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 peak within 10 minutes and resolve on their own, but those minutes can feel terrifying for the person experiencing one. Your steady presence makes a real difference in how quickly they move through it.
Recognizing a Panic Attack
Panic attacks can look different from person to person, but the physical signs are usually visible. You might notice rapid or heavy breathing, trembling hands, sweating, or sudden paleness. The person may clutch their chest, seem dizzy or unsteady, or say they feel numb or tingly in their hands. Some people go very still and quiet; others pace or seem agitated.
What’s happening inside their body is essentially a false alarm. A small region in the brainstem that controls breathing, heart rate, and body temperature fires off a cascade of stress signals. The result is a flood of adrenaline that produces real, intense physical symptoms: pounding heart, shortness of breath, chest tightness, nausea, chills. The person isn’t imagining these sensations. Their body is genuinely in emergency mode, even though there’s no actual danger.
What to Say (and What Not to Say)
Keep your language short, simple, and calm. Long explanations or complex questions will bounce off someone whose brain is in survival mode. Speak in brief sentences, and be predictable. Avoid sudden movements or surprises.
Phrases that help:
- “You can get through this.” Simple reassurance that this will end.
- “Focus on your breathing. Stay in the present.” Gives them one concrete thing to do.
- “What you’re feeling is scary, but it’s not dangerous.” Acknowledges their fear without dismissing it.
- “Tell me what you need right now.” Gives them a sense of control.
Avoid saying “just calm down,” “there’s nothing to worry about,” or “you’re overreacting.” These phrases invalidate what they’re going through and can make the panic worse. You don’t need to fix what’s happening. You need to be a steady anchor while it passes.
Walk Them Through Breathing
Hyperventilation is one of the most common features of a panic attack, and it fuels a vicious cycle: fast, shallow breathing lowers carbon dioxide levels, which causes more dizziness, tingling, and chest tightness, which makes the person breathe even faster. Slowing their breathing can interrupt that loop.
Ask them to breathe with you. Inhale slowly through your nose for four counts, hold for a moment, then exhale through your mouth for four to six counts. Do it visibly so they can mirror you. Don’t force it if they can’t match you right away. Even slightly slower breaths will help. If counting feels like too much, just say “in” and “out” at a calm pace and let them follow your lead.
Try a Grounding Technique
Grounding works by pulling attention out of the spiral of fear and into the physical world. The most widely recommended method is the 5-4-3-2-1 technique, which walks through each sense one at a time. You can guide someone through it conversationally:
- 5 things they can see. Ask them to name five objects around them. A chair, a light, a crack in the ceiling. Anything visible.
- 4 things they can touch. Have them feel the texture of their shirt, the ground under their feet, a wall, their own hair.
- 3 things they can hear. Traffic outside, the hum of a fan, their own breathing.
- 2 things they can smell. This might mean walking them toward soap, fresh air, or coffee.
- 1 thing they can taste. Gum, water, or even just the taste already in their mouth.
You don’t need to be rigid about it. The point is to gently redirect their focus from the internal alarm to the external world. Some people respond better to a single strong sensation, like holding an ice cube, splashing cold water on their wrists, or pressing their feet firmly into the floor.
Know When It Might Not Be a Panic Attack
Panic attacks and heart attacks share several symptoms, including chest pain, shortness of breath, and sweating. If the person has never had a panic attack before, or if something feels different this time, it’s worth knowing how to tell them apart.
With a panic attack, chest pain generally stays in the chest. With a heart attack, pain often radiates to the arm, jaw, or neck. Panic attack symptoms typically peak within minutes and then fade, resolving within an hour at most. Heart attack pain doesn’t go away. It may fluctuate in intensity, dropping and then surging back, but it persists. If the person is over 40, has heart disease risk factors, or describes pain that spreads beyond the chest and won’t let up, call emergency services. It’s always better to be wrong about a heart attack than to miss one.
What to Do Once the Attack Passes
When the worst is over, the person will likely feel drained. Panic attacks burn through a lot of adrenaline, and the aftermath often includes exhaustion, muscle soreness, and emotional vulnerability. Some people feel embarrassed or frustrated with themselves. Resist the urge to immediately analyze what happened or ask a lot of questions.
Instead, keep things low-key. Offer water. If you’re in a crowded place, suggest moving somewhere quieter. Let them set the pace for conversation. A simple “I’m glad you’re feeling better” or “That looked really rough, you handled it” goes further than a debrief.
In the hours and days after, gentle physical activity like a walk, light stretching, or even a warm bath can help release residual tension. Encourage them to avoid caffeine, alcohol, and nicotine, all of which can heighten anxiety and lower the threshold for another attack. Rest matters too. Sleep deprivation is a reliable anxiety trigger, so the night after a panic attack is a good time to prioritize a full night’s sleep.
If It Keeps Happening
A single panic attack doesn’t necessarily mean someone has panic disorder. But when attacks become recurrent, or when the fear of having another attack starts limiting someone’s daily life (avoiding certain places, refusing to drive, not wanting to be alone), that pattern has a name and effective treatments exist for it.
Cognitive behavioral therapy is the most well-studied treatment for panic disorder and has strong success rates. It works by helping people recognize that the physical sensations of panic, while frightening, aren’t dangerous, and by gradually reducing the avoidance behaviors that keep the cycle going. Some people also benefit from medication that reduces the frequency or intensity of attacks.
If someone you care about is having repeated panic attacks, the most helpful thing you can do beyond being present during an episode is to normalize getting professional support. Many people with panic disorder wait years before seeking help, often because they feel they should be able to handle it on their own. Letting them know that treatment works, and that panic disorder is one of the most treatable anxiety conditions, can be the nudge that makes the difference.