When someone is having a panic attack, your first job is to stay calm and be present. Do not tell them to calm down or breathe slowly, as this can feel like pressure. Instead, acknowledge what is happening, use a steady and reassuring voice, and help them ground themselves in the present moment.
What Does a Panic Attack Actually Feel Like?
A panic attack is a sudden surge of intense fear that peaks within minutes. The body’s fight-or-flight system activates even though there is no real physical danger. This causes a wave of physical symptoms that can be genuinely terrifying.
The person may feel their heart racing or pounding, experience chest pain, and struggle to catch their breath. They might feel dizzy, shaky, or nauseous. Many people describe a feeling of choking, numbness or tingling in their hands, and hot flashes or chills. A common and frightening symptom is the feeling of detachment from reality, as if they are watching themselves from outside their body.
Understanding this mechanism is key. The person is not overreacting to a small stressor. Their brain and body are responding as if they are facing a life-threatening emergency. This is why telling them “there is nothing to be afraid of” does not work—their nervous system is not listening to logic right now.
How To Help Someone Going Through A Panic Attack
Your immediate goal is to be a calm anchor. Start by stating the obvious in a neutral way. Say something like, “You are having a panic attack right now. This is uncomfortable, but it will pass.” This simple statement can be incredibly effective because it names the experience and provides a timeline.
Do not ask a lot of questions. During a panic attack, the brain has trouble processing complex information. Asking “What do you need?” or “Should we go outside?” can be overwhelming. Instead, make simple suggestions and wait for a response.
If you are in a safe location, suggest they sit down. Offer them a glass of cold water. If they are willing, try a grounding exercise together. Ask them to name five things they can see, four things they can touch, three things they can hear, two things they can smell, and one thing they can taste. This technique forces the brain to shift focus from internal fear to external reality.
Match their breathing only if it feels natural. Some guides suggest breathing with the person to slow their pace. This can work, but it can also cause you to hyperventilate if you are not careful. A safer approach is to breathe audibly and slowly yourself, modeling a calm rhythm without instructing them to follow it.
Keep your voice low and slow. Speak in short, simple sentences. Avoid saying “don’t worry” or “relax.” These commands can make the person feel like they are failing at something they cannot control. Instead, use phrases like “I am here with you” and “You are safe.”
What Not To Do During a Panic Attack
Some well-meaning actions can make a panic attack worse. Do not grab the person or try to physically restrain them. This can increase their sense of being trapped and amplify the fear.
Avoid minimizing the experience. Phrases like “It’s all in your head” or “Just snap out of it” are harmful. The physical symptoms are real, and dismissing them can make the person feel ashamed and isolated.
Do not hand them a paper bag to breathe into. This old advice is dangerous. Rebreathing carbon dioxide from a paper bag can lower oxygen levels in the blood and is not recommended for panic attacks. It can cause more harm than good.
Do not leave them alone unless they explicitly ask you to. The presence of a calm person is often the most powerful tool during an attack. If you must leave, make sure someone else stays with them.
When Should You Seek Emergency Medical Help?
It can be difficult to tell a panic attack from a heart attack because the symptoms overlap. Chest pain, shortness of breath, and a racing heart occur in both conditions. If this is the person’s first panic attack, or if you are unsure, call for emergency medical help.
You should also seek immediate medical care if the chest pain feels like pressure or squeezing, if it spreads to the arm, neck, or jaw, or if the person has a history of heart disease. Other warning signs include fainting, confusion, severe dizziness, or symptoms that do not improve after 20 minutes.
Even if it turns out to be a panic attack, it is always acceptable to err on the side of caution. A trip to the emergency room is a reasonable price for ruling out a cardiac event. Doctors can perform an EKG and blood tests to check for heart problems and provide a clear diagnosis.
What To Do After The Panic Attack Ends
When the acute symptoms subside, the person will likely feel exhausted and emotionally drained. This is a normal part of the recovery process. Do not rush them to move on or immediately analyze what happened.
Offer them water and a quiet place to rest. Let them talk about the experience if they want to, but do not force a debrief. Some people prefer to sit in silence until their body fully settles.
After the immediate crisis, gently suggest they speak with a healthcare provider. Recurrent panic attacks can be a sign of panic disorder, which is a treatable condition. Cognitive behavioral therapy and certain medications have strong evidence for reducing the frequency and intensity of panic attacks.
Encourage them to see their primary care doctor for a full check-up. This can rule out other medical conditions that mimic panic symptoms, such as thyroid problems or heart rhythm issues. A medical evaluation is a sensible first step before starting any mental health treatment.
How To Support Someone Long-Term
Living with panic attacks is exhausting. The fear of having another attack can cause people to avoid places or situations where attacks have occurred. This can lead to agoraphobia, where the person becomes afraid of leaving home.
You can help by being patient and non-judgmental. Never shame them for canceling plans or needing to leave a situation early. Instead, ask how you can help them feel more comfortable.
Learn to recognize their early warning signs. Some people experience a subtle shift in mood, increased tension, or a specific physical sensation before a full panic attack. If you notice these signs, you can offer support early, which may help prevent the attack from escalating.
Do not take on the role of their therapist. Your job is to be a supportive friend or family member, not to treat their condition. Encourage them to seek professional help and offer to accompany them to an appointment if they are nervous.
Can You Stop a Panic Attack Once It Starts?
You cannot stop a panic attack once it begins, and neither can the person experiencing it. The attack has a natural course that typically peaks within 10 minutes and resolves within 20 to 30 minutes. Trying to force it to end can create additional anxiety.
What you can do is help make the experience less frightening. By staying calm and providing grounding techniques, you can reduce the secondary fear—the fear of the fear itself. This often shortens the perceived duration of the attack, even if the actual physiological timeline remains the same.
Medication can help in some cases. Doctors sometimes prescribe fast-acting anti-anxiety medications to be taken at the onset of a panic attack. These are not appropriate for everyone and can be habit-forming. This is a decision that must be made by a doctor, not by a friend or family member.
Frequently Asked Questions
How long does a panic attack last?
A panic attack usually peaks within 10 minutes and most resolve within 20 to 30 minutes. Some people experience waves of symptoms that last longer, but the intense peak is typically brief.
Should I call an ambulance for a panic attack?
Call for emergency help if this is the first attack, if you are unsure whether it is a panic attack, or if the person has chest pressure, fainting, or a history of heart disease. It is always safer to have a medical professional rule out a heart attack.
Can someone die from a panic attack?
No, a panic attack itself is not fatal. However, the symptoms can feel like a life-threatening medical emergency, which is why a medical evaluation is sometimes necessary to rule out other conditions.
What is the best thing to say during a panic attack?
Use short, calm phrases like “I am here with you” and “You are safe.” Avoid telling the person to calm down or breathe slowly, as this can feel like pressure and make the attack worse.
