How do I help someone experiencing a panic attack?

Note: NAMI volunteers are not medical or mental health professionals, and we cannot offer medical or mental health advice.  The material outlined below is informational and we hope that it helps provide guidance toward getting support.

When a person experiences a panic attack, there are things you can do and ways to help that will guide them through the attack and renormalize their physical state. Below you'll find strategies to help during a panic attack and long-term tips for managing a panic disorder. 

Panic Disorder is an anxiety disorder characterized by panic attacks and sudden feelings of terror sometimes striking repeatedly and without warning.  Often mistaken for a heart attack, a panic attack causes powerful physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset.  Many people will go to great lengths to avoid an attack, including social isolation.  

For further information, you may wish to consult the Anxiety Disorders page of NAMI’s website where you will find more on the condition, current treatments, and ways to support recovery. Anxiety disorders are a group of related conditions, each having unique symptoms.   However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not life-threatening.  People typically experience one or more of the following symptoms:

Emotional symptoms:

• Feelings of apprehension or dread
• Feeling tense or jumpy
• Restlessness or irritability
• Anticipating the worst and being watchful for signs of danger

Physical symptoms:

• Pounding or racing heart and shortness of breath
• Sweating, tremors and twitches
• Headaches, fatigue and insomnia
• Upset stomach, frequent urination or diarrhea

Using the Diagnostic and Statistical Manual of Mental Disorders (DSM) a mental health professional can identify the specific type of anxiety disorder causing symptoms as well as any other possible disorders that may be involved.  Tackling all disorders through comprehensive treatment is the best recovery strategy.

Helping to Manage a Panic Attack

We have outlined a few options to help a loved one reach a state of calm while experiencing a panic attack. Please know that NAMI does not endorse any particular suggestion provided below.  If someone you know is experiencing a panic attack, they may become very anxious and might not be thinking clearly.  You may be able to help them by doing the following: 

• Stay in communication with them; speak calmly and gently in short, simple sentences. 
• Ask if there is medicine the person usually takes during a panic attack.
• Don't make assumptions about what your loved one needs, ask them.
• Help your loved one slow their breathing by breathing with them. Speaking slowly in a reassuring tone, say: “We’re going to focus on your breathing right now. Just do your best to take a slow, deep breath in through your nose. Hold that breath for a moment…  Now slowly exhale through your mouth. Now another slow, deep breath in. Hold it… And again, slowly exhale through your mouth.” 
• If the panic attack continues, ask: “Has this happened to you in the past? What has helped you in the past?” 
• If your loved one is unable to identify what has worked in the past, offer help in a way that gives them agency.  Example: “I know a technique that helps with panic attacks.  Would you like to try the technique with me?”

8 Self-Help/Grounding Strategies for a Loved One Experiencing a Panic Attack

• Use one intervention at a time; move through it slowly & calmly, allowing some time for each step to take effect.
• Panic attacks start rapidly but resolve more slowly. Commit to a technique for a period, rather than jumping rapidly from one to the next. Your goal is to create a feeling of serenity and calm during the interaction.
• Some people prefer not to focus on their breathing; if so, try a strategy related to movement or visualization.

Counting Slowly count backwards from 10  

5-4-3-2-1 Grounding Technique This method uses the 5 senses to create mindfulness & calm anxious thoughts. Try this script:  

• Vision. Describe 5 separate objects you can see nearby (color, shape, etc.), one at a time.  
• Hearing. Name 4 distinct sounds you can hear nearby. Describe where each one came from. What sets each one apart? (Ex: wind blowing, passing cars, conversations, dog barking)  
• Touch.  Touch 3 nearby objects, one at a time. For each one, describe its texture, temperature, and what it’s used for. 
• Smell. Identify 2 different things you can smell (ex: soap, car exhaust, laundry detergent on clothes). 
• Taste. Name 1 thing you can taste (ex: coffee, something you recently ate, or try drinking a glass of cold water). 

Ice Suggest they try placing an ice cube against their wrists or face for a few moments.

Movement Suggest taking a walk together outside or stretching.

