Watching someone have a panic attack can be frightening, particularly if you have never seen it happen before. They may be shaking, struggling to speak or asking to leave. Other people become very quiet. You might be worried yourself and unsure whether to stay beside them, give them space or get help.
I would begin by finding out what they need, rather than trying to find the perfect thing to say. If this is a familiar panic attack for them, calm company and a few simple choices can help. You do not have to make the anxiety disappear. This article explains how to support someone during an attack, and how that support can change once they are feeling more settled. For the fuller explanation of the condition, see my guide to panic attacks.
What to do first
Ask them what is happening and what would help. If they recognise it as a panic attack they have had before, listen to what they tell you. They may want you to stay nearby, sit down with them or give them a little space.
If this is new to them, very different from their usual panic, or they seem seriously unwell, get medical help.
What to say during a panic attack
Keep your voice steady and your sentences short. You might say, “I’m here. Would you like me to stay with you?” If they tell you it is their usual panic attack, you can acknowledge that without dismissing how frightening it feels: “I know this feels awful. We can take a minute.”
Ask one question at a time and allow time for an answer. “Would you prefer to sit here or somewhere quieter?” is easier to answer than several people asking what is wrong. Some people want to talk; others find conversation tiring while the symptoms are intense.
If they want help with breathing, encourage an easy, gentle pace rather than repeated large breaths or a complicated counting routine. You can offer to do it alongside them, but stop if they find that unhelpful. There is more detail in my practical guide to managing a panic attack.
What is less helpful to say
“Calm down” gives the person an instruction without showing them how. “There is nothing wrong with you” can sound as though you do not believe what they are feeling. You can believe their distress without agreeing that the feared catastrophe is happening.
Try not to promise things you cannot know, such as “Nobody noticed” or “You definitely won’t be sick.” Repeating those promises may lead to another request for certainty as soon as the reassurance wears off. A more honest response is, “I can see you’re frightened. What can I do to help?”
You do not need to get every word right. If something you say makes them feel worse, listen and adjust. A kind response matters more than delivering a script perfectly.
Give them space and a choice
Ask before touching or hugging them. Avoid crowding them, drawing an audience or speaking over them. If you are somewhere busy, offer a quieter place nearby. They may prefer to stay where they are, and they may prefer to move.
Do not block the exit, take their belongings or insist that they stay to prove they can cope. Planned exposure work is agreed with the person; it is not something a friend should spring on them during an attack. If they have a treatment plan that includes staying in a particular situation, ask whether they want your help following it.
For example, if your partner becomes panicky in a supermarket, you could ask whether they want you beside them while they take a minute or whether they would prefer to step outside. Later, when they are ready to talk, you can discuss what they would like to try on another visit. The decision does not have to become an argument in the aisle.
Helping between panic attacks
Sometimes a person begins to feel they can only go somewhere if you are with them, or asks you the same health question many times a day. This can become exhausting for both of you.
Talk about it when they are feeling more settled. Ask what they would like to do on their own again and what help they would like from you. For instance, someone who wants to shop independently might first choose an item themselves while you shop in another aisle. A later visit could involve a short agreed period on their own. Agree on what to try together, and follow any advice they have been given in treatment.
Do not withdraw support suddenly or make affection conditional on completing a task. My explanation of safety behaviours describes why the purpose of a behaviour matters. Ordinary companionship, disability support and medically needed help are not things to remove simply because someone also has panic attacks.
After the attack
They may be tired, upset or embarrassed. Ask whether they would like some company, quiet time or help with an ordinary task. You do not need to analyse the whole episode immediately.
When they are ready, a short conversation can be useful: “Was there anything I did that helped?” and “Would you like me to do anything differently next time?” If they want to talk about what they feared, listen without arguing them out of every possibility. The guide to the first day after a panic attack covers the aftermath in more detail.
Helping a child or teenager
Stay with them as appropriate for their age, acknowledge the fear and help them explain what is happening. A child may describe a sore tummy or feeling strange before they can describe panic. Avoid treating this as attention-seeking or requiring them to use an adult’s coping plan.
If attacks recur or anxiety is affecting school, sleep, friendships or family life, speak with their GP and involve school supports where appropriate. A plan for attendance or facing fears should be developed with the child, their carers and relevant professionals. The HSE’s guidance on anxiety in children explains the support routes.
Helping at work or in public
Protect the person’s privacy. Ask who, if anyone, they would like you to contact. If you are a colleague, check whether they want the workplace first aider or other appropriate help, rather than announcing what you think is happening.
A short break or somewhere quieter may help, but the next decision depends on their condition and their job. Someone operating equipment, driving or caring for others may need to stop the task safely. Taking leave or asking for an adjustment can be appropriate; it should not automatically be described as avoidance.
When urgent help is needed
If they are injured, affected by alcohol or drugs, at risk of self-harm, or someone is in danger, get urgent help. You do not have to handle that situation on your own.
A short support script
“I’m here. We can take a break. Would you like me to stay with you or give you a bit of space? Just tell me what you’d like me to do.”
Use your own words. If the person has already told you what helps, that is a better starting point than memorising any particular sentence.
When to encourage further help
If attacks keep happening, the person is avoiding more of everyday life, or both of you are struggling to manage, encourage a conversation with their GP or a therapist. CBT for panic attacks can address the fear of symptoms and the responses that keep panic going. Offering to help arrange an appointment may be more useful than repeatedly trying to settle the same fear yourselves.
You are allowed to need support too. Agreeing what you can offer, and when professional help is needed, can make it easier to remain kind and consistent.