The most important thing you can do for someone having a panic attack is stay calm yourself and stay with them. Panic attacks typically last 5 to 20 minutes, peaking in intensity around the 10-minute mark before symptoms start to fade. You can’t stop one instantly, but your presence and a few simple techniques can make the experience far less frightening and help it pass more quickly.
What a Panic Attack Looks Like
Someone having a panic attack may grab their chest, hyperventilate, tremble, or say they feel like they’re dying. They might pace, cry, or freeze in place. The physical symptoms are real and intense: racing heart, sweating, numbness or tingling in the hands, nausea, dizziness, and a feeling of choking or not being able to breathe. These aren’t exaggerated reactions. The body’s fight-or-flight system has fired at full strength without an actual threat, and the person is experiencing a genuine physiological storm.
The hallmark symptom that separates a panic attack from other medical events is intense, overwhelming fear. If the person tells you they feel a deep sense of dread or like something terrible is about to happen, that’s a strong signal you’re dealing with a panic attack rather than something else.
What to Do in the Moment
Start by being a steady, reassuring presence. Kneel or sit at their level. Speak in a slow, even tone. Tell them you’re going to stay with them. Avoid saying things like “just relax” or “there’s nothing to be afraid of,” because those phrases dismiss what they’re feeling. Instead, try: “I’m right here. This is going to pass. You’re safe.”
Ask before touching them. Some people find a hand on their shoulder grounding; others feel more trapped by physical contact during a panic attack. A simple “Is it okay if I put my hand on your back?” lets them decide.
If you’re in a crowded or noisy space, gently suggest moving somewhere quieter. Reducing sensory input helps. Turn down music, dim lights if you can, and ask bystanders to give space. The fewer stimuli competing for the person’s attention, the easier it is for their nervous system to start winding down.
Guide Their Breathing
Hyperventilation drives many of the worst panic symptoms, including dizziness, tingling, and the feeling of not getting enough air. Slowing the breath down is one of the most effective things you can do.
The simplest approach: breathe with them. Say “Breathe in with me” and inhale slowly through your nose, visibly expanding your chest so they have something to mirror. Then exhale slowly through your mouth. Keep the exhale longer than the inhale, which signals the nervous system to calm down.
If they’re able to follow more structured guidance, try the 4-7-8 technique. Walk them through it step by step: inhale through the nose for 4 counts, hold for 7 counts, exhale through the mouth for 8 counts. Repeat for three or four cycles. Count out loud for them so they don’t have to think about it. Not everyone can manage a hold that long during a panic attack, so don’t push it. Even getting them to slow their exhale is a win.
Use a Grounding Technique
Grounding pulls a person’s attention out of the panic spiral and back into the physical world around them. The most widely used method is the 5-4-3-2-1 technique, and you can walk someone through it conversationally.
Ask them to name five things they can see. Anything counts: a crack in the ceiling, a pen on the table, the color of your shirt. Then four things they can physically touch, like the fabric of their clothes, the floor under their feet, or the texture of a wall. Then three things they can hear. Then two things they can smell. Then one thing they can taste.
This works because it forces the brain to process concrete sensory information, which competes with the abstract catastrophic thoughts fueling the panic. You don’t need to explain why it works. Just gently prompt each step: “Okay, now tell me four things you can feel right now.” Keep your voice calm and unhurried. If they can only get through a few steps, that’s fine.
What Not to Do
Don’t tell them to “snap out of it.” They can’t. A panic attack is not a choice or an overreaction. Don’t ask a lot of questions about what triggered it, at least not during the attack itself. That conversation can happen later. Right now, problem-solving adds cognitive load to a brain that’s already overwhelmed.
Don’t hand them a paper bag to breathe into. This is an outdated recommendation that can actually reduce oxygen levels dangerously if the symptoms turn out to be something other than a panic attack. Guided slow breathing is safer and more effective.
Don’t leave them alone unless they specifically ask for space. Even then, stay nearby and check in after a minute or two.
After the Panic Attack Passes
Once the intensity fades, the person will likely feel drained. Post-attack exhaustion is normal. They may feel embarrassed, shaky, tearful, or just wiped out. Offer water. Let them sit quietly for as long as they need. Don’t rush them back into whatever they were doing.
Keep your tone matter-of-fact and warm. Something like “That looked really rough. I’m glad you’re okay” validates the experience without making it into a bigger event than they want it to be. Follow their lead on whether they want to talk about it. Some people need to process out loud; others just want to move on.
If this is someone who experiences panic attacks regularly, you can gently ask later (not in the aftermath) whether they’ve talked to a doctor or therapist about it. Panic disorder is highly treatable, and many people don’t realize how much help is available. But the moments right after an attack are not the time for that conversation.
When It Might Not Be a Panic Attack
Panic attack symptoms overlap significantly with heart attack symptoms: chest pain, shortness of breath, nausea, dizziness. The two can be genuinely difficult to tell apart, even for medical professionals. Heart attacks often build gradually, with discomfort that worsens over several minutes, while panic attacks tend to hit peak intensity within about 10 minutes. Women experiencing a heart attack are more likely to have back pain, jaw pain, or nausea rather than classic chest pain.
If the person has never had a panic attack before, is over 40, has risk factors for heart disease, or their symptoms include crushing chest pressure that radiates to the arm or jaw, call emergency services. If you’re not sure, err on the side of calling. No one in an emergency room will fault someone for coming in with chest pain that turns out to be a panic attack.