Numbers Try a few simple math problems (1+1 is…, 1+2 is…) or recite times tables (2x1 is…, 2x2 is…) 

Fist Clench This method uses visualization to calm anxious thoughts. 

• “Clench your hands into fists.  As you do this, visualize gripping all the negative and nervous energy in your hands. Squeeze as hard as you can, then let go, and notice how your body feels as you release the tension. (If your loved one seems to be responding, continue) “Let’s try this a few times in a row.” 

Grounding Chair This method uses visualization to calm anxious thoughts. Try this script: “Think about where you’re seated right now. Think about how it feels as you sit, and how your body fits into your seat. Lightly press the soles of your feet against the floor as you relax into your seat, allowing your seat and the floor to support you. Visualize all the negative and nervous energy flowing out through your feet and onto the floor.” 

Happy Place This method uses visualization to calm anxious thoughts. Try this script: “Visualize your favorite place: Use all your senses to create a mental image. Think of the colors you see, sounds you hear, and sensations you feel on your skin. Remember the last time you were there. Who were you with, if anyone? What did you do there? How did you feel?” 

Wrap-up with some encouragement 

• “I’m grateful that you reached out to me for support.”  
• “I’m glad you’re doing better.” 

By following these simple suggestions, you may be able to reduce the amount of stress in this very stressful situation, prevent the situation from getting worse, and may help put some control back into a confusing situation.  

Long-term Tips to Manage Panic Disorder

Learn about your loved one’s triggers, stressors and symptoms.  By being informed and aware, you may help prevent an increase in symptoms.  Look for things like rapid breathing, fidgeting or avoidance behaviors.  Discuss your friend or family member’s past experiences with them so they can recognize the signs early as well. Below are helpful suggestions:

• Play a role in treatment. Increasingly, mental health professionals are recommending couple or family-based treatment programs. And on occasion, a therapist might enlist a loved one to help reinforce behavior modification techniques with homework. Ultimately, the work involved in recovery is the responsibility of the person with the disorder, but you can play an active, supportive role.
• Communicate. Speak honestly and kindly. Make specific offers of help and follow through. Tell the person you care about her. Ask how she feels and don’t judge her for her anxious thoughts.
• Allow time for recovery. Understanding and patience need to be balanced with pushing for progress and your expectations.
• React calmly and rationally. Even if your loved one is in a crisis, it’s important to remain calm. Listen to him and make him feel understood, then take the next step in getting help.

Find out more about taking care of your family member or friend (without forgetting about yourself!).

• Anxiety & Depression Association of America (ADAA) offers in-depth information on anxiety, depression, OCD, and PTSD and co-occurring disorders, including treatment, resources, and support group information. Through the ADAA Support Group Locator you can search for in-person and online support groups that focus on support for individuals as well as families of those living with the condition. In addition, you can view the ADAA’s section on recommended mobile apps at www.adaa.org/findinghelp/mobile-apps.
• The Anxiety Network provides online resources and information on panic disorder, generalized anxiety disorder and social anxiety disorder. They also offer recommendations for anxiety therapy materials.
• Phobias Awareness is a free, online community forum for people experiencing anxiety to connect with others to gain support and learn coping techniques. 
• Student Tele-Health, (888) 247-5767, is a student benefit-based program that provides mental health access to counseling, therapy, and psychiatric services via web-based technology, 24/7. Designed to assist and support campus counseling services for students who experience symptoms of depression, anxiety, panic attacks, PTSD and other mental health diagnoses. Currently serving students at the following HCBUs: Edward Waters College, Jarvis Christian College, J.F. Drake Community & Technical College, Morris Brown College, Paine College, Shorter College, Voorhees College.
• (App) MindShift: (Apple and Android; Free) App developed in conjunction with Anxiety Canada that helps adolescents, teens and young adults gain learn basic skills to manage their symptoms of anxiety, including GAD, social anxiety, phobias and panic attacks. Also useful for managing worry, performance anxiety, test anxiety and perfectionism. Utilizes breathing exercises, mental imagery and mindfulness strategies in text and audio format. “Quick Tips” are included to assist with anxiety in the moment.

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