First Aid for Panic Attacks: How to Help Someone in Crisis

by Zencare team

Published on August 5, 2024 by Zencare Team and written by Dr. Michelle Solomon, PsyD

Anxiety is not a new phenomenon. It has always been a fundamental part of the human experience. In fact, everyone will experience a degree of anxiety at some point in their life. And they should. Moderate levels of anxiety can actually serve a beneficial purpose, acting as a motivator. It can help us prepare for important events, such as exams, a date, or public speaking, by sharpening focus and increasing awareness. This anxiety sweet spot can lead to improved performance and better outcomes.

Picture in your mind a round table, where every emotion is welcome and has a seat. Just like in the movie “Inside Out,” there are no "bad" feelings or “bad” parts — each one plays a vital role.  When all parts of you, even those you don't always like, work together, you create a balanced, functional system. This is harmony.

The state of anxiety inside and around us

Think of anxiety as that well-meaning but overzealous friend who's looking out for you. Anxiety taps us on the shoulder when our thoughts are heading in an unhelpful direction or when there's something we should pay attention to. It's our brain trying its best to keep us safe. Sure, it can be a bit much at times, but remember, it's coming from a place of care.

However, excessive amounts of anxiety can trigger an overactive response in our sympathetic nervous system, launching us into survival mode, causing a fight, flight, freeze, or fawn reaction.  We essentially become overwhelmed and may find it difficult to cope or manage daily tasks or make decisions.

It's important to recognize that anxiety disorders have been on the rise, even prior to the COVID-19 pandemic. According to the CDC, mental health was trending downward well before the onset of the pandemic. This is understandable, given the pervasive issues we face; increased pace of modern society, economic uncertainties, income inequality, domestic and global political issues, the stresses of constant information consumption through social media, “doom scrolling”, trying to keep up with Instagram and TikTok trends, social comparison, bullying, loneliness, and more.

What anxiety and panic feels like

If you experience symptoms of general anxiety, you are certainly not alone. Everyone feels nervous or worried from time to time. This is a very normal human reaction to stressful situations. But for people with anxiety disorders, these fears and concerns are not always temporary. Their anxiety tends to endure and may intensify over time.

Anxiety and panic attacks can show up differently for everyone. Some symptoms may include:

Anxiety

  • Excessive and persistent worry
  • Restlessness
  • Fatigue
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbances
  • Shortness of breath
  • Physical symptoms – headache, stomachaches, nausea, sweating
  • Can lead to depression

Panic

  • Rapid heartbeat
  • Shortness of breath
  • Chest pain
  • Dizziness or lightheadedness
  • Sweating
  • Shaking
  • A feeling of unreality — as if you’re “not all there” (depersonalization)
  • Fear of losing control
  • Fear of dying
  • Numbness or tingling

Panic can feel uncomfortable and oftentimes unpredictable. Like all of our emotions, anxiety is one to be understood, felt, and not ashamed.

How to help someone who is having a panic episode

In response to prevailing stressors, it’s highly probable that you or someone within your circle may encounter episodes of acute anxiety or panic.

Here are some ways you can help others:

1.     Approach with kindness and compassion: As best you can, honor their experience and emotions without judgment or criticism. Rather than trying to understand why it is happening, prioritize helping them feel grounded and safe with calming strategies.  This may look like not judging them for going on their phone, for taking a break from an activity, or leaving the table for a moment.  Everyone copes in their own ways.

2.     Reassure them using grounding language: “You are okay, you are safe, this will pass” and you can even ask, “What do you need?” (e.g., a walk, water, to remove themselves from the environment, to call a safe person).

3.    Acknowledge what is happening: We cannot control why or how our body is reacting to certain situations or stimuli, but we can control how we respond. Trying to stop or suppress anxiety or panic symptoms may create resistance and intensify the experience. Instead, acknowledge what is happening in the present, then focus on empowering the person with calming strategies and resources to manage symptoms.  Something I like to say to clients is, “Tell anxiety it can sit right next to you, it doesn’t have to go away.  We will be trying some soothing exercises, it is welcome to join.” Another approach once the feelings are acknowledged is to say, “Okay, this is happening, what is our next best option?”  This reframes the experience and can help them zoom out to gain a broader perspective.

