The most important thing you can do for someone having a panic attack is stay with them and stay calm. Panic attacks typically last 5 to 20 minutes, with symptoms peaking around the 10-minute mark before fading. Your job isn’t to fix what’s happening. It’s to be a steady, reassuring presence while their body’s alarm system winds itself back down.
What’s Happening in Their Body
A panic attack triggers the same fight-or-flight response the body uses when facing real physical danger. Heart rate and breathing speed up dramatically, as if the person were preparing to run from a threat. But there is no threat. The body is misfiring, flooding itself with stress hormones and creating a cascade of terrifying symptoms: chest pain, dizziness, tingling in the hands, shortness of breath, nausea, and a feeling of losing control or even dying.
The person knows, on some level, that they’re not in danger. But their body is telling them otherwise, and in that moment the body’s signals are louder than logic. Understanding this helps you respond with patience rather than frustration. They can’t just “snap out of it” any more than you could will your heart to slow down mid-sprint.
Your First Steps
Move quickly through these priorities in order:
- Stay and stay calm. Your composure is contagious. If you look worried, it confirms their fear that something is seriously wrong.
- Move them somewhere quieter. If you’re in a crowded or noisy place, guide them to a calmer spot. Less stimulation gives their nervous system less to process.
- Ask what they need. Some people want to be talked through it. Others want space. A simple “What do you need right now?” respects their experience instead of assuming.
- Speak in short, simple sentences. Their brain is overwhelmed. Long explanations won’t register. Keep your words direct and easy to follow.
- Be predictable. Avoid sudden movements, loud sounds, or surprises. Tell them what you’re going to do before you do it.
If the person has had panic attacks before, ask what has helped them in the past. They may already have a strategy that works for them, and following their lead is almost always better than introducing something unfamiliar.
What to Say (and What Not To)
The right words can cut through panic. The wrong ones make it worse. Phrases like “calm down,” “it’s all in your head,” or “you’re overreacting” dismiss what the person is feeling and can intensify their distress. Even well-meaning reassurances like “there’s nothing to worry about” can feel invalidating when their entire body is screaming otherwise.
Instead, try phrases that acknowledge the experience while reinforcing safety:
- “I’m here with you.”
- “You can get through this.”
- “Tell me what you need in this moment.”
- “This will pass. You’re safe.”
Keep your tone steady and warm. You don’t need to narrate everything or fill every silence. Sometimes just sitting next to someone, matching their breathing rhythm, and quietly repeating “I’m right here” is enough.
Help Them Slow Their Breathing
Hyperventilation is one of the most distressing parts of a panic attack, and it creates a vicious cycle. Rapid, shallow breathing lowers carbon dioxide levels in the blood, which causes tingling, dizziness, and lightheadedness, all of which make the panic feel worse. Slowing the breath interrupts that cycle by activating the body’s relaxation response.
Box breathing is one of the simplest techniques to walk someone through. Tell them you’re going to breathe together, then count out loud:
- Breathe in slowly for a count of 4
- Hold for a count of 4
- Breathe out slowly through the mouth for a count of 4
- Hold again for a count of 4
- Repeat
Don’t pressure them to get it perfect. Say something like, “We’re going to focus on breathing right now. Just do your best to take a slow breath in through your nose.” Breathing with them, visibly and audibly, gives them a rhythm to match. If they can’t manage the holds at first, that’s fine. Even shifting from gasping to slightly slower exhales helps.
Try a Grounding Technique
Grounding works by pulling attention out of the spiral of fear and anchoring it to the physical world. The 5-4-3-2-1 method is the most widely used version, and you can talk someone through it step by step. Ask them to name:
- 5 things they can see (a pen, a ceiling tile, a tree outside)
- 4 things they can touch (their hair, the fabric of a chair, the ground under their feet)
- 3 things they can hear (traffic, a fan, voices in another room)
- 2 things they can smell
- 1 thing they can taste (gum, coffee, the inside of their mouth)
You can also try simpler physical grounding if the countdown feels like too much. Ask them to press their feet firmly into the floor and describe how it feels, or have them raise their arms overhead and lower them slowly. Repetitive physical tasks give the brain something concrete to focus on, which competes with the panic for attention. Other options: counting backward from 100 by threes, naming every red object in the room, or describing a favorite place in detail.
After the Attack Passes
When the worst is over, the person will likely feel drained. Panic attacks are physically exhausting. Muscles that were tensed for minutes need to unclench, adrenaline needs to clear the bloodstream, and the emotional toll can leave someone feeling embarrassed, fragile, or shaken for a while afterward.
Don’t rush them back into whatever they were doing. Offer water. Sit with them. Let them set the pace. Some people want to talk about what happened, while others would rather have a normal conversation about something completely unrelated. Both are valid ways of recovering. Simply chatting about everyday things can help a person feel reconnected to normal life as their symptoms fade.
Resist the urge to analyze or problem-solve in the immediate aftermath. Saying “have you thought about therapy?” five minutes after a panic attack isn’t helpful, even if it comes from a caring place. Save that conversation for a calmer day. Right now, the most supportive thing you can do is normalize what happened without making it a bigger deal than they want it to be.
When It Might Not Be a Panic Attack
Panic attacks and heart attacks share several symptoms, including chest pain, shortness of breath, and a sense that something is terribly wrong. Knowing the differences matters, especially if the person has never experienced a panic attack before.
With a panic attack, chest pain tends to stay in the chest and often feels sharp or stabbing. It peaks within minutes and fades. With a heart attack, pain typically radiates to the arm, jaw, or neck. It feels more like pressure or squeezing, and it doesn’t go away. It may fluctuate in intensity, dropping and then surging back, but the pain persists. Heart attacks also tend to follow physical exertion like climbing stairs or heavy lifting, while panic attacks are more often tied to emotional triggers or come out of nowhere.
If the person has never had a panic attack before and suddenly becomes severely short of breath and anxious, take it seriously. Conditions like a blood clot in the lungs can mimic the feeling of a panic attack, including the overwhelming sense that something is very wrong. A first-time episode with no clear emotional trigger warrants emergency care. The same is true if the person expresses any thoughts of self-harm.
Supporting Someone Who Gets Panic Attacks Regularly
If someone in your life has recurring panic attacks, the most helpful thing you can do between episodes is learn their patterns. Ask them, during a calm moment, what they want you to do when an attack happens. Some people have specific techniques that work for them. Others just want someone nearby who won’t make a fuss. Having that conversation in advance means you won’t be guessing in the moment.
Avoid tiptoeing around the person or treating them as fragile. People with panic disorder often feel ashamed of their attacks, and being treated differently only reinforces the idea that something is fundamentally wrong with them. What helps most is consistency: being the same steady, nonjudgmental person whether they’re mid-attack or perfectly fine.