Updated: Sep 24, 2018
As ever, this advice won’t apply to everyone. Use it as a starting point for a conversation and to enable you to work out what is the best approach for yourself or your friend. I would really welcome any additional suggestions, advice or ideas you have to share – please leave them as a comment below. You can download this as a PDF handout here.
1. Take preventative action
Sometimes panic comes from nowhere, but sometimes we can feel it building up. When we feel it building we can take steps to prevent it, ideas to try include:
Being open and honest with a trusted friend or colleague and asking for their support preceding an attack
Taking active measures to use calming and relaxation strategies to try to control the underlying level of panic
Identifying and talking through the underlying feelings and sources of panic
Acknowledging that an attack may not be preventable and reminding yourself that if it happens it will only last for a limited time and I will be okay
Proactively considering where is the best place to be, and who is the best person to be with if an attack takes grip
Useful things to say to a friend:
I’m happy to listen if you’d like to talk about it
Are you able to explain how you’re feeling?
Is there anything I can do to help you feel calmer?
Is there somewhere we can go that you’d feel more comfortable?
Is there anything specific I can do to help you if you do have a panic attack?
I’m here for you and will stay with you until these feelings pass
You’re going to be okay, I’ll make sure you’re safe
You’re being really brave
Are you happy for me to be here or is there someone else you’d prefer?
2. Ride it out
If a panic attack sets in, there is little you can do except to ride it out. These attacks might last anything from 5 minutes to an hour but they will not last forever. No matter how many times you experience a panic attack, each time is completely unbearable, but remember – you’ve got through it before, you’ll get through it again.
A good strategy can be to try to manage your panic one minute at a time. You only ever need to get through the next minute. Focus on this and remember that with each passing minute, you are a minute closer to the end of the attack. Your body is physiologically incapable of maintaining a state of anxiety and panic indefinitely.
Useful things to say to a friend:
This will pass
I understand this is horrible, but you’ve got through it before, you’ll get through it again
You’re going to be okay
I’m here. I’m staying with you
You are safe
Let’s take this one minute at a time
Let’s focus on getting through the next sixty seconds
Your body can’t sustain this indefinitely, it will pass
We’re another minute closer to you feeling calmer again
3. Stay grounded
For some people (including me) at their peak, my panic attacks can give way to derealisation– a feeling of losing grip of who and where you are. To try and prevent this and to try to take control of panic more generally, it can be really useful to try and stay grounded and connected with reality.
How to help a friend:
There are some general ways that people find helpful to prevent derealisation and depersonalisation. You could encourage your friend to try these, they include:
Touching something warm or cold and focusing on the warmth or cold
Pinching yourself so that you feel how real you are
Trying to find a single object and identifying what it is and what you know about it
Counting something in the room. Identifying what they are
Utilising your senses in any way possible.
4. Use relaxation techniques and skills
There are a range of skills we can employ to help us feel calmer and more relaxed. These skills often work best if we practice them at times of calm so that we are better able to access them at moments of panic.
Different things work for different people but useful relaxation and calming techniques might include:
Listening to relaxing music
Walking with purpose
Guided meditation / mindfulness
How to help a friend
The most helpful way to help a friend is to talk to them at times other than those of high anxiety and ask them to help you understand what tools and skills they have for managing moments of high stress. They may be working with a professional to develop these skills via CBT (cognitive behavioural therapy) or DBT (dialectical behavior therapy). During calmer periods, ask your friend to explain these skills to you and discuss how you can help your friend to utilise them during times of higher anxiety.
No matter how well your friend learns their skills, it is likely that during an anxiety attack they may forget to use them or may struggle to employ them. With a good knowledge of the basics, you’ll be well placed to support and you may find the new skills you learn useful too.
I hope you find these ideas helpful - please leave a comment if you've got an experience or idea you'd like to share; or just to let me know if you found this helpful. Comments make me happy!
P.S. You might like this video I made about how to make life more manageable if you're living with anxiety: