Stay with the person, speak calmly, and help them slow their breathing. Most anxiety and panic attacks peak within minutes and resolve on their own, but the experience can feel terrifying for the person going through it. Your presence and a few simple techniques can make a real difference in how quickly they recover.
What’s Actually Happening in Their Body
When someone has an anxiety or panic attack, their nervous system has kicked into a full stress response, flooding the body with adrenaline. This causes a racing heart, rapid breathing, chest tightness, sweating, dizziness, and sometimes a feeling of losing control or dying. These sensations are intense but not dangerous. The body’s stress chemicals rise within minutes and typically resolve back to baseline within minutes to hours.
A quick note on terminology: “anxiety attack” isn’t a formal clinical diagnosis, while “panic attack” is. In everyday language, people use both terms. Panic attacks tend to hit suddenly and without warning, peaking within minutes. What people call anxiety attacks usually build gradually in response to stress and can last longer, persisting as long as the stressor remains. The steps below work for both.
Stay Calm and Say the Right Things
Your tone matters more than your words. Speak slowly and evenly. Avoid asking a lot of questions or telling them to “just relax” or “calm down,” which can feel dismissive when their body is in overdrive. Instead, use short, grounding phrases:
- “You can get through this.”
- “What you’re feeling is scary, but it’s not dangerous.”
- “Concentrate on your breathing. Stay in the present.”
- “Tell me what you need right now.”
Let them know you’re not going anywhere. If they can’t talk, that’s fine. Just being nearby and calm provides an anchor. Avoid touching them without asking first, as physical contact can feel overwhelming during an attack.
Guide Their Breathing
Hyperventilation fuels the cycle of panic. Slow, deep breathing activates the body’s calming branch of the nervous system, which directly counteracts the stress response by lowering heart rate and blood pressure. One effective method is the 4-7-8 technique:
- Breathe in through the nose for a count of 4.
- Hold the breath for a count of 7.
- Exhale slowly through the mouth for a count of 8, making a gentle whooshing sound.
The extended exhale is what does most of the work. Holding the breath briefly increases oxygen levels in the blood, which helps signal the nervous system to stand down. Don’t just tell them to do it. Breathe with them. Count out loud so they can follow your rhythm. Even two or three cycles can start to bring their heart rate down.
Try the 5-4-3-2-1 Grounding Technique
During an attack, the person’s mind is often spiraling through anxious thoughts about what’s happening or what might happen next. Grounding works by redirecting their attention to concrete, present-moment sensory input. Walk them through it one step at a time:
- 5 things they can see. Point them out if needed: a clock on the wall, the color of your shirt, a tree outside.
- 4 things they can touch. The texture of their clothing, the chair beneath them, the floor under their feet.
- 3 things they can hear. Traffic outside, a fan humming, birds.
- 2 things they can smell. If nothing is obvious, suggest they smell their sleeve or a nearby object.
- 1 thing they can taste. Gum, coffee, or just the taste already in their mouth.
This exercise pulls their focus out of their head and into the physical world around them. It doesn’t require any special tools, and you can guide someone through it anywhere.
Reduce Sensory Overload
If you can, move the person to a quieter space. A crowded, loud, or brightly lit environment adds fuel to an already overwhelmed nervous system. Turn down lights if possible. Step outside or into a hallway. If other people are hovering, gently ask them to give some space. The goal is fewer inputs for the brain to process, which makes the breathing and grounding techniques more effective.
Ask before making changes. Some people want to sit down; others need to pace. Some want a glass of cold water; others don’t want to hold anything. Let them guide you when they can.
How to Tell If It’s a Medical Emergency
Panic attacks can mimic heart attacks, and the overlap in symptoms is real: chest pain, shortness of breath, sweating, nausea. Here’s how to tell them apart.
Heart attack chest pain typically feels like pressure, squeezing, or something heavy sitting on the chest. It often radiates down one arm or up to the jaw and neck. It does not let up on its own. Panic attack chest pain tends to be sharper and more localized, and it fades as the attack passes, usually within 10 to 20 minutes.
A panic attack also tends to come with a noticeably racing or pounding heart, while a heart attack more often brings cold sweats and nausea without the sensation of the heart hammering. If chest pain or discomfort lasts longer than 10 minutes, call 911. When in doubt, always err on the side of calling. Emergency departments are equipped to rule out cardiac events quickly, and no one will fault you for being cautious.
There are also a few signs that anxiety symptoms could point to an underlying medical issue rather than a standalone panic disorder: new onset of anxiety symptoms after age 35, no personal or family history of anxiety, and no clear stressor triggering the episode. These patterns are worth mentioning to a doctor.
What to Do After the Attack Passes
Once the worst is over, the person will likely feel drained. An adrenaline surge takes a physical toll, and fatigue, muscle soreness, and emotional vulnerability are all normal in the aftermath. Don’t rush them back into whatever they were doing.
Offer water. Suggest a short walk if they’re up for it, as gentle movement helps burn off residual stress hormones. Keep conversation light or let them sit quietly. Avoid rehashing the attack in detail right away, though let them talk about it if they bring it up. Sometimes just saying “that looked really rough” is enough.
In the days that follow, encourage habits that reduce the likelihood of another attack: regular exercise (even 30 minutes of walking most days makes a measurable difference), consistent sleep, and cutting back on caffeine, alcohol, and nicotine, all of which can lower the threshold for another episode. Relaxation practices for 10 to 20 minutes a day, whether that’s deep breathing, progressive muscle relaxation, or just sitting quietly with calming music, help retrain the nervous system over time.
If someone is having repeated attacks, or if a single attack was severe enough to feel life-threatening, talking to a therapist or doctor is a logical next step. Panic disorder responds well to treatment, and most people see significant improvement once they have professional support.