If you have a friend or family member who experiences panic attacks, it's natural to feel overwhelmed and helpless if it happens in your presence. Like any other mental health condition, it's impossible to truly understand what a panic attack feels like unless you've experienced one yourself — but that doesn't mean you can't help your loved one through it.
By definition, a panic attack is a "sudden episode" in which a person experiences intense fear despite not being in any sort of danger. The fear manifests itself physically, and people who experience panic attacks often feel as though they're having a heart attack or even dying. Here are some strategies to help a loved one through it.
1. Do a Grounding Exercise Together
Doreen Marshall, PhD, licensed psychologist and vice president of mission engagement at the American Foundation For Suicide Prevention, told POPSUGAR that the first step is to help the person "ground" themself and connect to the present moment. "Since panic attacks have a beginning, middle, and end, when someone is in the moment of an attack, encourage them to use mindfulness techniques or deep breathing exercises to help reset their nervous system," Dr. Marshall said.
You can help ground someone by getting them to focus their attention on their immediate physical surroundings. For example, Dr. Marshall recommends having the person focus on a nearby object for 10 seconds or name five objects they notice around them. "It can also help to have the person make physical contact with a nearby object, such as putting their hands on a table or a chair or running their hands under cold water to help ground them," she said.
2. Help Them Regulate Their Breathing
A panic attack makes it difficult to breathe, which is why the person may feel like they're having a heart attack or dying. David Rakofsky, PsyD, licensed clinical psychologist and president of Wellington Counseling Group in Chicago, told POPSUGAR the best way to help a person regulate their breathing is to breathe with them. "By the time a person is in full panic mode, their blood gasses have likely shifted from an over-abundance of oxygen, which can fuel the accelerating state of the panic," Dr. Rakofsky explained. "By regulating breath, you start to reverse this cycle."
Dr. Rakofsky recommends the "times two" rule, which means that for every second you breathe air in, you double it on the way out. "Always keep in mind [that] a person in panic or in a heightened state of anxiety will not be able to take in a lot of air since there is a feeling of constriction in the chest," he said. For this reason, Dr. Rakofsky says to start small and then work your way up to taking longer, deeper breaths together.
3. Know What Not to Say
"Avoid phrases that could provoke more panic and come off as dismissive, shaming, or blaming," Dr. Marshall said. For example, you shouldn't tell someone who's experiencing a panic attack to calm down. Instead, use phrasing that shows you're focused on listening to the person and helping them get through the panic attack, like "I'm here with you," "Concentrate on your breathing," or "Stay in the present."
Dr. Rakofsky also emphasized the importance of never telling a person that the panic attack is all in their head. "The feeling of invalidation and psychological invisibility that comes with being told this is absolutely crushing and likely to bring about a greater state of panic and distress," Dr. Rakofsky told POPSUGAR, noting that it also increases distrust and a lack of hope that they'll find real, helpful treatment for their panic attacks.
"Once the panic attack is over, then you can help them address what may have contributed to the panic attack and seek professional help," Dr. Marshall said.
4. Encourage Them to Seek Professional Help
If a person has panic attacks and isn't receiving mental health treatment from a therapist and psychiatrist, encourage them to seek help from a professional who has experience treating panic and anxiety disorders. "Connecting with a mental health professional can help someone who experiences a panic attack or attacks have access to a resource who can help determine what's happening in the moment as well as manage episodes over time," Dr. Marshall said.