How to Help Someone Having a Panic Attack: A First Aid Guide

What Is a Panic Attack?

A panic attack is a sudden episode of intense fear or anxiety that triggers severe physical symptoms. Panic attacks can feel overwhelming and terrifying — many people experiencing their first panic attack believe they are having a heart attack, losing control, or dying. While panic attacks are not physically dangerous, they are extremely distressing and can significantly impact a person’s quality of life.

Panic attacks affect approximately 2 to 3 percent of the population, though many more people will experience at least one panic attack in their lifetime. They can occur at any age but most commonly begin in the late teens or early adulthood. Understanding panic attacks — both how to help someone experiencing one and how to manage your own — is an important component of mental health first aid.

Recognizing a Panic Attack

Panic attacks typically peak within 10 minutes and rarely last longer than 30 minutes. During a panic attack, a person may experience a rapid or pounding heartbeat, chest pain or tightness, shortness of breath or a feeling of being smothered, dizziness or lightheadedness, trembling or shaking, sweating, nausea or stomach distress, numbness or tingling in the hands and feet, hot flashes or chills, a feeling of unreality or detachment from oneself, and an overwhelming fear of dying or losing control.

Because many of these symptoms overlap with those of a heart attack, it is important not to dismiss someone’s distress. If there is any uncertainty about whether the person is having a panic attack or a cardiac event — especially if they have risk factors for heart disease, are over 40, or if this is their first episode — err on the side of caution and call 911.

Panic Attack vs. Heart Attack

Distinguishing between a panic attack and a heart attack can be challenging, even for medical professionals. However, there are some general differences. Heart attack pain is often described as a squeezing or pressure sensation that radiates to the arm, jaw, or back, while panic attack chest pain is more often sharp or stabbing and localized. Heart attack symptoms tend to be triggered by physical exertion and get worse over time, while panic attacks often come on suddenly and begin to subside after 10 to 20 minutes.

That said, these are generalizations and should never be used to make a definitive diagnosis. When in doubt, always seek emergency medical evaluation. It is far better to visit the emergency room for a panic attack than to dismiss a heart attack as “just anxiety.”

How to Help Someone Having a Panic Attack

Step 1: Stay Calm and Present

Your calm presence is the most powerful tool you have. The person experiencing a panic attack may feel like the world is ending, and having someone nearby who is steady and reassuring can help them feel anchored. Speak in a calm, confident voice. Avoid saying things like “calm down” or “there’s nothing to be afraid of,” as these phrases can feel dismissive. Instead, try “I’m here with you,” “You’re going to be okay,” and “This will pass.”

Step 2: Move to a Quiet Space

If possible, guide the person to a quieter, less stimulating environment. Crowds, noise, and bright lights can intensify panic symptoms. A quiet room, a bench away from a busy area, or even sitting in a parked car can provide a calmer setting for recovery.

Step 3: Encourage Slow Breathing

Hyperventilation — rapid, shallow breathing — is both a symptom and a driver of panic attacks. It reduces carbon dioxide levels in the blood, which can cause tingling, dizziness, and increased anxiety. Help the person slow their breathing by guiding them through a simple exercise: breathe in slowly through the nose for 4 counts, hold for 4 counts, breathe out slowly through the mouth for 6 counts. Repeat this cycle several times. Breathing together with the person can be helpful — they can match your rhythm.

Step 4: Use Grounding Techniques

Grounding techniques help redirect the person’s focus away from their panicking thoughts and back to the present moment. One effective method is the 5-4-3-2-1 technique: ask the person to name 5 things they can see, 4 things they can touch, 3 things they can hear, 2 things they can smell, and 1 thing they can taste. This engages the senses and interrupts the cycle of anxious thoughts.

Step 5: Stay Until It Passes

Do not leave the person alone during a panic attack. Stay with them until symptoms subside, which typically takes 10 to 30 minutes. After the panic attack passes, the person may feel exhausted, embarrassed, or shaky. Reassure them that panic attacks are common, they are not a sign of weakness, and that seeking help is a positive step.

Step 6: Encourage Professional Help

If someone is having recurrent panic attacks, encourage them to speak with a healthcare provider. Effective treatments for panic disorder include cognitive-behavioral therapy (CBT), medication, and lifestyle modifications. Early intervention can prevent panic attacks from becoming more frequent and debilitating.

What NOT to Do During a Panic Attack

Do not tell the person to “just relax” or “get over it.” Do not minimize their experience or compare it to your own stress. Do not give them medication unless it is their own prescribed medication and they ask for it. Do not encourage them to breathe into a paper bag — this outdated technique can be dangerous if the person is actually having a cardiac event. Do not restrain the person or prevent them from moving if they want to pace or stand.

Managing Your Own Panic Attacks

If you experience panic attacks, several strategies can help you manage them. Learn to recognize the early signs of a panic attack — catching it early makes it easier to manage. Practice breathing exercises and grounding techniques regularly, not just during attacks, so they become automatic. Regular physical exercise, adequate sleep, limiting caffeine and alcohol, and stress management techniques like mindfulness and meditation can all reduce the frequency of panic attacks.

Keep a record of your panic attacks, noting what was happening before each episode, to help identify triggers. Share this information with your healthcare provider, who can help you develop a personalized management plan.

First Aid Training Includes Mental Health

Modern first aid training recognizes that mental health emergencies are just as real and urgent as physical ones. At Coast2Coast in Toronto, Ottawa, Hamilton, Oakville, and over 30 locations across North America, our Standard First Aid courses equip you with the skills to support people in both physical and psychological emergencies.