How to help someone having a panic attack
Psychologist at Leeds Anxiety Clinic
Published Wednesday, 18 July 2018
Would you know what to do if the person you were with started having a panic attack? If not, read our guide.
What is a panic attack?
A panic attack is a sudden and overwhelming sense of fear that feels extremely discomforting and upsetting. They can occur at any time although sufferers typically have triggers, such as certain situations that set them off.
They typically last no more than 10 minutes. Those experiencing them may feel like they are going to die or suffer a range of unpleasant and uncontrollable symptoms. Panic disorder is a condition where people regularly experience panic attacks.
Spotting the signs
People with anxiety have probably had it for a long time, are probably embarrassed about it and are, therefore, probably very good at hiding it. So, don't be too hard on yourself if you fail to spot a friend in need. They have had a lifetime of practise hiding their fears from the world.
However, there are some symptoms to look out for:
- Sweating
- Trembling and shaking
- Breathing more rapidly
- Withdrawing from conversation
- Becoming less coherent in conversations
- Speaking more rapidly
- Losing the ability to concentrate
You may be able to spot and identify these signs. You may know the person you are with and know that they have panic disorder. Or they may be able to tell you that they are experiencing a panic attack.
If so, here is what to do.
Stay calm yourself
The last thing the situation needs is more panic. So, your first task is to stay calm yourself. Remind yourself that you do not have a duty of care to fix the situation. Of course you will want to help. But any help you can offer is a bonus. Nobody is expecting you to fix the situation. Just like nobody would expect you to be a paramedic if there was a physical injury. It is okay to not know how to fix a panic attack.
Second, remind yourself that the person having the panic attack is in no physical danger. You cannot die from a panic attack. You cannot even be physically injured from one. They are not physically harmful. Extremely unpleasant, yes, but the person experiencing it will pull through. So, even if you do nothing, they're not going to die.
Offer realistic reassurance
People having a panic attack can tell themselves that they are fine. But they won't believe themselves. They often feel like they are going to die, or going crazy, and so they don't trust the rational voice inside of their head. They are more likely to trust you, though. You are a more objective third party. So, offering them a voice of reassurance can be a good thing.
This is best delivered by acknowledging the reality of the situation. They are in a lot of discomfort, and they feel like they are going to die. So acknowledge their pain while offering that reassurance.
You could say something like:
"I know it feels awful, but it is going to stop at some point. They always stop at some point. I know that doesn't make you feel much better now, but it will be over soon."
Do encourage them to breathe
When people have a panic attack, they often begin to hyperventilate. This means they think they are not getting enough oxygen and so start to breathe faster and faster. In reality, the opposite is true. By breathing faster, they are taking too much oxygen in and pushing too much carbon dioxide out. Which makes them feel worse. So, they breathe faster, and the cycle continues.
To calm them down, we need to get them out of this cycle. Doing this starts with encouraging them to take slow deep breaths. Encourage them to place a hand on their stomach and breath from their stomach, feeling it go in and out, in for three seconds then breath out for three seconds. A good idea is for you to do the same as an example. Show them and count for you both. Three seconds in and three seconds out. They’ll be more confident following your example.
Do give them options
Often, panic attacks are triggered by a specific situation, such as being in a large crowd or a noisy environment. If that is the case, ask them if they want to go outside. Tell them that you can go together and so they will have you to reassure them and they won't be alone.
That may not be the cause of the panic attack, of course, and they may say no. But, if it is the cause, they may jump at the chance to escape the current situation. They may also want to be left alone. This is unlikely, but it is worth asking whether they would just like some space.
Don't tell them to calm down
When someone has a panic attack, nothing is more annoying to them than someone saying "just relax" or "calm down". If it were that simple, they would have done it already.
It can leave them feeling patronised, embarrassed or angry. They may snap at you, or even lash out at you. Not only will this be unpleasant for you, but it will make them feel awful when they have calmed down, too.
Conversation not distraction
You may think it is a good idea to take their mind off the panic attack. For example, you may talk about something unrelated or point to something interesting that is happening around them. Doing this is unlikely to help. They're having one of the most stressful experiences of their life, so a quick "look over here" isn't going to shift their mind off anything.
However, you could try engaging them in genuine conversation. Ask them if they want to chat. If they give you a signal that they do, you could try empathising with them. Be honest. Tell them you have no idea what it is like, but that you feel for them.
"I have never had a panic attack. But it sounds awful. I'm impressed at how well you keep it together."
Or you could ask them what you could do to help. Often, the person having the panic attack knows what would improve the situation but needs some encouragement to verbalise it.
Use physical contact, if appropriate
If you're helping a stranger, be mindful of appropriate physical boundaries. However, often the person experiencing the panic attack is a loved one. If so, and you have a close relationship, physical contact can help reassure them and make them feel better. You can offer them a hand to hold. Or ask them if they would like a hug.
Conclusion
Helping someone who is having a panic attack doesn’t require specialist training. With a basic understanding of what’s happening and how to usefully respond you can provide much needed support during a very frightening time. As long as you follow these simple steps, you will avoid making the situation worse, and be a source of support for the person experiencing the panic attack.