Someone next to you is suddenly struggling to breathe, gripping their chest, shaking, maybe saying they think they are dying. Perhaps it is your partner, your child, a friend, a colleague, a student, or a stranger on a train. You want to help and you do not know what to do. This page is for that moment, and for the quieter hour afterwards.

There is also a one-page sheet you can print or keep on your phone, with the same steps in short form.

First, the one question that matters

A panic attack is frightening to watch, but it is not dangerous in itself. The trouble is that it can look like something that is. Only a medical professional can tell them apart, and you are not expected to. So the first question is not “Is this panic?” but “Could this be an emergency?”

Call emergency services if:

there is chest pain that feels tight, crushing or squeezing, or pain spreading to an arm, the neck or the jaw
they are struggling badly to breathe, gasping or unable to speak in sentences
they faint, or become confused or hard to rouse
this is their first attack like this, or it feels different from ones they have had before
they have a heart or lung condition, diabetes, are pregnant, or have taken something
it is not easing after twenty minutes or so, or it keeps getting worse
you are in doubt. Nobody will mind that you called.

Emergency numbers: Ireland 112 or 999; UK 999 or 112; rest of the EU 112; US and Canada 911; Australia 000; New Zealand 111; elsewhere, your local emergency number. If you can, stay on the line and do what the operator says.

If none of these applies and the person tells you they have had panic attacks before, what follows is for you.

What a panic attack can look like

A racing or pounding heart, fast or shallow breathing, sweating, trembling, a tight chest, nausea, dizziness, tingling in the hands, feeling unreal or far away, and a strong fear of losing control, collapsing or dying. It comes on quickly and usually peaks within about ten minutes. Most attacks pass in five to twenty minutes, though the shaky, tired feeling can last longer. NHS; healthdirect.

The person is not being dramatic. Their body has set off a full alarm, and everything they feel is real. What they need from you is not an explanation. It is calm company until the alarm winds down.

While it is happening

Stay, and slow yourself down first. Your own calm is the most useful thing in the room. Take a slow breath before you speak. If you are shaky too, that is normal; you can still help.
Ask what they want. “I’m here. Do you want me to stay close, or give you a bit of space?” Some people want a hand on their arm; others cannot bear to be touched. Do not grab or crowd them, and do not form a circle of onlookers around them.
Name it gently, once. “I think this might be a panic attack. It’s horrible, and it will pass. I’m staying with you.” If they know their attacks, this reminds them. If they are frightened it is something worse, see the question above, and do not argue with them about it.
Keep your words short and your voice low. Long explanations are hard to take in. “You’re safe. Breathe out slowly. I’ve got time.” Say less than you think you need to.
Let the breathing settle; do not force it. Breathe slowly with them, a little longer on the out-breath. Counting out loud together to five, in and out, gives both of you something to hold on to. Do not tell them to take deep breaths over and over; fast deep breaths can make the dizziness worse. Do not hand them a bag to breathe into; it is no longer widely advised, and a plastic bag is dangerous. HSE; Mind.
Give them something ordinary to do. Feet flat on the floor. Press their hands against a wall or a table. Name five things they can see, four they can hear. Stamp on the spot. Sip water. Anything simple and repeated that brings them back into the room.
Move only if they want to. A quieter spot, fresh air, or a seat can help. Being marched outside can feel like being in trouble. Offer, and go at their pace.
Wait it out with them. This is the part people forget. You do not have to fix it. Sitting beside someone for ten minutes while it passes is the help.

Words that help, and words that do not

Try

“I’m here.” “You’re safe with me.” “This will pass.” “Breathe out slowly, with me.” “No rush. We have time.” “What usually helps you?”

And words to leave out, even though they come naturally:

“Calm down.” They would if they could. It can land as blame.
“There’s nothing wrong with you.” Something is very wrong with how they feel right now, even if nothing is wrong with their body.
“Just breathe.” Said once, kindly, it is fine. Repeated, it becomes pressure.
“You’re being dramatic”, or “Not this again.” Shame makes the next attack more likely and the next conversation less likely.
Questions that need long answers. “What brought this on?” can wait until later.