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4.     Look for the "and" in your emotional experience: When one feeling overwhelms, others often still exist, just quieter. Surprisingly to some, we can feel happy and sad at the same time. Ask what other emotions they may be feeling to create space for a fuller emotional picture and a more balanced perspective. By looking for an “and,” you can help them create distance from less comfortable feelings. Example, “You have let me know you are feeling anxious, are there any other feelings present?”  Remember, there is a part of you feeling anxious, not the whole of you.

5.    Try regulating or grounding techniques: You can model these exercises and offer to do some with them.

  • Unclench and relax your jaw
  • Relax the space between your eyebrows
  • Imagine your stomach feels like jelly
  • Open your palms and then face up
  • Feel your feet on the ground
  • Shake out your body
  • Tap alternating hands on your knees
  • Put something cold on your neck, or hold an ice cube
  • Feel different textures (wrap in a blanket or walk barefoot)
  • Deep breathing (2 inhales through your nose, long exhale out through mouth); Disclaimer, this may not always be the most appropriate intervention, as it can exacerbate panic symptoms.

6.     Mindset

  • 5-4-3-2-1 Method- Identify 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste
  • Visualize and imagine a calming place in detail
  • Distract with simple questions, “What are you doing this weekend?, What did you eat today?”
  • Encourage them to focus on the smells or sounds around them

These are anchoring statements that can be used daily and during a panic attack; even if they don’t believe it in the moment, the body listens to what you tell it:

  • Repeat the phrase, “I am calm.”
  • Or “I am safe, I am centered, and everything is always working out for me.”

Not all of these interventions will be accessible or appropriate to do in the moment, they are recommendations. What works so well for one person, may not work for you, this is where therapy comes in; to individualize healing.

How therapy can help with anxiety and panic

Anxiety can be triggered by subtle stimuli — a fleeting scent, a distant sound, or a brief image. Therapy helps you identify these triggers and understand their impact. What goes on in therapy is a microcosm from what goes on outside of the office. It highlights areas of relative strengths and vulnerabilities.  In therapy, you gain the opportunity to:

1.     Experiment with new behaviors

2.     Modify existing patterns

3.     Step back and examine your thoughts and challenges objectively

Approaches like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and internal family systems (IFS) are particularly effective. They help you:

1.     Recognize thought patterns and behaviors fueling anxiety

2.     Identify and get to know the different parts of ourselves

3.     Develop strategies to reframe negative thinking

4.     Learn techniques to calm your body and mind

Through consistent practice, these methods can help rewire your brain's response to stress, fostering a more balanced and peaceful state of being. Everyone experiences anxiety and the good news is that with the right tools, you can learn to manage these feelings effectively for yourself and help support others.

Regularly practicing positive self-talk and visualizing calmness can gradually reshape your mindset. Your body and mind respond to these repeated messages, slowly turning them into habits. Over time, this consistent practice can make a calm demeanor your default state. It's like building any skill — with repetition, what once required effort becomes second nature.

If you or a loved one are looking at engaging with therapy to help experiences with anxiety or panic, Zencare’s therapist directory can help you find your best fit therapist. You can use the filters to narrow down therapists who specialize in Anxiety and meet any other important criteria.

Please Note: If severe anxiety symptoms persist or worsen, don't hesitate to seek immediate medical attention. In cases of extreme distress, difficulty breathing, chest pain, or thoughts of self-harm, call emergency services (911 in the US) or go to the nearest emergency room. Your safety and well-being are paramount. Remember, trained professionals are available 24/7 to provide the urgent care you may need.

References

  1. Bourne, E. J. (2020). The anxiety and phobia workbook (7th ed.). New Harbinger Publications.
  2. https://www.hhs.gov/surgeongeneral/reports-and-publications/youth-mental-health/index.html
  3. https://www.apa.org/topics/anxiety/disorders
  4. https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBSDataSummaryTrendsReport2019-508.pdf&sa=D&source=docs&ust=1722270894511586&usg=AOvVaw1WwJI9AYrO729vrXW4n0Hc