Addressing panic attacks
When panic attacks occur, you might think you're losing control, having a heart attack, or even dying. The good news is these symptoms are not life-threatening and usually fade on their own.
A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause.
When someone is experiencing a panic attack, their body's "fight or flight" response (the sympathetic nervous system) has taken over, even though there is no immediate physical danger. This leads to a flood of adrenaline, rapid heart rate, and a sense of losing control. During an attack, which can last from minutes to over an hour, a person may experience a racing heart and chest pain, shortness of breath or dizziness, trembling, sweating, or chills, or numbness in the hands or stomach pain.
The steps listed below work to de-escalate the nervous system and move the person back into their "rational" brain. Here is the breakdown of why each step works and what you can say to help someone through their crisis:
1. Reassure and support
During a panic attack, the brain's "amygdala" triggers a false alarm, making the person feel like they are dying or in immediate danger. Asking simple questions can help pull them out of the "impending doom" sensation.
What to say:
"I am here with you. You are safe."
"I’m [Your Name]. What is your name?"
"What do you need in this moment?"
"Do you have medicine you usually take for this?"
2. Breathe & reset
Panic causes physical symptoms like a racing heart and shallow breathing (hyperventilation), which can lead to lightheadedness and more fear. Slowing the breath can help lower the heart rate. Ice provides a "thermal shock" that forces the brain to redirect its attention to a new sensation, while movement helps burn off the adrenaline surge causing the physical jitters.
What to say:
"Let’s breathe together. Breathe in... and out. We will count down from 10."
"Can you grab a piece of ice? Hold it in your hand or touch it to your wrist."
"Would you like to stand up and stretch or take a short walk while we talk?"
3. Ground the senses (5-4-3-2-1)
Panic often involves "dissociation," where the person feels detached from reality or trapped inside their own terrifying thoughts. By forcing the brain to identify specific external sensory details, you move the person's focus from their internal panic back into the physical world. It re-engages the prefrontal cortex, the "rational" part of the brain.
What to say:
"Tell me what you notice right now:"
5 things you see (Name them out loud).
4 things you hear (Listen closely).
3 things you can touch (What does the texture feel like?).
2 things you smell (Your coffee, the air, your clothes).
1 thing you can taste (A piece of candy or just the inside of your mouth).
4. Shift the focus
Even after the attack passes, the brain remains in a high-alert state, making a relapse into panic possible. Positive visualization encourages the production of calming neurochemicals like dopamine and serotonin. By asking detailed questions about a "happy place," you occupy the brain's "processing power" with peaceful imagery, leaving less room for anxious thoughts to return.
What to say:
"Tell me about your favorite place. What colors do you see there?"
"Who is with you? How does the air feel on your skin?"
5. Offer encouragement
The end of a panic attack often leaves a person feeling exhausted, embarrassed, or vulnerable. Validation removes the stigma and shame often associated with panic attacks. By praising their effort, you build their "self-efficacy"—the belief that they can survive this again.
What to say:
"You did a great job getting through that."
"I am really glad you reached out to me today."
Using any or all of these tips, you can help someone overcome a panic attack. If you notice one method is more successful than another, stick with that. Don’t give up. It might take a few attempts before grounding methods are successful. For frequent, unexpected panic attacks, consult a mental health professional for diagnosis and treatment.
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