How to help someone having a panic attack

A panic disorder is characterized by recurring panic attacks. These attacks are best described as moments of intense fear. Panic attacks differ from a typical fear response because there’s often no actual threat involved in the immediate vicinity. The body may be saying there’s danger, when in reality there may not be any threat present in the moment. For the person having a panic attack, the danger feels no less than if a predator is literally about to pounce on them. It feels REAL.

There are many panic attack warning signs to look out for, including some of the most common physical signs. Many people experience dizziness, body tension, gastrointestinal distress, shortness of breath, sweating or chills, a rapid heartbeat, and trembling, during a panic attack.

A looming fear of death is another familiar feeling. While having a panic attack, many people feel like they’re not going to be able to make it through.  Panic attack triggers aren’t always easy to identify, so people who have one attack often worry about having more, especially in public. Recurring panic attacks may lead to isolation and loneliness. Often, it may be difficult to leave the house.

What to do :
You Might Need to Get Help
If an individual requires emergency assistance, get help. Panic attack symptoms can be similar to heart attack symptoms. If they are experiencing chest pain and hasn’t had a panic attack before, you should call 911. While most panic attacks are short, some of them can last hours. One panic attack can lead to another.

Recognize the Symptoms
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

Reassure
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. Your ability to offer empathy and recognize their distress as real and significant is important.

Validate their distress
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. 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. Let me know what I can do to support you.”

Key Points
-reassuring them you won’t leave
-reminding them the attack won’t last
-telling them they’re safe

Stay Calm Yourself
People with anxiety are experiencing very intense feelings and symptoms during a panic attack. One easy way to help ground them through that experience is to remain calm. While you might feel scared yourself, showing that you’re afraid can worsen the person’s panic attack. Remaining steady by their side can help them stay present and know that they can get through what they’re feeling. They’ll feel protected knowing someone is there to emotionally hold them through this experience.

Help them stay grounded
Grounding techniques can have benefit for a range of anxiety issues, including panic attacks. These techniques help the person focus on what’s actually happening, not their fear of the attack. Remember that grounding can be highly personal for each person. Some people prefer to pace or move; others want to hunker down, often in a corner or curled up in a ball; some want to be outside, others don’t want to leave the room. I always tell patients to listen to what their body wants to do in that moment; it has wisdom.

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
-have them lie on the ground, floor, or grass; being close to the earth can be reassuring

After the panic attack
When someone chooses to tell you about their panic attacks, take this as a sign of trust. Many people feel embarrassed and vulnerable after a panic attack.  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.

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.
-Don’t compare normal stress and fear to panic
-You might even have anxiety yourself. Avoid trying to draw comparisons between your different experiences.
-If you have experienced extreme fear, let that memory inform you. Remind yourself they aren’t just afraid or stressed. They may also feel helpless, unable to manage what’s happening, out of control, physical pain or discomfort. You might not intend to make your friend feel ashamed, but denying the reality of their distress can certainly have that effect.
-Avoid saying things like:
“Just relax. There’s nothing to be afraid of.”
“You’re upset over that?”
“What’s wrong with you?”
“Are you sick?”
“Did you forget your meds?”
-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, not just during a panic attack.  When these techniques are only utilized during moments of panic, they may wind up backfiring. Deep breathing can turn into hyperventilating and the mind may become too overwhelmed to focus.

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 the person has already tried unless they’ve told you.
Listening and holding space with the power of your presence can go a long way.
Also see Ways to Stop a Panic Attack.

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