Recurrent panic attacks are highly treatable. Many people benefit from evidence-based care such as therapy, medication, and nervous-system regulation strategies. For some individuals, TMS may be an additional, noninvasive option to discuss with a clinician.
How You Can Help Someone During a Panic Attack
Dr. Jamie Rogers • January 26, 2026
Helping someone through a panic attack
Your goal isn’t to “stop” it — it’s to communicate safety, reduce stimulation, and help their nervous system settle.
What’s happening
- Fight-or-flight turns on fast (heart pounding, shaky, dizzy).
- It can feel like danger even when there isn’t one.
- Confusion + “impending doom” thoughts are common.
What helps most
- Stay with them; speak in short, steady sentences.
- Offer simple choices (“sit or stand?”) to restore control.
- Model slow breathing (don’t force a technique).
What not to do
- Avoid “Calm down” / “Relax” / minimizing language.
- Don’t debate logic or push complex decisions.
- Don’t leave abruptly — stay until it eases.
When to treat it as an emergency
- New or unusual symptoms, or not improving.
- Chest pain radiating to arm/jaw/back.
- Loss of consciousness, seizure-like activity, severe distress.
Note: Panic symptoms can mimic medical events. When in doubt, seek urgent evaluation.
Panic attacks often arrive without warning and create a rush of fear and physical discomfort that feels out of proportion to any real danger. And while a single panic attack can be frightening, recurrent panic attacks can begin to take a serious toll on someone’s daily life.
Anxiety-related conditions (like panic disorders) are far more common than many people realize, affecting nearly one in five U.S. adults each year. This prevalence means panic attacks are not rare, isolated events. They’re part of a broader mental health picture that millions of people must navigate every day.
Panic attacks can be sudden and deeply unsettling for the person experiencing them as well as for those who witness them. Knowing how to help someone during a panic attack can make a meaningful difference in how they get through it.
What Is a Panic Attack?
A panic attack is a sudden surge of intense fear or discomfort that strikes even when there’s no real threat or danger present. During an attack, the body activates its built-in “fight-or-flight” system, flooding the nervous system with stress hormones and physical sensations designed for survival (such as heart pounding, rapid breathing, shaking, or dizziness).
Because this response is happening without an actual emergency, panic attacks feel confusing and disorienting for many people. They can also occur alongside other mental health conditions, but it’s important to note that not everyone who has a panic attack will develop panic disorder. Panic disorder is diagnosed when someone experiences recurring, unexpected panic attacks alongside persistent worry or behavioral changes related to future episodes.
What Causes Panic Attacks?
Panic attacks don’t always have an obvious cause, but several factors can increase the likelihood of one occurring. Some potential triggers include, but are not limited to:
- Phobias like flying or heights
- Reminders of past trauma
- High-stakes performance situations like public speaking
- Caffeine consumption
- Alcohol withdrawal
- Substance use
- Certain medical conditions
- Intense exercise that mimics panic sensations
In other cases, panic attacks seem to erupt “out of the blue,” which can make them feel even more frightening.
Recurrent panic attacks are associated with panic disorder and other anxiety-related conditions, all of which are relatively common and treatable. Research suggests that biology, genetics, and environment contribute to these patterns, and that some individuals may be more sensitive to bodily sensations or stress cues.
Chronic activation of the body’s
stress response
can further prime the nervous system, making it easier for panic to ignite even when no danger exists.
Signs Snapshot: what a panic attack can look like
Symptoms vary person to person. This “at-a-glance” view makes the full pattern easier to recognize.
Physical
- Racing heart
- Shortness of breath
- Chest tightness
- Dizziness
- Sweats / chills
- Trembling
- Numbness/tingling
- Nausea
- Choking sensation
Thoughts & feelings
- Impending doom
- Intense fear
- “I’m dying” thoughts
- Fear of losing control
- Fear of fainting
- Unreality / detachment
Behavior
- Seeking reassurance
- Avoiding triggers
- Freezing / withdrawing
How to Recognize the Signs of a Panic Attack
Panic attacks can look different from person to person, which is why it’s important to be able to recognize a range of symptoms. Some signs are highly visible, while others are entirely internal. Taken together, they reflect the body and mind reacting as if danger is present (despite no real threat). Here’s what to look for.
Physical Symptoms
Physical symptoms often appear quickly and can be intense enough to mimic a medical emergency, such as a heart attack. Common physical signs include:
- Racing or pounding heart
- Shortness of breath or feeling unable to breathe
- Chest pain or tightness
- Dizziness or lightheadedness
- Sweating or chills
- Trembling or shaking
- Numbness in the fingers, toes, or face
- Nausea or stomach discomfort
- Choking sensation
Because these sensations are alarming and hard to rationalize in the moment, many people genuinely fear they are in physical danger.
Cognitive or Emotional Symptoms
Alongside physical sensations, panic attacks can trigger cognitive distortion (thoughts that make the experience even more frightening). Cognitive signs of a panic attack may include:
- A sense of impending doom
- Sudden, intense fear
- Catastrophic thinking (“I’m dying,” “I’m losing control”)
- Fear of going crazy or fainting
- Detachment or unreality (depersonalization or derealization)
Behavioral Symptoms
Emotionally, panic attacks often feel overwhelming and frighteningly urgent, which may lead people to:
- Seek reassurance from others
- Avoid situations they associate with panic
- Withdraw or freeze due to overwhelm
These behavioral responses are attempts to regain safety or control during an otherwise disorienting moment.
