How to Help Someone Having a Panic Attack

Someone you love is sitting on the edge of a chair, breathing fast, telling you they cannot breathe, and asking if they are having a heart attack.

Your instinct is to do something: reassure them, find a solution, get them out of there. Some of those instincts help. A few of them make it worse.

The good news is that the useful version is simpler than it looks, and it mostly involves being calm and staying put.

What is happening to them

A panic attack is an alarm system firing when there is no emergency. Adrenaline floods the body, the heart speeds up, breathing gets fast and shallow, and the whole system prepares to run from something that is not there.

It peaks and then comes down on its own, usually within several minutes, because the body cannot sustain it. That matters for you, because it means your job is not to stop it. Your job is to be a steady presence while it passes.

The fear of the panic is often the larger part, especially the fear of losing control or being humiliated. That is the part you can actually affect.

The first thing to do is slow yourself down

Panic is catching. If your voice goes up and you start moving quickly, their alarm reads that as confirmation that something is genuinely wrong.

So drop your own volume and pace. Breathe slowly yourself, visibly. Sit down rather than standing over them. Keep your hands still.

You are not performing calm for their benefit so much as giving their nervous system something quieter to sync with, which it does more than people expect.

What to say

Short sentences. Simple words. Nothing clever.

I am here. This is a panic attack. It will pass. You are safe. Breathe out with me, slowly.

Then stop talking and let there be quiet. A stream of reassurance is hard to process in that state, and silence with someone next to you is often the most useful thing in the room.

If they can manage it, breathe with them: in for four, out for six or seven, with the out-breath longer. Do it out loud and let them follow. Do not tell them to take a deep breath; people in panic usually have too much air, not too little, and gasping makes the dizziness worse.

Give them something physical and dull to do: feet pressed into the floor, something cold to hold, naming five things they can see.

What not to say

Calm down. There is nothing to worry about. Why are you like this. You were fine a minute ago. Just relax.

All of these say the same thing underneath: your reaction is wrong. That adds shame to panic, and shame makes the next one more likely and harder to admit to.

Also avoid interrogating them about why it started. That can come later if they want it to. Mid-wave, explaining is one more demand on a system that is already overloaded.

Ask before you touch

A hand on the back helps some people enormously and makes others feel trapped. You cannot tell by looking.

So ask plainly: would it help if I held your hand, or would you rather I just sit here. Either answer is fine, and asking itself gives them a small piece of control back at a moment when they feel they have none.

The same goes for leaving. Do you want to go outside, or stay here. Shall I stay or give you a minute. Let them choose.

Do not rush them out of the situation

This one is subtle. Getting someone out of a crowded room can be a kindness, and it can also teach both of you that escape is the only thing that works.

If they want to leave, help them leave; this is not the moment for exposure practice. But if they can stay, stay with them, and afterward notice out loud what happened: it came, it peaked, it passed, and you got through it here.

Over time that is the thing that shrinks panic. Being rescued every time tends to make the world smaller.

Afterward

People are often exhausted and embarrassed once it passes. Both are worth answering.

Keep it light and matter-of-fact. Something like: that looked rough, I am glad I was here, do you want a glass of water. No big debrief unless they start one.

Later, when things are ordinary again, ask what they want next time: what helped, what did not, whether there is a phrase they want you to use. A plan made in a calm moment is worth a great deal in a bad one.

When it is more than panic

Panic itself is not dangerous, but a few things need medical attention. If this is the first time anything like it has happened, if there is chest pain spreading to the arm or jaw, trouble breathing that does not ease as the panic settles, fainting, or confusion, treat it as a medical emergency and call for help rather than assuming it is panic.

And if panic is happening regularly, encourage them to see a doctor or a therapist; it responds very well to treatment, often in a short course of therapy. If they ever tell you they do not want to be here anymore, take it seriously, stay with them, and help them reach someone that day. In the US you can call or text 988 at any time.