The most important thing you can do for someone having a panic attack is stay calm, stay present, and help them ride it out. A panic attack typically peaks within 10 minutes and resolves within 5 to 20 minutes, though some last up to an hour. You can’t stop one instantly, but you can make it shorter, less frightening, and easier to recover from.
What’s Happening in Their Body
During a panic attack, the brain’s threat-detection center fires an emergency alarm even though there’s no actual danger. It bypasses normal processing and floods the body with stress hormones, triggering a full fight-or-flight response. The person’s heart races, their breathing speeds up, and their muscles tense as if they’re about to flee a predator. This is sometimes called an “emotional hijack,” and the person experiencing it has very little conscious control over it.
That’s why telling someone to “just relax” doesn’t work. Their nervous system is responding to a perceived emergency. The physical symptoms are real: pounding heart, chest tightness, shortness of breath, trembling, sweating, dizziness, nausea, numbness or tingling, chills or hot flashes, and a feeling of detachment from reality. Many people also feel an overwhelming sense of doom or a genuine fear that they’re dying. Understanding this helps you respond with patience instead of frustration.
How to Recognize a Panic Attack
Panic attacks look different from person to person. Some people go very still, others pace or hyperventilate. Common visible signs include rapid breathing, shaking, clutching their chest, sweating, or saying they feel like they can’t breathe. They may tell you something feels terribly wrong or that they think they’re having a heart attack.
The overlap with heart attack symptoms is real and worth knowing. Heart attacks usually build gradually, with chest pain that worsens over several minutes and often radiates to the arm, jaw, or back. Panic attacks come on quickly and hit peak intensity in about 10 minutes. If the person has risk factors for heart disease, is over 40 and experiencing a first episode, or has crushing chest pain that doesn’t ease after 10 to 15 minutes, treat it as a potential cardiac event and call emergency services. When in doubt, always err on the side of calling for help.
What to Say (and How to Say It)
Speak in short, simple sentences. Your tone matters as much as your words. Stay calm, keep your voice steady, and be predictable. Avoid sudden movements or surprises. Here are phrases that genuinely help:
- “You can get through this.” Simple reassurance that this will end.
- “What you’re feeling is scary, but it’s not dangerous.” This validates their experience without feeding the fear.
- “Tell me what you need right now.” Gives them a sense of control when they feel like they have none.
- “Concentrate on your breathing. Stay in the present.” A gentle redirect toward something concrete.
Avoid minimizing what they’re going through. Phrases like “you’re fine,” “it’s all in your head,” or “there’s nothing to worry about” dismiss an experience that feels life-threatening to them in the moment. Don’t ask them to explain what triggered it while it’s happening. Don’t tell them to calm down. Just be there.
Guide Them Through Breathing
Breathing techniques work because they directly counter the hyperventilation that fuels panic symptoms. When someone breathes too fast, their carbon dioxide levels drop, which causes tingling, dizziness, and chest tightness, all of which make the panic worse. Slowing their breathing breaks that cycle.
Box breathing is one of the simplest methods to walk someone through. Ask them to breathe in for four counts, hold for four counts, breathe out for four counts, and hold again for four counts. If four seconds feels too long (it often does mid-panic), start with two or three counts per step and work up. Breathe with them. Counting out loud gives them something external to focus on and shows them the rhythm you’re aiming for.
Use Grounding to Bring Them Back
Grounding techniques pull attention away from the internal storm and anchor it to the physical world. The most widely used is the 5-4-3-2-1 method, which walks through each sense one at a time. You can guide someone through it conversationally:
Ask them to name five things they can see, even small things like a crack in the ceiling or a pen on a desk. Then four things they can physically touch: the texture of their clothing, the floor under their feet, the arm of a chair. Three things they can hear outside their own body. Two things they can smell (if nothing’s nearby, suggest walking to find soap, fresh air, or anything with a scent). Finally, one thing they can taste, even if it’s just the lingering flavor of coffee or toothpaste.
This works because it forces the brain to process real sensory input, which competes with the false alarm signals driving the panic. You don’t need to explain why it works. Just walk them through it calmly.
What to Do After the Attack Passes
When the worst is over, the person will likely feel drained, shaky, and embarrassed. Panic attacks are exhausting, and the aftermath can last longer than the attack itself. Don’t rush them. Don’t immediately dissect what happened.
Offer water. Suggest sitting somewhere comfortable or going for a short walk if they feel up to it. Physical movement can help release residual tension. Encourage them to avoid caffeine, alcohol, and nicotine in the hours afterward, since all three can reignite anxiety. If they’re open to it, 10 to 20 minutes of a simple relaxation exercise, like slow breathing or gentle stretching, can help the nervous system fully reset.
One of the most useful things you can say after an attack is a version of: “That looked really hard. I’m glad you got through it.” Acknowledging their experience without dramatizing it goes a long way.
Supporting Someone Who Gets Them Regularly
A single panic attack doesn’t mean someone has panic disorder. But when attacks become recurrent and the person starts worrying persistently about having another one, or begins avoiding situations, activities, or places because they fear an episode, that pattern meets the clinical threshold for panic disorder. At that point, professional help makes a significant difference.
Bringing up therapy can feel delicate. One approach that works well is framing it as a single appointment rather than a commitment: “It’s just an initial check-in, like a physical but for your mental health.” If they try a therapist and it doesn’t click, encourage them to try another. Fit matters enormously in therapy.
The most effective treatment for panic disorder is cognitive behavioral therapy, which teaches people to gradually face the situations and sensations they fear in a controlled way. It also helps them reframe the catastrophic thoughts that fuel attacks. Some people benefit from medication alongside therapy. Both options are more effective the earlier someone starts, so gently encouraging a loved one to get help sooner rather than later is one of the best things you can do.
Taking Care of Yourself as a Supporter
Helping someone through repeated panic attacks is emotionally taxing. You may feel helpless, frustrated, or anxious yourself. That’s normal. Ask your loved one, during a calm moment, what specific things help them most during an attack, so you’re not guessing each time. Ask if you can attend a therapy session with them to learn better support skills. And protect your own energy by maintaining your own interests, boundaries, and social life. You can’t pour from an empty cup, and burning out helps no one.