The most important thing you can do for someone having a panic attack is stay calm, stay present, and let them lead. A panic attack typically peaks within 10 minutes and lasts 5 to 20 minutes total, though some stretch longer. You can’t stop it instantly, but you can make the experience far less frightening for the person going through it.
What’s Happening in Their Body
A panic attack triggers the body’s fight-or-flight system. The brain floods the body with adrenaline and norepinephrine, chemicals designed to help someone escape danger. Heart rate spikes, breathing gets fast and shallow, muscles tense, and the person may feel dizzy, nauseated, or like they’re about to die. None of this is voluntary. The person isn’t choosing to panic, and they can’t simply decide to stop.
Understanding this matters because it shapes how you respond. Telling someone to “just calm down” fights against a powerful automatic response and tends to make things worse. Your role isn’t to fix the attack. It’s to be a steady, reassuring presence while their nervous system winds down on its own.
Step by Step: What to Do
Start by staying visibly calm yourself. If you look panicked, their brain reads that as confirmation that something is genuinely wrong. Take slow, deliberate breaths and keep your voice low and even.
Move them to a quieter spot if possible. Fewer people, less noise, and less stimulation all help. Ask what they need rather than assuming. Some people want you close; others need space. A simple “What do you need right now?” gives them a sense of control when everything feels out of control.
Speak in short, simple sentences. Be predictable and avoid sudden movements or surprises. Useful things to say include:
- “You’re not alone. I’m right here.”
- “You can get through this.”
- “There’s no pressure to feel okay right now.”
- “Tell me what you need.”
If they seem open to guidance, try matching your breathing to theirs and then gradually slowing yours down. Counting slowly to 10 together can also help. You can also ask them to do a simple physical task, like raising their arms overhead repeatedly. Physical movement can redirect the nervous system’s energy and break the feedback loop of panic.
Grounding Techniques You Can Walk Them Through
Grounding works by pulling the person’s attention out of their spiraling thoughts and anchoring it in the physical world around them. The most widely used method is the 5-4-3-2-1 technique, and you can guide someone through it conversationally.
Ask them to name five things they can see, then four things they can physically feel (their feet on the floor, the texture of their shirt), then three things they can hear, two things they can smell, and one thing they can taste. It doesn’t need to be perfect. Even getting partway through forces the brain to shift from internal alarm mode to processing external sensory information, which naturally dials down the panic response.
If the person can’t talk or focus enough for 5-4-3-2-1, try something simpler. Ask them to press their feet into the ground and describe what the floor feels like, or have them hold something cold like a water bottle and focus on the sensation.
Breathing Exercises That Help
Box breathing is one of the most effective techniques for panic because the structure gives the mind something concrete to follow. It works in four equal steps: breathe in for four seconds, hold for four seconds, breathe out for four seconds, hold for four seconds. Repeat the cycle.
One important note: don’t just tell the person to “focus on your breathing.” That phrase, on its own, can actually increase anxiety because it draws attention to how fast or shallow their breathing already is. Instead, breathe with them. Count out loud. Say “breathe in, two, three, four” and do it alongside them so they have a rhythm to follow rather than a vague instruction to decode while panicking.
Physical Touch: Always Ask First
Holding someone’s hand or putting a hand on their shoulder can be deeply grounding for some people and completely overwhelming for others. During a panic attack, sensory input is already turned up to maximum. Unexpected touch can feel like an intrusion.
Ask before you touch. Something like “Would it help if I held your hand?” respects their autonomy. If they say no, or if they ask you to leave, step back a few feet but stay nearby. Let them know you’ll come right back if they change their mind.
What Not to Say
Certain well-meaning responses consistently make panic attacks worse. Avoid phrases like “calm down,” “don’t worry,” “try to relax,” or “it’s all in your head.” These minimize what the person is experiencing and can increase feelings of shame or isolation on top of the panic itself.
Don’t tell them they’re overreacting or doing it for attention. Don’t suggest breathing into a paper bag, which is outdated advice that can actually reduce oxygen levels dangerously. And don’t push them to explain what triggered the attack. Many panic attacks have no identifiable trigger, and being asked “what’s wrong?” over and over can feel like pressure to justify something they can’t explain.
Patience is the key quality here. The attack will pass. Your job is to be steady and nonjudgmental until it does.
After the Attack Passes
Once the worst is over, the person will likely feel exhausted, shaky, or embarrassed. Don’t rush them back into whatever they were doing. Help them find a comfortable, quiet spot to sit for a while. Offer water. Let them set the pace for conversation.
In the hours and days that follow, gentle physical activity, adequate sleep, and avoiding stimulants like caffeine, alcohol, and nicotine can all reduce the chance of another episode. If you’re close to this person, checking in later without making a big deal of it (“Hey, how are you feeling today?”) goes a long way. It signals that what happened was okay and that you don’t think less of them for it.
When to Call 911
Panic attacks and heart attacks share several symptoms, including chest pain, shortness of breath, sweating, and nausea. If you’re not sure which one is happening, err on the side of calling for help.
Call 911 if:
- Chest pain or pressure lasts more than 10 minutes
- The person has never experienced anything like this before and symptoms aren’t fading
- They feel a squeezing or crushing sensation in the chest along with nausea or cold sweats
- Pain radiates down the arm, up to the jaw, or into the neck
A few differences can help you tell them apart. Panic attacks typically involve a racing or pounding heart and a sharp, intense chest pain that peaks quickly. Heart attacks more often feel like heavy pressure or squeezing that builds and doesn’t go away on its own. Panic attacks usually resolve within 20 minutes. Heart attack symptoms persist until the person gets medical treatment. But these distinctions aren’t always clear in the moment, and no one should feel bad about calling emergency services when they’re unsure. If the person is having chest pain, do not drive them to the hospital yourself. Call 911 so paramedics can intervene if something goes wrong en route.