What to do when someone is having a panic attack: a calm, simple guide

You're out for dinner with a friend when their breathing changes. They grip the edge of the table, go pale and say they can't breathe and need to leave. You freeze, not sure whether to talk, touch them or call for help. If you'd like support, we offer panic attack therapy in Kitchener-Waterloo, in person or online anywhere in Ontario.

The short version: stay calm, stay close, keep things simple and let the panic pass. You don't have to fix anything. Knowing what to do when someone has a panic attack is mostly about being a steady person nearby while their body settles. This article covers helping someone through a panic attack step by step: what to do, what to say, what to avoid, when to get medical help, and how to support someone you care about over time.

How to help someone having a panic attack

When someone is having a panic attack, their body's alarm is firing at full strength. They may feel as if they're dying, losing control or about to pass out. You can't switch that alarm off for them, but you can make the attack easier to get through. Learning how to help someone with a panic attack doesn't take special training. It takes patience, a few simple steps and the willingness to stay. A panic attack is frightening to watch, but it's not dangerous, and the person in the middle of a panic attack usually needs much less than you'd think.

Stay calm yourself

Your own calm is the most useful thing you bring. Slow your breathing, lower your voice and move a little more slowly. If you keep your cool, the person has something steady to hold on to. A calm presence tells their nervous system that this isn't an emergency, even when their body insists it is.

It's normal to feel a jolt of worry yourself. Take a breath before you speak. It's easier to stay calm when you remember the attack will pass. You don't need perfect words; you need to keep steady and stay close.

Ask what they need

People who have panic attacks often know what helps them. Gently ask what they need: "Do you want me to stay? Would it help to step outside? Do you want a chair?" Keep your questions short, and offer simple choices rather than open questions. If they've had attacks before, they may already have a plan, and you can simply follow it. If you know someone has panic attacks, it can help to ask them when they're calm what they'd like you to do next time. Every panic attack is a little different, and the plan you make together will help you both feel more prepared.

Help them slow their breathing

During an attack, breathing often becomes fast and shallow, which can make the light-headed feeling and tingling worse. Don't tell them how to breathe. Instead, breathe slowly yourself, and invite them to join you: "Let's breathe together. In through your nose, and a long, slow breath out." Slow, steady breathing beside them is often more helpful than instructions.

Ground them in the room

Grounding helps bring attention back to the present. If they'd like, help them sit down with their feet on the floor. Offer a textured object to hold, like a sweater sleeve or a set of keys, or ask them to name a few things they can see. Physical contact can help some people and overwhelm others, so ask first. You might offer to hold their hand, and take no for an answer. Touch is a choice, not a fix.

Give them room if they ask

Some people want space during panic. If they ask you to step back, give them space, but stay nearby where they can see you. Let them know you're close: "I'll be right over here." Even when they need distance, it helps to know someone is there. Being near someone having a panic attack without crowding them is one of the most useful things you can do.

How to tell someone is having a panic attack

Panic can look different from person to person, and it doesn't always look dramatic. Knowing the warning signs helps you respond sooner. You might notice:

• Shortness of breath, gasping or fast, shallow breathing
• Shaking or trembling hands
• Sweating, chills or a pale face
• Dizziness, or holding on to something for balance
• A racing heart, or a hand pressed to their chest
• Feeling detached, or seeming far away
• A sudden fear response that seems out of proportion to the situation

Some people go quiet and still. Others want to leave the room right away. Many people with panic attacks hide the symptoms well, so if someone seems suddenly unwell and frightened, it's okay to ask gently whether they're having a panic attack. Naming it calmly can take away some of the fear. Saying "I think this might be a panic attack, and it will pass" gives them something solid to hold on to. Their symptoms are real, even if the danger isn't. If you're not sure what's happening, or the symptoms seem unusual, treat it as a health concern and get help.

What to say to someone having a panic attack

During an attack, the person may have trouble following long sentences. Keep your words short, warm and simple. Speak slowly, and leave room for silence.

Phrases that calm panic

• "I'm here with you."
• "You're safe."
• "This will pass."
• "Let's breathe together."
• "You don't have to talk."
• "Take all the time you need."

Say one thing, then pause. Saying it again quietly is fine. The aim isn't to argue the person out of the panic; it's to keep them company while it passes. Short, gentle reassurance works better than a stream of words. During a panic attack, the mind is busy with alarm, so simple words are easier to take in. Your tone matters as much as what you say: slow, low and kind.

