A panic attack is a brief but intense rush of fear. These attacks involve symptoms similar to those experienced when facing a threat, including:

• intense fear
• a sense of doom
• sweating or chills
• shaking
• pounding heart
• difficulty breathing
• head and chest pain

Panic attacks differ from a typical fear response because there’s no actual threat involved.

Panic attack triggers aren’t always easy to identify, so people who have one attack often worry about having more, especially in public.

Panic attacks usually feel very uncomfortable and cause significant distress. Many people believe they’re experiencing a heart attack or other life-threatening issue.

If you know someone who experiences panic attacks, there are several things you can do (and avoid doing) to help them in the moment.

Remain Calm

Keeping your cool is one of the best ways you can help.

Panic attacks usually don’t last long.

But someone having an attack may not have much concept of time as it happens. They might feel terrified or think they’re about to die.

Even if you feel a little afraid yourself, stay calm. If your voice seems to help (and they haven’t asked you to keep quiet), talk to them in a calm voice.

What to say

Try:

• reassuring them you won’t leave
• reminding them the attack won’t last long
• telling them they’re safe

Ask how you can help

Most people who experience panic attacks or live with other types of anxiety have their own go-to coping methods. When offering support, keep in mind your loved one knows best when it comes to what will help most.

During an attack, however, they might find it harder to communicate this. Consider asking in advance how you can offer assistance if they experience an attack around you.

During an attack, it’s okay to calmly ask what you can do to support them. Just prepare for the possibility of a short or curt response.

What if they want me to leave?

As long as they’re not in immediate danger, take a few steps back and give them some space. Stay nearby so you can still keep an eye on things, and let them know that should they change their mind, you’ll come right back.

Learn the warning signs

If you haven’t already, take some time to familiarize yourself with the early signs of a potential panic attack.

Panic attacks commonly begin with:

• a feeling of terror or dread
• hyperventilation or shortness of breath
• feelings of choking
• a pounding heart
• dizziness and shaking

Not everyone experiences panic attacks in the same way, so it’s best to ask what signs they tend to experience.

The sooner you realize what’s happening, the faster you can help them get to a more private place, or wherever they need to feel more comfortable.

Focus on action over words

A soothing, familiar voice helps some people, but try to avoid repeatedly saying things like “don’t worry” or asking them if they’re alright over and over.

Of course you mean well, but your words may not have much benefit in the moment. They can also make the situation more stressful, since your loved one may believe they’re doing something wrong by not being alright.

How to make your words more actionable

Take action with your words by:

• asking if they want to leave the room and go somewhere else
• reminding them to keep breathing
• engaging them in light conversation, unless they say they don’t want to talk

Validate their distress

People often have a hard time sharing their experiences with mental health issues, including panic attacks.

Some avoid talking about mental health issues because they believe others won’t understand what they’re going through. Others worry about being judged or told what they experience isn’t a big deal.

Outsiders often don’t understand the fear caused by panic attacks and may even consider it illogical.

But the response is real, and the person experiencing the attack can’t control it.

An empathic response can be as simple as, “That sounds really tough. I’m sorry you experience that. Let me know what I can do to support you.”

What to avoid

If someone chooses to tell you about their panic attacks, take this as a sign of trust.

To show respect for their experience and honor this trust:

• respond with compassion
• be mindful of your words and actions, during an attack and at any other time

You might have all the best intentions, but it’s entirely possible to make someone feel bad without realizing you’re doing so.

Keeping these suggestions in mind can help you avoid unintentional harm:

Don’t compare normal stress and fear to panic

Maybe you’ve felt stressed or terrified in a dangerous situation. You might even have anxiety yourself.

These experiences aren’t quite the same as a panic attack, though. Avoid trying to draw comparisons between your different experiences. Unless you also get panic attacks, you probably don’t entirely understand how they feel.

If you have experienced extreme fear, let that memory inform you on what your friend is going through. Remind yourself they aren’t just afraid or stressed.

They may also feel:

• helpless
• unable to manage what’s happening
• physical pain or discomfort

Don’t shame or minimize

It’s pretty common to worry about having a panic attack, especially in front of strangers, or believe the attack might annoy or inconvenience friends or loved ones.

Avoid saying things like:

• “Just relax. There’s nothing to be afraid of.”
• “You’re upset over that?”
• “What’s wrong with you?”

You might not intend to make your friend feel ashamed, but denying the reality of their distress can certainly have that effect.