If someone near you is having an anxiety attack or panic attack, the most important things you can do are stay calm, help them feel safe, and guide them through slow breathing. Most attacks peak within 10 to 20 minutes, though some symptoms can linger for an hour or more. Your steady presence during that window makes a real difference.
Recognize What’s Happening
An anxiety attack can look alarming from the outside. The person may be breathing rapidly, shaking, sweating, or clutching their chest. They might say they feel like they’re dying or losing control. Other common symptoms include dizziness, nausea, numbness or tingling in the hands, and a feeling of being detached from reality.
These symptoms can closely mimic a heart attack or other serious medical event, which often makes the fear worse. If the person has never experienced an episode like this before, or if they have chest pain and you’re unsure of the cause, treat it as a medical situation and call emergency services. But if they’ve had panic attacks before and recognize what’s happening, your role is to help them ride it out.
Make the Environment Feel Safe
Start by reducing stimulation around them. If you’re in a crowded or noisy space, gently suggest moving somewhere quieter. Give them physical space so they don’t feel crowded. If other people are standing around watching or making unhelpful comments, ask those people to step away.
Remove anything that’s obviously adding to their distress, whether that’s a loud TV, bright overhead lights you can dim, or a triggering conversation happening nearby. Do not grab, hold, or restrain them, and don’t touch them without asking first. Some people find a hand on their shoulder grounding; others find any touch overwhelming. Let them tell you what they need.
Keep Your Voice Calm and Simple
What you say matters less than how you say it. Speak slowly, in short sentences, with a steady tone. Too much talking can actually increase panic, so resist the urge to explain or reason through what’s happening. Instead, use brief, reassuring phrases:
- “You can get through this.”
- “What you’re feeling is scary, but it’s not dangerous.”
- “Tell me what you need right now.”
- “Concentrate on your breathing. Stay in the present.”
Avoid saying things like “just calm down,” “there’s nothing to be afraid of,” or “you’re overreacting.” These responses, even when well-intentioned, dismiss what the person is physically experiencing. Their body is in a genuine fight-or-flight response. The fear and the physical symptoms are real, even though there’s no external threat causing them.
Guide Them Through Breathing
Controlled breathing is one of the most effective tools during an attack because it directly counters what’s happening in the body. Rapid, shallow breathing fuels the cycle of panic by keeping the nervous system in high alert. Slow, deliberate breaths activate the body’s calming response, lowering heart rate and blood pressure.
Box breathing is a simple technique you can walk someone through in the moment. It works in four equal steps, each lasting about four seconds:
- Breathe in slowly for 4 seconds
- Hold that breath for 4 seconds
- Breathe out slowly for 4 seconds
- Hold again for 4 seconds
Repeat the cycle. Do it with them. Breathe audibly so they can match your rhythm. If counting to four feels too long, start with three seconds per step. The specific count matters less than the pattern of slow, even breathing.
Try a Grounding Exercise
If breathing alone isn’t cutting through the panic, a grounding technique can help pull their attention away from the spiral of anxious thoughts and back into their physical surroundings. The 5-4-3-2-1 method works by engaging each of the five senses, one at a time:
- 5 things they can see. Ask them to name five objects around them. A chair, a crack in the ceiling, their shoes, anything visible.
- 4 things they can touch. The texture of their jeans, the cool surface of a table, the ground under their feet, their own hair.
- 3 things they can hear. Traffic outside, the hum of a refrigerator, birds. Focus on sounds outside their body.
- 2 things they can smell. If nothing’s obvious nearby, suggest walking to a bathroom to smell soap, or stepping outside for fresh air.
- 1 thing they can taste. Gum, coffee, the lingering taste of their last meal, or just the taste of their own mouth.
You can walk them through each step by asking gently: “Can you tell me five things you see right now?” The goal isn’t to distract them from their feelings. It’s to anchor their mind in the present moment instead of letting it race through worst-case scenarios.
Stay Until It Passes
Most panic attacks peak within 10 to 20 minutes. The intense symptoms will fade on their own even without intervention. Your job isn’t to fix what’s happening. It’s to be a calm, patient presence while their nervous system settles back down.
After the worst passes, the person will likely feel exhausted, shaky, or emotionally drained. Some people feel embarrassed. Don’t rush them to get back to normal or immediately analyze what triggered the episode. A simple “I’m glad you’re feeling better” or “I’m proud of you, good job” goes further than you might expect. Let them set the pace for what comes next, whether that’s sitting quietly for a while, getting some water, or heading home.
When It’s a Medical Emergency
Two situations call for emergency help. First, if the person expresses any thoughts of hurting themselves or suicide during or after the attack, get them to an emergency room. Second, if this is a completely new experience for them, they’ve never had a panic attack before, and they’re hyperventilating with severe chest tightness or a feeling of impending death, call for medical help. Conditions like a blood clot in the lungs can produce symptoms that feel almost identical to a panic attack, including extreme anxiety, shortness of breath, and a sense that something is terribly wrong. A first-time episode with no history of anxiety warrants medical evaluation to rule out a physical cause.
For someone who has a known history of panic attacks, the episode itself isn’t medically dangerous, even though it feels that way. The body’s stress response is intense but temporary, and it won’t cause lasting physical harm.