DR. ESSLIN TERRIGHENA shares some tips on how to support someone through a panic attack.
Panic attacks can seem scary and they can also be highly contagious. This is because as humans, we take cues from the people around us, and if they are experiencing intense terror, our brains pick up on this and alarm us that there is likely danger in our environment that we need to get away from. This is important to keep in mind when you recognize someone is experiencing severe anxiety or a panic attack, as we may start feeling anxious and distressed ourselves. This means, that our first step is using our own coping strategies to remain calm so that we are able to provide support to the anxious or panicked person.
Key to getting out of a panic attack is to soothe the body and help the brain recognize that we are not in danger. Here are some ways we can do that for someone else:
· Ask Permission – The person may be in an intense emotional state and feel overwhelmed, but that does not mean they cannot make choices. It is crucial to ask for permission on whether it is okay to help, stay, and provide some techniques to support them with. Having someone else just take control or start rattling down various coping techniques can add to a sense of disempowerment, unsafety, and panic. Being asked and granting permission can be an initial step in helping someone feel safer.
· Guide Breathing – Guiding breath with counting can become a comforting rhythm. 448 breathing involves breathing in to a count of four, holding breath for a count of four and breathing out for a count of eight can activate the parasympathetic nervous system which counteracts the sympathetic fight-flight activation and put the body into a rest, recovery, and calm state. Adjust the counting length if needed, but ensure that the exhale is at least as long as or longer than the inhale. For a guided breathing exercise, please click here.
· Facilitate Grounding – Grounding involves getting out of our heads and into our bodies and the here-and-now where it is safe. This is best done engaging all five senses: eyes, ears, touch, smell, taste. You can ask the person to name all items of a particular colour or sounds that they can hear, or describe a picture, sound, item, sensation, smell, or taste in detail. You can also encourage the use of items that stimulate the senses, for example a peppermint, ice cube, orange, or perfume. For loved ones, hugs, gentle touch, or massaging can be comforting and release oxytocin which can contribute to a sense of safety and connection. For a guided grounding exercise (Basic Vagus Nerve Exercise), please click here.
· Normalize Physical Symptoms – Panic attacks have very intense physical symptoms that can feel scary and like a serious health issue. It is not uncommon for people in a panic attack to think they may be having a heart attack or be dying. If you are able to, it can be beneficial to normalize the physical symptoms, give some information on panic attacks and what they are experiencing, and why. To familiarize yourself with what the symptoms are, please click here.
· Provide Reassurance – There are two important things to reassure someone experiencing a panic attack on: 1. We are safe where we are, 2. I am here and will not leave you. Create a safe environment for the person and remain present, supportive, and available. Always communicate clearly and calmly. If change is needed, communicate any kind of change before it happens and why it is happening, and how you will support the person. For example, if you have to move to a different place, if emergency line needs to be called, or if other people need to be involved.
· Questions – Questions can help to engage the higher cortical areas, but can also feel overwhelming or accusing to a person going through a panic attack. You can gently encourage them to share their inner experience, asking questions such as ‘what are you feeling?’, ‘what feels unsafe?’, or ‘what do you need?’. If the person is unsure, focus on providing reassurance, grounding, and breathing instead.
· If someone says stop, stop immediately – Sometimes help can feel like additional pressure or unsafe during a panic attack. If the person you are supporting asks you to stop what you are doing, do so immediately. Pause and, if feasible, reassure the person that you will not do anything that they do not want, and that you will stay with them until they feel better. You can try different techniques or re-visit the strategy at a later point, but it is important to make the person feel a sense of control over what is happening.