Many of us will experience a panic attack during our lifetime. It’s an overwhelming feeling of sudden and intense anxiety that quickly rises to a crescendo, and which perhaps seems to come out of the blue, but is often triggered by stressful situations, life events, phobias, memories of unpleasant events or as a feature of other anxiety disorders.
During a panic attack, physical symptoms build very quickly, including:
• a pounding or racing heartbeat
• feeling faint, dizzy or light-headed
• feeling very hot or very cold
• sweating, trembling or shaking
• feeling sick
• pain in your chest or abdomen
• struggling to breathe or feeling like you’re choking
• feeling like your legs are shaky or are turning to jelly
• feeling disconnected from your mind, body or surroundings, which are types of dissociation
Chances are you know someone who has had, or will have, one. If you happen to be nearby when it happens, just by staying put you can help them to feel safer, but add in a few research-backed techniques, and you’ll be better equipped to provide support.
1. Name it
Gently let the person know that you think they might be having a panic attack, that they’re safe, it will pass and that you’re there for them. This provides a context for what’s happening and relieves the fear of the unknown.
2. Stay calm yourself
One of the best ways to help is to remain calm yourself, even if you’re feeling on edge about what’s happening. Keep calm with square breathing: Inhale through your nose for a count of 4, hold at the top of the breath for 4, exhale through the mouth for 4, then pause and hold for 4.
3. Help them control their breathing
Using a calming tone and speaking at a slower pace than is usual, help them regulate their breathing. Try saying, “Focus on me and my voice, follow me, breathe in….and out…..in……and out… slow…and smooth…and calm….and even.”. Slow the pace down as they calm down, and keep going until they’re feeling calmer.
4. And afterwards
Once their breath has returned to normal, they feel more in control of their body and their thoughts have calmed down, assist them in doing whatever it helpful, such as sitting down, resting, perhaps get some air, have a drink of water or move around.
Panic disorder, not panic attacks
Sometimes panic attacks are an indication of a condition called panic disorder, meaning the person experiences recurrent attacks that seem to come out of nowhere, and are often linked to a catastrophic belief, perhaps of imminent death, collapse or even a fear that they’re going crazy.
If someone who know experiences panic disorder ensure you do not reinforce the panic cycle through inadvertently reinforcing escape behaviors. While it’s tempting to help them avoid the feelings of panic by distracting them from their bodily sensations or taking them away from the situation, these are considered ‘safety behaviors’. While safety behaviors might help to ease anxiety in the moment, they could actually reinforce the cycle of panic that exists in panic disorder. The same would be said for excessive reassurance.
Safety behaviors prevent people from learning that panic attacks, while uncomfortable, are not actually harmful or dangerous. The sufferer needs to learn that they can manage panic without actually doing anything, and it’s important for them to know that anxiety about panic goes away on its own without causing them harm. Rather than giving a lot of reassurance, it can help to remind them that they can cope with what’s happening on their own. Focus on empowering them to tolerate the situation, and use statements such as “You can handle this, the feelings aren’t comfortable but you can accept them”. If they ask you to stick around then that’s fine, but reinforce their ability to experience their symptoms by uttering the coping statement once or twice, and then letting them ride out their symptoms until they pass without interference.
Finally, panic disorder can be a debilitating condition, so a great way to help someone is to support them getting in touch with a suitably-qualified therapist, and then continuing to cheer them on as they gradually expose themselves to their fears with expert guidance.