What not to say or do

Some common reactions can make an attack harder, even when they come from love. Try to avoid:

• "Just relax" or "calm down." If they could, they would.
• "Snap out of it" or "you're overreacting."
• Minimizing, such as "it's not a big deal" or "everyone gets stressed"
• Asking why it's happening or what set it off, in the moment
• Crowding them, standing over them or bringing others in to watch
• Asking "are you okay?" again and again

This often shows up as a kind instinct to fix things fast. But pushing can add pressure. Instead, validate what they're feeling: "This is really hard right now, and I'm here." You don't have to agree that something terrible is happening. You only have to accept that the person feels terrified.

When the attack starts to ease

Most panic peaks within about ten minutes and then slowly settles. You may see their breathing slow, their shoulders drop and their colour return. Stay with them as the attack fades, and don't rush them to carry on as if nothing happened.

It's okay for the person to feel shaky or tearful as the attack winds down. Some people want to talk; others need quiet. Let them lead. You can say, "You got through it," and leave it there. Waiting through the end of an attack is part of the help. The end of a panic attack can be the moment they need you most, because the fear of another attack often arrives just as the first one fades.

After the attack

Once the attack has passed, the person may feel exhausted, embarrassed or worried about having another. Offer water, a quiet place to rest, or a slow walk. Check in gently later: a text that evening or the next day saying "Thinking of you, how are you feeling?" shows you care without making a fuss.

Try not to tease or bring it up in front of others. Many people feel ashamed after an attack, and kindness afterward helps them trust you next time. Your steady care after an attack matters almost as much as your help during it. If they want to talk about the panic later, listen without judging. If they don't, that's okay too. Seeing a panic attack up close can leave you shaken as well, so be gentle with yourself.

When it's more than a panic attack

Most panic attacks pass on their own, but sometimes it's right to get medical help. Call 911 if:

• It's their first attack and you don't know what's happening
• They have chest pain that spreads to the arm, jaw or back, or signs of a heart attack
• Their breathing doesn't improve
• They faint, or the symptoms keep getting worse after 20 minutes

A panic attack and a medical emergency can look alike, so err on the side of caution. Their health comes first. If you're unsure, it's always okay to call. Getting checked is never an overreaction. If they're frightened they're dying, our article on can you die from a panic attack can help you both understand what's happening.

Helping a loved one manage panic over time

When someone is having panic attacks again and again, life can start to shrink around the fear of the next one. This is the panic cycle: an attack, worry about another, avoiding places where panic happened, and more panic as a result. Panic episodes can come and go for years without support. Each new attack can leave the person more watchful and more afraid of their own body, and their mental health can suffer as the panic spreads into work, sleep and relationships. People sometimes call these an anxiety attack, but anxiety tends to build slowly, while panic comes on fast.

Your support can make a real difference. Be patient, and celebrate small steps, such as going back to a store they've been avoiding. Try not to help with avoidance by doing everything for them, even when it's tempting; gently encouraging small steps helps more over time. Encourage them to talk to a therapist, and offer practical help as they learn to manage panic, like finding options or going with them to a first appointment.

Treatment for panic works well for most people. In therapy, we can look at what sets the panic off, what keeps it going and how to break the cycle. Depending on what fits, that might include CBT to work with the thoughts that keep panic going, exposure therapy to gently face the sensations and places they've been avoiding, ACT to make room for discomfort, or Somatic Experiencing to help the body feel safer. Good support at home and good support in therapy work well together, and both protect the person's mental health. Therapy for panic attacks is practical and focused, and it can happen in person or online. Many people notice the panic easing within weeks, and the attack that once felt impossible starts to feel manageable. As the panic eases, their health, mood and confidence often improve too. A loved one who feels understood at home tends to stick with therapy, and that's good for everyone's health.

Looking after yourself

Watching someone you love in distress is hard, and a panic attack in someone close to you can stay with you afterward. Looking after your mental health is part of being able to help. It's normal to feel scared, helpless or tired, especially if attacks happen often. Your own health and your own mental health matter too. Supporting someone through panic can wear on your mental health over time, especially if you're the person they always turn to. Take breaks, keep up your own routines, and talk to someone you trust about how it's affecting you.

You can't carry someone else's panic for them, and you don't have to. Getting support for yourself, from friends, family or a counsellor, makes you steadier for them. Caring for a loved one with panic is easier when your own health is looked after. Many people find that a few sessions of therapy help them support a partner or family member without burning out, and protect their own health along the way.