The most important thing you can do for someone having a panic attack is stay calm, stay present, and let them know they’re safe. Panic attacks typically last 5 to 20 minutes, with symptoms peaking around the 10-minute mark before fading. That window can feel eternal for the person experiencing it, but your steady presence makes a real difference in how quickly they come through it.
What’s Happening in Their Body
During a panic attack, the brain’s threat-detection center fires an emergency signal that activates the fight-or-flight response, even when there’s no actual danger. The brain essentially skips its normal processing steps and floods the body with stress hormones as if a real threat were present. This produces a cascade of physical symptoms: racing heart, rapid breathing, sweating, chest tightness, dizziness, tingling in the hands, and sometimes a feeling of detachment from reality.
The person isn’t choosing to react this way, and they can’t simply decide to stop it. Their nervous system has taken the controls. Understanding this helps you respond with patience rather than frustration, which is exactly what they need from you.
What to Say (and What Not To)
Keep your language simple and grounding. Short, clear statements work best: “You are not alone,” “I’m right here,” and “This will pass.” Asking “How can I help?” gives them some sense of control in a moment when everything feels out of control. Speak slowly and in a low, even tone.
Avoid anything that sounds dismissive or corrective. Phrases like “just calm down,” “there’s nothing to worry about,” or “you’re overreacting” feel unsympathetic even when you mean well, and they can actually intensify the panic. The person already knows, on some level, that the danger isn’t real. That knowledge doesn’t help them stop it, and being reminded of it can add shame to an already overwhelming experience. Don’t ask a lot of questions or try to problem-solve in the moment. Just be there.
Guide Their Breathing
Hyperventilation is one of the most distressing parts of a panic attack, and it feeds the cycle by making dizziness and tingling worse. If the person is open to it, guide them through box breathing: breathe in slowly for a count of 4, hold for 4, breathe out for 4, hold again for 4. Repeat this cycle several times.
Do the breathing with them rather than just giving instructions. Exaggerate your own breaths so they can see and hear the rhythm. If counting feels like too much, simply say “breathe in” and “breathe out” at a slow, steady pace. Some people find it easier to focus on making the exhale longer than the inhale, which naturally slows the heart rate. Don’t force it if they resist. Not everyone wants to be coached through breathing, and that’s fine.
Try the 5-4-3-2-1 Grounding Technique
Grounding works by pulling attention away from the internal spiral and anchoring it to the physical world. The 5-4-3-2-1 method walks through each sense, one at a time. You can talk the person through it once their breathing has started to settle, or even while they’re still in the thick of it.
Ask them to name five things they can see around them. Then four things they can physically touch, like the fabric of a chair or the ground under their feet. Next, three things they can hear, even something as subtle as an air conditioner or their own breathing. Then two things they can smell. If nothing is obvious, suggest walking a few steps to find a scent: soap, fresh air, a candle. Finally, one thing they can taste, even if it’s just the lingering flavor of coffee or toothpaste.
The specific answers don’t matter. What matters is that naming concrete sensory details forces the brain to engage its rational processing centers, which helps interrupt the fear loop. You can make it conversational: “What can you see right now? Tell me five things.” Keep your voice calm and unhurried.
Practical Things to Do Around Them
If you’re indoors, open a window or move to a less crowded space. Cool air on the face can help counteract the flushing and overheating that comes with the fight-or-flight response. Offer a glass of cold water. Reduce noise and stimulation where you can.
Ask before you touch them. A hand on the shoulder or a hug might feel comforting to some people and claustrophobic to others, especially mid-attack. A simple “Would it help if I held your hand?” lets them decide. If they say no or pull away, don’t take it personally.
Don’t leave them alone unless they specifically ask you to. Even if they can’t talk or make eye contact, your quiet presence is an anchor. Sit nearby, match their level (if they’re on the floor, sit on the floor), and wait. Sometimes the most powerful thing you can do is simply not panic yourself.
When to Call 911
Panic attack symptoms overlap significantly with heart attack symptoms, and it’s not always obvious which one is happening. A few key differences can help you decide. Panic attacks tend to produce sharp, intense chest pain that responds to deep breathing and calms down within 10 to 20 minutes. Heart attacks more often cause a pressure, squeezing, or heavy sensation in the chest, sometimes described as something sitting on it.
Call 911 if chest pain or pressure lasts longer than 10 minutes without improving, especially if it comes with nausea or drenching sweats. Call if this is a brand-new symptom the person has never experienced before and it isn’t easing up. A panic attack is a finite event that resolves on its own. A heart attack will not get better without medical treatment. When in doubt, always err on the side of calling for help.
Supporting Them After It Passes
A panic attack doesn’t just end and disappear. Many people experience what’s sometimes called a “panic hangover,” a period of deep fatigue, mental fog, muscle soreness, and emotional vulnerability that can last hours. The adrenaline surge takes a real physical toll, and the person may feel wiped out or embarrassed afterward.
Don’t immediately debrief or analyze what happened unless they want to. Some people need to talk it through, and that can actually help them identify what triggered the episode. Others just need quiet. Follow their lead. Offer a low-key next step: a short walk outside, some gentle stretching, a cup of tea, or simply sitting together watching something familiar. Light movement helps stabilize mood by improving blood flow and releasing endorphins, but keep it gentle. If they’re exhausted, a short nap can help restore energy.
In the days that follow, check in without making it a big deal. A simple “How are you doing?” signals that you care without treating them like they’re fragile. If panic attacks are happening repeatedly, gently encourage them to explore options with a therapist who specializes in anxiety. Panic disorder is highly treatable, and recurring attacks don’t have to become a permanent part of someone’s life.