The most important thing you can do for someone having a panic attack is stay calm, stay present, and help them slow their breathing. Panic attacks typically last 5 to 20 minutes, with symptoms peaking around the 10-minute mark. You can’t stop an attack instantly, but you can make it shorter, less frightening, and easier to recover from.
Recognize What’s Happening
A panic attack floods the body with stress hormones in seconds. The brain’s threat-detection center misreads a situation as dangerous and triggers a full fight-or-flight response, even when there’s no real threat. That’s why the person may look terrified, shake, sweat, hyperventilate, or clutch their chest. Their heart rate can spike dramatically. In a young adult, it can climb close to 200 beats per minute.
The person may tell you they feel like they’re dying. That sense of impending doom is actually more common in panic attacks than in heart attacks, which is worth knowing because the two can look similar. Both cause chest discomfort, racing heart, sweating, and dizziness. A few differences can help you tell them apart:
- Chest sensation: Panic attacks often produce sharp, intense chest pain. Heart attacks feel more like pressure, squeezing, or something heavy sitting on your chest, and the discomfort may radiate down the arm, into the jaw, or up the neck.
- Duration: A panic attack is self-limiting. It will peak and fade on its own. A heart attack won’t resolve without medical treatment and can last hours.
- Context: Panic attacks often have an emotional trigger, even if the person can’t identify it in the moment. Heart attacks tend to strike without a clear precipitating event.
If you’re unsure, or if this is someone’s first episode, call emergency services. It’s always safer to rule out a cardiac event than to assume it’s panic.
What to Say (and What Not To)
Keep your sentences short and simple. Speak slowly. Be predictable, and avoid surprises. The person’s brain is in overdrive, and complex instructions or sudden movements will make things worse.
Phrases that actually help:
- “You can get through this.”
- “What you’re feeling is scary, but it’s not dangerous.”
- “Concentrate on your breathing. Stay in the present.”
- “Tell me what you need right now.”
What not to say: “Just calm down,” “You’re overreacting,” or “There’s nothing wrong.” These dismiss what the person is experiencing and can escalate the panic. They already know, on some level, that the danger isn’t real. That knowledge doesn’t help when their body is screaming otherwise. Acknowledge what they’re feeling without reinforcing the fear.
Guide Their Breathing
Hyperventilation is both a symptom and an accelerant of panic attacks. When someone breathes too fast, they exhale too much carbon dioxide, which makes their fingers tingle, their vision narrow, and their dizziness worse. Slowing the breath is the single most effective thing you can do in the moment.
Box breathing works well because it’s simple enough to follow mid-panic. Walk the person through it step by step:
- Breathe in slowly through the nose for a count of four.
- Hold the breath for a count of four.
- Exhale slowly through the mouth for a count of four.
- Hold again for a count of four.
- Repeat.
Do it with them. Breathe audibly so they can match your rhythm. If counting to four feels too long, start with two or three and work up. The goal is slow, steady breathing, not perfection.
Use Grounding to Interrupt the Spiral
Panic attacks pull a person out of the present moment and into a loop of fear about what’s happening inside their body. Grounding techniques work by redirecting attention to the external world, giving the brain something concrete to process instead of spiraling.
The 5-4-3-2-1 technique is one of the most widely recommended. Once you’ve helped them start slowing their breath, walk them through it:
- Name five things you can see.
- Touch four things around you (a wall, your own sleeve, the ground under your feet).
- Listen for three things you can hear.
- Identify two things you can smell.
- Notice one thing you can taste.
You can prompt them gently. “What do you see right around us? Tell me five things.” This gives them a task, something small and manageable, that pulls their focus outward. Some people find it helpful to hold something cold, like ice or a chilled water bottle, because the sharp physical sensation is hard for the brain to ignore.
Offer Physical Comfort Carefully
Ask before touching someone mid-panic. Some people want a hand on their back or to be held. Others feel trapped by physical contact. A simple “Is it okay if I put my hand on your shoulder?” lets them decide.
If the person is open to it, progressive muscle relaxation can help release the physical tension that builds during an attack. The idea is simple: tense one muscle group for about five seconds while breathing in, then release it all at once while breathing out. Start with the hands (clench both fists, then release), move to the shoulders (shrug them up to the ears, then drop), and work through whatever feels natural. You don’t need to hit every muscle group. Even doing two or three can signal to the nervous system that the threat has passed.
Stay Until It Passes
Don’t leave. Your calm presence is doing more than you think. Most panic attacks resolve within 20 minutes, though some people report episodes lasting up to an hour. The worst of it, the peak intensity, usually hits within the first 10 minutes and then gradually subsides. Knowing this timeline can help you reassure the person that it will end.
Resist the urge to rush them. Don’t suggest they “shake it off” or push them to get up and move before they’re ready. Let them set the pace. Some people want to sit quietly. Others want to talk. Follow their lead.
What to Do After the Attack Ends
A panic attack is physically exhausting. The surge of stress hormones leaves the body drained, sometimes for hours afterward. The person may feel shaky, foggy, embarrassed, or emotionally flat. All of that is normal.
Encourage them to drink water and eat something small if they haven’t recently. Help them find a quiet, comfortable spot to rest. Gentle movement, like a slow walk, can help burn off residual adrenaline, but only if they feel up to it.
In the hours and days after, caffeine, alcohol, and nicotine can all lower the threshold for another attack. If you’re close enough to the person to have this conversation, it’s worth mentioning gently. Regular relaxation practice, even 10 to 20 minutes a day of slow breathing or progressive muscle relaxation, can reduce the frequency and severity of future episodes over time.
When Panic Attacks Keep Happening
A single panic attack doesn’t mean someone has a panic disorder. Many people have one or two in their lifetime during periods of extreme stress and never have another. But when attacks become recurrent, or when the person starts avoiding places and situations out of fear that an attack might strike, that pattern points toward something that benefits from professional support. Cognitive behavioral therapy is one of the most effective treatments, and it specifically targets the cycle of fear and avoidance that keeps panic disorder going.
If someone you care about is having repeated attacks, the most helpful thing you can do beyond the immediate crisis is normalize getting help. Panic disorder is common, well understood, and highly treatable. Framing therapy as a practical skill-building tool, not a sign of weakness, makes it easier for someone to take that step.