I've had a fair share of my panic attacks in public places and have seen all kinds of reactions. I know seeing a person in such a distressed state is not pleasant. It can be scary, it's most definitely awkward and can feel pretty bad if you don't know what to do. Today I wanted to tell you what are the best most appropriate reactions that I've gotten from people and what I would generally advise you to do if you face such a situation.
Every panic attack is a unique experience and it's very different for someone who knows what they are and have had them before and someone who has never experienced anything like this before. We'll talk about them both.
If somebody is clearly not alarmed by it, seems almost calm and is aware of their surroundings, you're probably looking at someone who has dealt with anxiety for a while. They know what's happening, they've been down that road before. They probably know what they need in order to be comfortable. In that situation, I would advise you to simply ask if they need anything. At this point they'd nod or shake their head, it should be very obvious. If they don't react to you at all, please don't persist with talking, because that can intensify the struggle significantly. You can gently repeat the question if you're not sure whether they heard it or not, but if they don't respond then, that's a "no".
If that person is not alone, you want to address the non-panicking person. You can receive some guidance from there.
However, if someone is panicking alone but said no to your help offer, probably the best thing you can do is to comfort the people around. They will be alarmed, they will be curious, some of them might want to ask if everything is ok. Indicate that there is nothing to worry about, you're helping that person already and everything is under control.
After the panic attack passes, the person will probably feel a bit guilty for alarming people around and taking your time (this is just my personal experience) and the best way to reassure them is to say that it's not inconvenient in the slightest, there is nothing to worry about and you were just making sure that everything is all right.
Let me give you a few examples when I felt like strangers nailed it. The first one happened on an airplane just after takeoff. The flight attendant immediately noticed and approached. She very quietly asked my husband if I'm feeling all right. He told her that it's just a panic attack and I'll be just fine on my own. The lady immediately left us alone and returned in about 20 minutes with a cup of water and the warmest smile in the world. Minimal talking, confidence and thoughtfulness.
The other good example would be a military post in Mexico. I don't do well on curvy roads, so my husband had to pull over (for some reason I can't have the panic attack in the vehicle, I absolutely have to get out of it and have it on the ground). It just happened to be 10-15 meters away from a military inspection (they have them everywhere in Baja). A soldier approached, of course. They have to make sure that we didn't pull over to dump something illegal or anything like that. He noticed I wasn't feeling great and asked my husband if there was anything they could do. He left right after Memo explained the situation. After I calmed down and we made it to the actual inspection, both soldiers looked me dead in the eye and asked me if I was all right and if there was absolutely anything that I needed. They were very nice. Actually, Mexican soldiers are always lovely.
The last example would be the only time my husband wasn't with me. It happened in my daughter's school. Sofi was next to me, so I had to explain to her what was happening. She knows I have panic attacks, she's seen most of them and my husband and I always take time to explain what they are and that there is nothing to worry about. But this was the first time we were by ourselves and she didn't quite know what to do so I was comforting her when her teacher discovered us. She sat by my side, took care of my daughter and repeated over and over: "It's all good. There is no one but us here. Take your time". Even though I don't like when people talk to me during those moments, it was incredibly soothing. It meant a lot. It was the perfect thing to say.
Now let's talk about people who don't have much experience with anxiety. The thing you need to keep in mind: if it's their absolute first panic attack, they'll probably believe something is seriously wrong. The first time I had it, I thought I was having a heart attack. It's painful, it feels unnatural and it's absolutely terrifying. So the very first thing you need to do is to tell them what's going on. Let them know that it's just a panic attack and they are in no danger whatsoever.
Having said that, you need to make sure that they are really having a panic attack and not something life-threatening. Unfortunately, you can't be 100% certain. For me, a giveaway will be the fear. They will be very confused, they will probably act frantic, they might bring their hands to their chest, they might try to flee or collapse to the floor, they might tremble.
Offer water if it's immediately accessible. Water is a great way to calm someone down. I have no idea why, but it works.
Offer them a bag. First of all, they might get nauseous and having a bag in their hands will be comforting. Secondly, hyperventilation does the most amount of damage here. It affects everything and the quicker you breathe, the more panicky and lightheaded you'll get. I actually carry a sickness bag with me at all times, although I rarely use it. Normally, I just cover my mouth with my hands.
Remind them that it doesn't last more than 20-30 minutes. The very first panic attack ever tends to last a bit longer than the rest. You naturally want to fight it and since such a thing is happening for the first time, you're extra scared. You don't feel safe. Right now, mine are usually 7-15 minutes, but 30 minutes is quite realistic when it comes to first times. Reassure them that it's nearly over. Give them something to look forward to.
Let them know that they are not an inconvenience. Panic attacks feel very embarrassing. Accepting other's help can be tough. Be very clear that you are absolutely staying with them for as long as needed, it's not a problem at all, there is no other place you'd rather be and there is no need to apologize.
Make sure your talking doesn't make them feel worse. I am one of those people who finds silence soothing. A word, a sound, a persistent person will make my panic attack longer, stronger and can even make it come back for round two. I always say it up front, but not everyone is able to speak well while panicking. Sometimes, people are lost for words. They might cover their ears, flinch or visibly shrink at the sound of your voice and that's a clear indication that being quiet is the way to go. In that case, just sit or stand near. Don't stare at them, there is nothing worse.
Don't let people disturb the panicking person. Attention is not the most pleasant thing is such a vulnerable moment, so make sure people don't approach. Again, just signal that everything is all right and you just need a bit of privacy.
Be thoughtful. Imagine yourself in their place. It's incredibly awkward and embarrassing (at least it has been for me) and people often get stuck and don't know what to say. Don't feel bad if they seem a bit distant after their panic attack. They probably don't know how to act. They might want to thank you and apologize for the inconvenience at the same time, but expressing it can be tricky. Don't expect much and go gentle on them.