How You Can Help Someone During a Panic Attack
When someone is in the middle of a panic attack, your response can make the experience feel safer and more manageable. The goal isn’t to “stop” the attack. You’ll want to stay grounded, communicate safety, and help the person’s nervous system settle. Here are a few supportive ways to accomplish that:
- Stay calm and stay with them. A steady presence helps reduce fear and prevents escalation, especially when the person feels disoriented or alone.
- Move to a quieter, low-stimulation space if possible. Loud crowds, bright lights, and sudden movements can intensify panic.
- Use short, simple sentences. Panic affects processing, so clarity matters. Brief statements like “I’m here,” or “You’re safe with me” land better than long explanations.
- Ask what they need by offering easy-to-understand choices. Try: “Do you want to sit or stand?” or “Would you rather stay here or step outside?” Offering options gives back a sense of control.
- Validate and reassure. Avoid logic debates or minimization. Instead, say things like “This is scary, but you’re not in danger” or “This will pass. Let’s get through it together.”
- Encourage slow, steady breathing, without forcing it. You can model slow breathing or count quietly, but avoid strict techniques that may backfire if the person feels pressured. If you model it, they may start to mirror your breathing pattern without realizing they’re doing so.
- Use grounding techniques when appropriate. The 5-4-3-2-1 sensory exercise can shift focus away from catastrophic thoughts and back into the present moment. But do not force this on the person if they’re not ready for it or open to it.
- Respect personal space and sensory needs. Some people find touch grounding; others find it overwhelming. Always ask first.
- Stay until the symptoms ease. Most panic attacks peak within a few minutes, and staying calm helps the person feel safer while it passes.
None of these steps requires medical training. All you have to do to help someone during a panic attack is remain calm, have patience, and demonstrate empathy. Your willingness to sit with someone in a moment of fear rather than trying to fix it can go a long, long way.
Grounding tool: the 5-4-3-2-1 reset
Use only if they’re open to it. The aim is to gently return attention to the present.
Open the step-by-step prompt
- 5 things you can see
- 4 things you can feel (feet on floor, chair, fabric)
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste (or a sip of water)
Tip:
Keep your voice calm and slow. If they get frustrated, pause and return to “I’m here with you.”
What Not to Do When Someone’s Experiencing a Panic Attack
Certain reactions, even if well-intentioned, can make panic attack symptoms worse or leave the person feeling misunderstood. For example, avoid saying things like “Calm down,” “Relax,” or “There’s nothing to worry about.” Minimizing or dismissing what they’re going through only increases fear and shame.
It’s also important not to compare their experience to your own or offer unsolicited advice in the moment. Doing so can feel invalidating and can overwhelm someone who is already struggling.
Steer clear of forcing specific breathing techniques or pushing them to confront whatever they fear, since these approaches may backfire during an acute episode. Only use breathing techniques if a loved one has previously expressed that it has worked for them.
Don’t leave suddenly, either. Staying until the episode eases helps prevent confusion or panic from escalating.
Finally, avoid pressuring them to make decisions or talk through complex issues while they’re panicking; their nervous system is in survival mode, not problem-solving mode.
In the moment: what to do (and what to skip)
Use short phrases, lower stimulation, and prioritize safety over “fixing.”
DO
- Stay with them and keep your voice steady.
- Offer simple choices (sit/stand, here/outside).
- Validate: “This is scary — I’m here with you.”
- Model slow breathing; let them mirror you.
- Move to a quieter space if possible.
DON’T
- Don’t say “Calm down” or minimize what’s happening.
- Don’t argue, lecture, or overload with advice.
- Don’t force breathing drills or exposure.
- Don’t make them decide big things mid-panic.
- Don’t leave suddenly — stay until it eases.
What If a Panic Attack Seems Like a Medical Emergency?
While panic attacks are typically not dangerous on their own, their symptoms can look and feel very similar to cardiac events (i.e., racing heart, chest tightness, shortness of breath, dizziness, or nausea). Because of this overlap, it’s important to stay alert to signs that may indicate a medical emergency.
Seek emergency care if:
- Chest pain radiates to the arm, jaw, or back
- Symptoms are new or markedly different than usual
- Symptoms persist despite calming efforts
- The person has cardiovascular risk factors
If there is loss of consciousness, seizure-like activity, or major medical distress, call 911 immediately.
Seeking a medical evaluation can help rule out conditions such as arrhythmias, thyroid issues, or cardiac disease. Alongside a mental health evaluation, this physical evaluation is an essential step for anyone experiencing recurring panic-like symptoms.
Find Lasting Support for Panic Attacks through TMS Therapy in Greenville, NC
Panic attacks can feel overwhelming in the moment, but it’s important to remember that they are highly treatable and manageable with the right support. Evidence-based care often includes cognitive behavioral therapy, medication, and lifestyle strategies that help calm the nervous system and reduce future attacks, while emerging treatment approaches continue to expand options for long-term relief (particularly for individuals who haven’t yet responded to traditional treatments).
One option for treating panic attacks and anxiety disorders that many people don’t realize exists is transcranial magnetic stimulation (TMS). TMS therapy is a noninvasive, FDA-approved, medication-free intervention that has shown promise for panic disorder and related anxiety conditions by safely modulating brain circuits involved in fear and stress.
If you or someone you love experiences recurrent panic attacks, you don’t have to navigate them alone. The TrueNorth IMH team is here to help you every step of the way.
Contact us to learn more about treatment options, schedule a consultation, or ask whether TMS may be right for you.
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