A Guide to Helping Yourself (and Others) Through a Panic Attack

Anxiety is a fairly constant factor in my life right now, and the same is true for many people. When this is the case, we have two choices: we can let it control us or try to take control of it. Because I don’t not want to spend the next six months in my bedroom, I’m keen on the latter.

But, this does mean facing the reality of panic attacks fairly regularly. I’m lucky to have many friends and colleagues who want to support me, but perhaps don’t know how. This post is to help both me and them understand the best steps to take to manage panic attacks.

As always, this advice won’t apply to everyone. Although my background is in child and adolescent mental health, use the following as a starting point. I welcome any additional suggestions, advice or ideas you have to share – please leave them as a comment below.

Here’s my guide to helping yourself (and others) get through a panic attack:

1. Take preventative action.

Sometimes panic comes from nowhere, but sometimes we can feel it building up. If you can feel an attack coming on, preventative steps you could try are:

• Being open and honest with a trusted friend or colleague and asking for their support preceding an attack.
• Taking active measures to use calming and relaxation strategies to try to control the underlying level of panic.
• Identifying and talking through the underlying feelings and sources of panic.
• Acknowledging that an attack may not be preventable, but reminding yourself it doesn’t last forever.
• Proactively considering where is the best place to be, and who is the best person to be with, if an attack takes grip.

If you’re a loved one of someone about to have a panic attack, some useful things to say are:

• “I’m happy to listen if you’d like to talk about it.”
• “Are you able to explain how you’re feeling?”
• “Is there anything I can do to help you feel calmer?”
• “Is there somewhere we can go that you’d feel more comfortable?”
• “Is there anything specific I can do to help you if you do have a panic attack?”
• “I’m here for you and will stay with you until these feelings pass.”
• “You’re going to be OK. I’ll make sure you’re safe.”
• “You’re being really brave.”
• “Are you happy for me to be here or is there someone else you’d prefer?”

2. Ride it out. 

If a panic attack sets in, there’s sometimes little you can do except to ride it out. The length of the attacks might vary, but they will not last forever. No matter how many times you experience a panic attack each feels completely unbearable, but remember – you’ve got through it before, you’ll get through it again.

A good strategy is to try to manage your panic one minute at a time. You only need to get through the next minute. Focus on this and remember that with each passing minute, you are a minute closer to the end of the attack. 

If you’re a loved one of someone having a panic attack, some useful things to say are:

• “This will pass.”
• “I understand this is horrible, but you’ve got through it before, you’ll get through it again.”
• “You’re going to be OK.”
• “I’m here. I’m staying with you.”
• “I’ll keep you safe.”
• “Let’s take this one minute at a time.”
• “Let’s focus on getting through the next 60 seconds.”
• “Your body can’t sustain this indefinitely, it will pass.”
• “We’re another minute closer to you feeling calmer again.”

3. Stay grounded.

At their peak, my panic attacks can give way to derealization – a feeling of losing grip of who and where I am. Many others experience this to some degree, too. To prevent this, it can be useful to stay grounded and connected with reality.

Things I find useful are:

• Having someone talk to me – either in person or on the phone (I find it helpful to be talked to, other people might prefer to do the talking.)
• Being held or touched – a hand on my arm, having my hands held or being hugged really help me stay connected with another person and helps to ground me.

If your loved one is experiencing derealization, you can encourage your friend to try:

• Touching something warm or cold and focusing on the warmth or cold.
• Pinching herself so she can feel she is real.
• Trying to find a single object and identifying what it is and what he knows about it.
• Counting something in the room.
• Utilizing senses in any way possible.

4. Use relaxation techniques and skills.

There are a range of skills we can employ to help us feel calmer and more relaxed. These skills often work best if we practice them at times of calm so that we’re better able to access them at moments of panic.

Different things work for different people, but useful relaxation and calming techniques might include:

• Breathing techniques
• Listening to relaxing music
• Walking with purpose
• Guided meditation/mindfulness
• Muscle relaxation

How to help a friend use relaxation techniques:

One of the most helpful ways to help a friend is to understand what tools and skills they have for managing moments of high stress. No matter how well your friend learns their skills, it’s possible that during a panic attack they may forget to use them or struggle to employ them. So during calmer periods, ask your friend to explain these skills to you and discuss how you can help your friend utilize them during times of higher anxiety.

With a good knowledge of the basics, you’ll be in a good position to help. You may even find the new skills are useful for you, too.

Anxiety and panic are very difficult to live with and can be completely debilitating. If you or someone you know is affected, there’s no need to suffer in silence; instead, seek help from your doctor who can suggest local sources of support. This might include medication, talking, or skills therapies. Don’t be afraid to give these things a try. They can make a huge difference once given time to establish.