situations but also during calm moments or even during sleep.
It might seem helpful to tell your friend there’s nothing to be afraid of. But they’re probably perfectly aware there’s no actual threat.
That’s part of what makes panic attacks so confusing. The reaction matches a fear response — but nothing’s happening to cause that fear. In response, someone who gets panic attacks might begin to fear the symptoms themselves, or link them to a serious health issue.
“It’s typical to feel embarrassed or ashamed of such an intense reaction,” Bingham explains. “But having a trusted companion offer compassion can allow space for the person to return to baseline.”
You can be that person even without understanding why they get panic attacks. That’s far less important than your ability to offer empathy and recognize their distress as real and significant.
People often have a hard time sharing their experiences with mental health issues, including panic attacks.
Some avoid talking about mental health issues because they believe others won’t understand what they’re going through. Others worry about being judged or told what they experience isn’t a big deal.
Outsiders often don’t understand the fear caused by panic attacks and may even consider it illogical.
But the response is real, and the person experiencing the attack can’t control it.
An empathic response can be as simple as, “That sounds really tough. I’m sorry you experience that. Let me know what I can do to support you.”
Grounding techniques can have benefit for a range of anxiety issues, including panic attacks.
“Grounding techniques can help contain panic attacks after they begin,” explains Megan MacCutcheon, a therapist in Vienna, Virginia.
These techniques help the person focus on what’s actually happening, not their fear of the attack. They’re often most helpful once the intensity of the attack has faded a bit.
Quick grounding tips
To help someone ground themselves, you can try:
- physical touch, like holding their hand (if they’re okay with it)
- giving them a textured object to feel
- encouraging them to stretch or move
- encouraging them to repeat a soothing or helpful phrase, like “this feels awful, but it’s not going to hurt me”
- talking slowly and calmly about familiar places or activities
Say you just sat with your friend while they had a panic attack. When it’s over, they seem calmer but tired. You had plans to see a show, one you’d both been looking forward to, but your friend asks you to take them home instead.
Naturally, you’re probably disappointed. But remember: Your friend can’t help what happened. They’re probably disappointed and exhausted. They may also feel bad about ruining your plans, which can compound the distress associated with the attack itself.
It’s common to feel completely wiped out as your body and its processes return to normal after an extreme fear response. Someone who’s just had a panic attack might not feel up to anything beyond quiet relaxation.
“Inquiring what they need and honoring that request is crucial,” Bingham says. “Asking too much after a panic experience can aggravate the healing process.”
You might think going to see the show will cheer them up or improve their mood, but forcing them to keep engaging when they would prefer space can keep that stress response lingering, Bingham explains.
If someone chooses to tell you about their panic attacks, take this as a sign of trust.
To show respect for their experience and honor this trust:
- respond with compassion
- be mindful of your words and actions, during an attack and at any other time
You might have all the best intentions, but it’s entirely possible to make someone feel bad without realizing you’re doing so.
Keeping these suggestions in mind can help you avoid unintentional harm:
Don’t compare normal stress and fear to panic
Maybe you’ve felt stressed or terrified in a dangerous situation. You might even have anxiety yourself.
These experiences aren’t quite the same as a panic attack, though. Avoid trying to draw comparisons between your different experiences. Unless you also get panic attacks, you probably don’t entirely understand how they feel.
If you have experienced extreme fear, let that memory inform you on what your friend is going through. Remind yourself they aren’t just afraid or stressed.
They may also feel:
- unable to manage what’s happening
- physical pain or discomfort
Don’t shame or minimize
It’s pretty common to worry about having a panic attack, especially in front of strangers, or believe the attack might annoy or inconvenience friends or loved ones.
“People struggling with anxiety or panic attacks might intellectually understand the response is illogical. But hearing that from someone else can increase their isolation,” Bingham explains.
Avoid saying things like:
- “Just relax. There’s nothing to be afraid of.”
- “You’re upset over that?”
- “What’s wrong with you?”
You might not intend to make your friend feel ashamed, but denying the reality of their distress can certainly have that effect.
Don’t give advice
Not every coping technique works for everyone. Deep breathing and other relaxation techniques can have benefit, but they often help most when practiced regularly, MacCutcheon says.
“When these techniques are only utilized during moments of panic, they often wind up backfiring. Deep breathing turns into hyperventilating and the mind becomes too overwhelmed to focus on unfamiliar things.”
While it can help to remind your friend to breath, telling them to take deep breaths may not help.
In short, avoid telling someone how to manage symptoms. Sure, you may have heard yoga, meditation, or giving up caffeine can help. But you don’t know what your friend has already tried unless they’ve told you.
Wait until you’re asked for suggestions. If you have personal experience, you might say, “I get panic attacks too and I’ve found yoga really helpful. If you’re interested in trying it out, we could go together sometime.”
It can be frightening to watch someone have a panic attack, but at what point should you bring in additional help? It’s hard to say.
Calling your local emergency number might seem like the safest move, but this can often make the situation even more stressful for the person having a panic attack.
Simply sticking around and seeing them through the experience might not feel like much to you, but it can make a significant difference for the person having the attack.
That said, reach out for emergency help if:
- chest pain feels like squeezing (not stabbing) and moves to their arms or shoulders
- symptoms persist for longer than 20 minutes and get worse, not better
- shortness of breath doesn’t improve
- pressure in the chest lasts more than a minute or two