Every panic attack is a unique experience and it's very different for someone who knows what they are and have had them before and someone who has never experienced anything like this before. We'll talk about them both.
If somebody is clearly not alarmed by it, seems almost calm and is aware of their surroundings, you're probably looking at someone who has dealt with anxiety for a while. They know what's happening, they've been down that road before. They probably know what they need in order to be comfortable. In that situation, I would advise you to simply ask if they need anything. At this point they'd nod or shake their head, it should be very obvious. If they don't react to you at all, please don't persist with talking, because that can intensify the struggle significantly. You can gently repeat the question if you're not sure whether they heard it or not, but if they don't respond then, that's a "no".
If that person is not alone, you want to address the non-panicking person. You can receive some guidance from there.
However, if someone is panicking alone but said no to your help offer, probably the best thing you can do is to comfort the people around. They will be alarmed, they will be curious, some of them might want to ask if everything is ok. Indicate that there is nothing to worry about, you're helping that person already and everything is under control.
After the panic attack passes, the person will probably feel a bit guilty for alarming people around and taking your time (this is just my personal experience) and the best way to reassure them is to say that it's not inconvenient in the slightest, there is nothing to worry about and you were just making sure that everything is all right.
Let me give you a few examples when I felt like strangers nailed it. The first one happened on an airplane just after takeoff. The flight attendant immediately noticed and approached. She very quietly asked my husband if I'm feeling all right. He told her that it's just a panic attack and I'll be just fine on my own. The lady immediately left us alone and returned in about 20 minutes with a cup of water and the warmest smile in the world. Minimal talking, confidence and thoughtfulness.
The other good example would be a military post in Mexico. I don't do well on curvy roads, so my husband had to pull over (for some reason I can't have the panic attack in the vehicle, I absolutely have to get out of it and have it on the ground). It just happened to be 10-15 meters away from a military inspection (they have them everywhere in Baja). A soldier approached, of course. They have to make sure that we didn't pull over to dump something illegal or anything like that. He noticed I wasn't feeling great and asked my husband if there was anything they could do. He left right after Memo explained the situation. After I calmed down and we made it to the actual inspection, both soldiers looked me dead in the eye and asked me if I was all right and if there was absolutely anything that I needed. They were very nice. Actually, Mexican soldiers are always lovely.
The last example would be the only time my husband wasn't with me. It happened in my daughter's school. Sofi was next to me, so I had to explain to her what was happening. She knows I have panic attacks, she's seen most of them and my husband and I always take time to explain what they are and that there is nothing to worry about. But this was the first time we were by ourselves and she didn't quite know what to do so I was comforting her when her teacher discovered us. She sat by my side, took care of my daughter and repeated over and over: "It's all good. There is no one but us here. Take your time". Even though I don't like when people talk to me during those moments, it was incredibly soothing. It meant a lot. It was the perfect thing to say.
Now let's talk about people who don't have much experience with anxiety. The thing you need to keep in mind: if it's their absolute first panic attack, they'll probably believe something is seriously wrong. The first time I had it, I thought I was having a heart attack. It's painful, it feels unnatural and it's absolutely terrifying. So the very first thing you need to do is to tell them what's going on. Let them know that it's just a panic attack and they are in no danger whatsoever.
Having said that, you need to make sure that they are really having a panic attack and not something life-threatening. Unfortunately, you can't be 100% certain. For me, a giveaway will be the fear. They will be very confused, they will probably act frantic, they might bring their hands to their chest, they might try to flee or collapse to the floor, they might tremble.
Offer water if it's immediately accessible. Water is a great way to calm someone down. I have no idea why, but it works.
Offer them a bag. First of all, they might get nauseous and having a bag in their hands will be comforting. Secondly, hyperventilation does the most amount of damage here. It affects everything and the quicker you breathe, the more panicky and lightheaded you'll get. I actually carry a sickness bag with me at all times, although I rarely use it. Normally, I just cover my mouth with my hands.
Remind them that it doesn't last more than 20-30 minutes. The very first panic attack ever tends to last a bit longer than the rest. You naturally want to fight it and since such a thing is happening for the first time, you're extra scared. You don't feel safe. Right now, mine are usually 7-15 minutes, but 30 minutes is quite realistic when it comes to first times. Reassure them that it's nearly over. Give them something to look forward to.
Let them know that they are not an inconvenience. Panic attacks feel very embarrassing. Accepting other's help can be tough. Be very clear that you are absolutely staying with them for as long as needed, it's not a problem at all, there is no other place you'd rather be and there is no need to apologize.
Make sure your talking doesn't make them feel worse. I am one of those people who finds silence soothing. A word, a sound, a persistent person will make my panic attack longer, stronger and can even make it come back for round two. I always say it up front, but not everyone is able to speak well while panicking. Sometimes, people are lost for words. They might cover their ears, flinch or visibly shrink at the sound of your voice and that's a clear indication that being quiet is the way to go. In that case, just sit or stand near. Don't stare at them, there is nothing worse.
Don't let people disturb the panicking person. Attention is not the most pleasant thing is such a vulnerable moment, so make sure people don't approach. Again, just signal that everything is all right and you just need a bit of privacy.
Be thoughtful. Imagine yourself in their place. It's incredibly awkward and embarrassing (at least it has been for me) and people often get stuck and don't know what to say. Don't feel bad if they seem a bit distant after their panic attack. They probably don't know how to act. They might want to thank you and apologize for the inconvenience at the same time, but expressing it can be tricky. Don't expect much and go gentle on them.
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