The most important thing you can do for someone having a panic attack is stay calm, stay present, and let them know they’re safe. Panic attacks typically reach their peak intensity within about 10 minutes and can last anywhere from a few minutes to an hour. You can’t stop one instantly, but you can make the experience significantly less frightening by how you respond.
Recognize What’s Happening
A panic attack can look alarming from the outside. The person may have a pounding or racing heart, difficulty breathing, chest pain, trembling, sweating, dizziness, numb or tingly hands, nausea, or chills. They may feel convinced they’re dying or losing control. These symptoms are real and intense, but they are not physically dangerous.
Your first job is simply to recognize that this is a panic attack and not react with your own alarm. If you panic, they’ll feel less safe. Take a breath yourself before you do anything else.
What to Say (and What Not to Say)
Keep your language simple. Use short, steady phrases and repeat them if needed. Something like “You’re safe,” “I’m right here,” or “This will pass” works well. Repetition is actually helpful during a panic attack because the person’s brain is flooded with fear signals, and consistent, calm words can cut through that noise.
Validate what they’re feeling without reinforcing the fear. Saying “I can see this feels really scary” acknowledges their experience. Saying “There’s nothing wrong with you” or “Just calm down” does the opposite. It dismisses what they’re going through and often makes people feel more isolated in the moment. Avoid arguing with their perception of what’s happening, even if it seems irrational. Don’t tell them they’re overreacting. Don’t ask a lot of questions. Don’t raise your voice or speak quickly.
Guide Their Breathing
Hyperventilation is one of the most common features of a panic attack, and it feeds a vicious cycle: rapid breathing makes dizziness, tingling, and chest tightness worse, which increases panic, which speeds up breathing further. Helping someone slow their breathing is one of the most effective things you can do.
Try box breathing. Ask them to breathe in through their nose for a slow count of four, hold for four, exhale for four, then hold again for four before the next breath. Count out loud with them so they have something to follow. If the counting feels like too much, just model slow breathing yourself and ask them to try matching yours. Even getting a few slow breaths in can start to shift their body out of fight-or-flight mode.
You don’t need to be rigid about the technique. The goal is simply slower, deeper breaths. If they can only manage breathing in for two counts, that’s fine. Meet them where they are.
Use Sensory Grounding
During a panic attack, a person can feel completely disconnected from their surroundings. Grounding techniques work by redirecting attention away from internal panic signals and toward the physical environment. The most well-known version is the 5-4-3-2-1 method, and you can walk someone through it conversationally.
Ask them to name five things they can see. Then four things they can physically touch, like the texture of their shirt, the floor under their feet, or a wall nearby. Then three things they can hear outside their own body. Then two things they can smell. Then one thing they can taste. You can prompt them gently: “What’s something you can see right now?” Give them time to respond. The act of searching for sensory details pulls their focus into the present moment and away from the spiral of fear.
Physical touch can also help, but ask first. Some people find a hand on their back or arm reassuring. Others feel more trapped or overwhelmed by physical contact during a panic attack. A quick “Is it okay if I put my hand on your shoulder?” respects their boundaries without making a big deal of it.
Reduce Stimulation Around Them
If you’re in a crowded or noisy place, try to move them somewhere quieter. Fewer people, less noise, and more space all help. If moving isn’t possible, position yourself between them and the crowd so they have a smaller visual field to deal with. Turn off loud music or television if you can. Dim bright lights.
Offer something cold to hold, like a glass of ice water or a cold can from a fridge. Cold sensations on the skin activate the body’s calming nervous system and can help interrupt the panic response. Even running cold water over their wrists can make a difference.
Stay Until It Passes
Don’t leave unless they ask you to. Your presence is more powerful than any specific technique. You don’t need to fill the silence with constant talking. Sometimes just sitting next to someone, breathing slowly, and being there is the most helpful thing. Let them know you’re not in a rush and you’re not going anywhere.
As the attack winds down, the person will likely feel exhausted, embarrassed, or shaky. This is normal. Don’t immediately dissect what happened or ask them to explain what triggered it. Give them water, give them space to recover, and let them set the pace for conversation. A simple “How are you feeling now?” is enough.
Know When It Could Be Something Else
Panic attacks and heart attacks share several symptoms, including chest pain, shortness of breath, and dizziness. The American Heart Association notes that heart attacks most often start slowly, with mild discomfort that gradually worsens over several minutes. Panic attacks, by contrast, hit fast and peak within about 10 minutes.
That said, you are not in a position to diagnose someone in the moment. If the person has chest pain that radiates to their arm or jaw, if they lose consciousness, or if their symptoms don’t begin to improve after 20 to 30 minutes, treat it as a medical emergency. This is especially important if the person has never had a panic attack before, has heart disease risk factors, or is over 40. It’s always better to call for help and find out it was a panic attack than to assume and be wrong.
After the Attack: What Helps Long-Term
Once someone has recovered, you can gently ask if panic attacks are something they’ve experienced before. If this is new for them, encourage them to talk to a healthcare provider. Recurring panic attacks that cause ongoing anxiety or avoidance of certain situations may indicate panic disorder, which responds well to treatment.
For someone who has panic attacks regularly, one of the most supportive things you can do is learn their preferences in advance. Ask them during a calm moment: “What helps you most when this happens? Do you want me to talk to you, or give you quiet? Is touch okay?” Having that information ahead of time means you won’t be guessing during the next episode.
Practices like regular breathing exercises, mindfulness, and physical activity strengthen the body’s ability to recover from stress responses over time. You can’t do that work for someone, but you can be the person who makes a panic attack feel less lonely and less terrifying while it’s happening. That matters more than most people realize.