Most times in my practice working with counselees battling anxiety and panic attacks, it becomes imperative to discuss with their close family what needs to be done in the event of an episode. But, what would you do if you were to be present in such a situation with a co-worker in the office, or a relative at a social gathering or a friend going through a personal crisis? You may feel helpless or do unhelpful things.

Let’s begin with understanding briefly what a panic attack is

A panic attack is an exaggerated response to a real or perceived stress or danger.

Panic attacks may have various presentations, one which we may be familiar with is where it closely mimics a heart attack. Some other signs and symptoms include:

  • Fear of death or impending doom
  • Pounding heartbeats
  • Sweating, trembling
  • Shortness of breath
  • Tightness or pain in the chest
  • Nausea, abdominal cramps
  • Headache, dizziness, numbness

Below is a quick guide to helping someone experiencing a panic attack:

  • Keep calm: it’s a stressful situation to find yourself in and the most important thing to do at this point is keep yourself calm and in control, before you can move ahead with supporting someone having a panic attack.
  • Ask what you can do at that moment: please remember, you are in that position to support them and not give your set of advice or remedies. In most cases, people suffering from panic attacks are aware of their own coping mechanisms. Some may be ok receiving help while others may prefer being left alone. Trust them but do check in to confirm.
  • What not to do: one way to support an acute episode is to be conscious about what are unhelpful actions and words. Saying “calm down” or “it will get fine” does not help. In fact, it may sound more like you are invalidating their experience.
  • Grounding or Calming techniques: It always helps to know some techniques or interventions. I have listed a few below that you could practice for such situations. However, rule 2 still applies where you may need to seek their permission to help with these techniques. 
  • Voice your support: During and post the attack it’s very important to validate the event and the emotions of those who experience it. It’s not possible to really understand what they feel in the moment (so do refrain from the “I know what it feels like” type of statements unless you suffer from panic attacks yourself.) They may feel a sense of shame or feel judged by those around them, and it would help to say reassuring words (consciously not sounding full of pity)
  • Future reference: After the episode, it always helps to have a discussion around what could you do to support better next time. Having a support structure in the form of people who understand and an environment that supports, ensures reduced episodes and better coping. A Kind non-judgemental space to talk about their challenges goes a long way.

Some techniques to have handy:

  • Breathing exercise:

breathe in as slowly, deeply, and gently as you can, through your nose.

breathe out slowly, deeply, and gently through your mouth.

Close your eyes and focus on breathing.

  • 5,4,3,2,1 grounding technique

Bring your mind to the present moment by focusing on:

5 things you can see.

4 things you can feel.

3 things you can hear.

2 things you can smell.

1 thing you can taste.

And last but not least encourage someone struggling with panic attacks and anxiety to seek therapy. CBT (Cognitive Behavioural Therapy) & DBT (Dialectical Behavioural Therapy) are the common and well-researched therapy approaches in cases of panic attacks. However, this is not to be considered amid a panic attack. At that moment, it’s your presence that can make all the difference.

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