Panic Attacks!

I was asked to give some active suggestions, instead of just what NOT to do. It’s good to know that people care about other people, and want to be helpful. But, here is the problem: everyone is different.

In order to be helpful to someone who is having a panic attack it becomes important to know a bit more about what that person is all about.

The underlying causes of panic attacks are very varied, and often mysterious, even to the person who has them. People who have them develop a sensitivity to them, which makes them come more often.

What makes them frightening is that they are usually responses to irrational cues. People who get them are usually sensitive people to begin with, often this is some kind of genetic predisposition. Usually, they have been under stress often for a long time, sometimes for most of their lives. This stress makes them vigilant to any possible danger, real or suspected. Any change, even something positive, or something as small as becoming too tired, or too hot, can set them off.

Many people now realize that a “panic attack” is a a strong shot of adrenaline running through someone’s body. The kind of adrenaline a person should get when they are confronted with a danger: a tiger, a landslide, a terrorist — except the danger is not there, or at least it isn’t apparent to anyone else.

The person who is “panicked” feels his/her heart racing. They are breathing quickly, they often get sweaty and their mind get full of half thoughts that keep changing rapidly. Their most common response is something like “what the fuck is happening to me?” They feel as if they are going crazy, or having a heart attack or going to pass out. Some people feel as if the world is not real, or they are not real, or just that they are lost and want it to end.

What can anyone do to help?

Depends — on who they are, what has worked before, what shape they are in — physically, mentally, and socially.

Before I list some possible responses I want to make it clear that once a real panic attack begins the adrenaline has to work it’s way through the person’s body. That can take a while. There is no way to just turn it off.

Some possible responses:

Tell the person that they seem to be having a panic attack, which is not fun, but not fatal, and it will pass.

They can try to slow down their breathing — take deep breaths and hold them. Then let the air out slowly. Or blow into a paper bag.


You can try to distract them by getting them to talk about anything but the panic. Help them get their mind more organized, Tell them to do some arithmetic problems, or describe something real in their environment.


Get them to walk in circles or do jumping jacks ( if they are healthy enough) to use up the energy generated by the adrenaline.


Get them to face the fear: Are they having a heart attack? Did they turn into an unreal person? Can they breathe?


Our lives are much faster and more stressful, in more subtle but constant ways, than ever. Almost everyone with a job and a family has some level of anxiety, or people have anxiety because they don’t have a job or a family. Let people know, or know for yourself, that this is normal and wide-spread.

There are many good therapists who are well trained in how to help people deal with and even eliminate panic attacks. The approach usually needs two layers: One to deal with the symptoms, and another to deal with the stress of the underlying cause. People need to learn to chill and feel safe, but both of those often need a lot of work to achieve. It doesn’t just happen.

Try not to rush to use drugs. Some drugs can be helpful to treat the symptoms. But those drugs are often addictive, and they don’t help with changing the stressful circumstances that have caused this condition.

Obviously, this is a bit of a simplistic and over-generalized explanation. People are very complex. No one goes through life without anxiety. The causes are complex: a mix of genetics, environment, relationships, health and nutrition.

I hope this has been helpful. If you have any more questions you can ask. I am retiring from my practice and should have time to answer, although the last time I said that on an Internet site I got over 500 questions in three days, so be patient.

Be well. Take good care of yourself and those you care about.

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