Afterwards

When it eases, people are often exhausted, embarrassed or tearful. A glass of water, somewhere to sit, and a little time are usually what is wanted. You do not need to ask for an account of what happened. “That looked hard. I’m glad I was here” is enough.

Later, when things are ordinary again, two conversations are worth having, if the person wants them:

What helped, and what did not. Everyone is different. Asking means you will do better next time, and it hands the person back some control.
Whether to see a doctor. After a first attack, or if the attacks keep coming, a check with a GP or family doctor is sensible. It rules out physical causes and opens the door to help that works. The free panic attack plan is a good thing to make together on a calm day.

If the panic attacks keep happening

Repeated panic attacks, and the fear of the next one, are very treatable. Cognitive behavioural therapy for panic has good evidence behind it, and many people improve within months. Any question about medication needs to be discussed with a qualified prescriber. NIMH. The panic attacks page explains what treatment involves, and anxiety treatment sets out the options.

If the attacks wake them from sleep, panic attacks at night is written for that.

If they have started avoiding places for fear of another attack, afraid of the next panic attack may help you both.

Your part is encouragement without pushing, and ordinary life without reorganising it around the panic. If you notice that you have become the person who must always be there, or that places and plans are quietly being dropped, that is worth a gentle conversation too. How to help someone with anxiety has more on supporting without taking over.

Looking after yourself

Watching someone you care about in that state is frightening, and it can leave you shaky for the rest of the day. That is a normal reaction, not a weakness. Let yourself come down afterwards. If you are living with someone whose panic attacks are frequent, you need people to talk to as well, and there are limits to what any one person can carry.

Talking to someone

It can be very helpful to talk to someone, for the person who had the attack and for you. Here are a few ways to begin, to use or change as you like.

To the person, a day or two later

“I’ve been thinking about the other day. I’d like to know what helps you, so I can do it better next time. No pressure to talk about it now.”

If you are the one who has the attacks, to someone you trust

“Sometimes I get panic attacks. If it happens when you’re with me, the most helpful thing is to stay nearby and keep it simple. It passes in a few minutes.”

To a doctor

“I’ve had a few panic attacks and I’d like to understand what’s happening and what might help. Can we start there?”

There are more words to borrow in the free communication and appointment prompts. If someone is treating you badly or you do not feel safe with them, they are not the person to tell. Choose someone else, or a helpline.

If you need help now

If someone is in immediate danger, or cannot keep themselves safe, contact your local emergency services straight away. Ireland 112 or 999; UK 999 or 112; rest of the EU 112; US and Canada 911; Australia 000; New Zealand 111; elsewhere, your local emergency number.

Someone to listen, day or night: Samaritans 116 123 (Ireland, UK); text HELLO to 50808 (Ireland); call or text 988 (US, Canada); Lifeline 13 11 14 (Australia); call or text 1737 (New Zealand); elsewhere, findahelpline.com lists free helplines.

The one-page sheet

Everything above in short form, to print for a staff room, a classroom, a kitchen drawer or a wallet, or to keep on your phone. Free to read, and you may pass on unchanged printed copies that keep the website address, so others can find more free information.

Download the free sheet (A4) Download the free sheet (US Letter)

More free sheets, including the panic attack plan, are in the free collection.

Would you like to talk with someone? Dr Jonathan Haverkampf offers psychotherapy and counselling for adults on Dame Street in Dublin 2, or by video call where suitable. You are welcome to find a time that suits you.

Make an appointment

Sources

Sources checked 7 November 2026. This guide is educational. It is not a diagnosis, first-aid training or a substitute for care from a qualified professional. Disclaimer.

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More free guides at jonathanhaverkampf.com