Panic attack – supporting somebody

This depends on how well you know the person and whether you've seen a panic attack before. You might get a clue to what is happening if you have seen signs of the person getting more and more anxious or agitated, especially if you can see a trigger for anxiety, eg, an argument or difficult work meeting. They may start breathing faster, sweating, shaking or holding their chest. They may stop talking or talk strangely.

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You can't be sure that this a panic attack unless the person tells you so, or if you know them well and they've told you before that they have panic attacks.

Don’t assume that a panic attack is what is happening. A person having a heart attack can look like a person having a panic attack.

If someone is having difficulty breathing or has collapsed, call 111.

If you know that this is a panic attack, there are things you can do to help:

• Make a calm space.
• Breathe.
• Listen.
• Check on them later.

Read more in the sections below.  

• Stay calm yourself. Your calm will help them to gradually become calmer.
• Help them to a quiet private place. Noise, bright light and people staring or asking questions can make them feel worse.
• 1 or 2 people helping is best. If others are helping, it may be that the best thing you can do is leave.
• Understand that they can't think logically or follow complicated directions right now.

• Breathe slowly and deeply together – you can even count aloud, or move your arm up and down (as a music conductor does) so you can both breathe in time to the arm movement. See the video below for a square breathing exercise to help you relax.
• Note that breathing into a paper bag doesn't help and can be dangerous.
  
  

Video: Guided square breathing exercise in 2 minutes

You can guide them through a mindfulness exercise to help them focus on themselves and their senses. It's called the 5–4–3–2–1 grounding technique.

In brief, encourage them to think about or name:

• 5 things they can see
• 4 things they can feel
• 3 things they can hear
• 2 things they can smell
• 1 thing they can taste.

Read more about this approach to becoming calm at Very Well Mind(external link). 

• Listen to what they say without trying to solve any problems.
• Even though you're trying to help, it’s not helpful to tell them to calm down, or to pull themselves together, or compare their experience to yours.
• It can help to encourage them to stamp their feet on the ground (you can to it together) which reminds them of the world around them.
• You could try talking about something that interests you both outside of the situation that’s happening at the moment. This acts as a distraction. Do this without asking questions, so they don’t feel a pressure to reply until they feel ready.
• Let them move at their own pace. When they feel ready to go, let them go. They will likely feel tired and need some time to recover.
• Offer to be the one to let the boss or others know that everything is OK now.

If this is a person you know, check in gently a few hours later or the next day. They may feel embarrassed and it’s good to let them know you care.

If it's appropriate, you can encourage them to see a counsellor or psychologist to help identify what was going on and why, and to help prevent future panic attacks. They will also be able to get some advice on what to do if it happens again.