Supporting a Loved One Through a Panic Attack: A Resource for Family Members, etc.

In the previous post, I wrote about how to survive a panic attack. In this post, we’ll explore how to support our loved ones when they are suffering panic.

Panic Attacks Are Not Just "All in Their Head"
Panic attacks are overwhelming surges of fear or distress, often accompanied by racing heart, shallow breathing, dizziness, and the intense feeling that something terrible is about to happen. Though they are not physically dangerous, they are emotionally intense and deeply unsettling to witness or experience.

Key insight: Panic is often rooted in attachment distress — a reaction in the brain's emotional systems that signals threat, disconnection, or vulnerability. Neuroscientist Jaak Panksepp identified PANIC/GRIEF as one of the brain’s core emotional systems — the same system activated during separation, loss, or loneliness.

What Panic Attacks Feel Like to the Person Experiencing One:

• “I think I’m dying.”

• “I feel like I can’t breathe.”

• “I’m going crazy.”

• “I have to get out of here.”

These thoughts are often not rational — they are physiological reactions.

What Family Members May Feel:

• Helpless

• Anxious or panicked themselves

• Frustrated or confused

• Unsure what to do or say

Important: The more confident and calm you can stay, the more their nervous system can begin to settle.

How to Help During a Panic Attack

DO:

• Speak gently and slowly. Try: “You’re safe right now. I’m here.”

• Guide them to breathe slowly (match your breath with theirs if they can’t follow commands).

• Help them orient: “Can you look around and name 5 things you see?”

• Offer presence, not solutions (don’t ask a bunch of questions): Sit beside them, be steady.

• Use their name. If appropriate, offer a hug, or touch their shoulder or hand gently (only if welcomed).

• Afterward, offer water or something grounding (a cool cloth, weighted blanket, or walk).

DON’T:

• Say “calm down” or “you’re overreacting.”

• Ask them to explain or justify their feelings.

• Leave unless they ask for space and are safe.

Understanding the Emotions Behind Panic: The Change Triangle (from the work of Hilary Jacobs Hendel)

The Change Triangle shows how we often move from core emotions (like fear, sadness, anger, joy) → to anxiety or panic → and then to defenses (like shutting down, lashing out, numbing). Panic attacks may appear out of nowhere, but they are often a signal that unprocessed core emotions have built up or been avoided.

Helping someone move from panic toward core emotion (like grief or fear) and then to connection or relief takes time, presence, and a calm environment.

You Are Not Their Therapist — But You Are Their Anchor

Your role is not to fix or diagnose. Your role is to be a safe attachment figure — someone whose presence says: “You are not alone in this.”

Think of yourself as a calm dock as they ride out a storm. You don’t have to stop the storm. Just stay close.

Helping Yourself While Helping Them

• Take a deep breath yourself.

• Remind yourself: “This is hard, but I can stay with it.”

• Reach out to your own support system if needed.

• Reflect on what you need afterward (rest, time alone, reassurance).

Repeat This to Yourself:

“This is not forever. This is a nervous system in distress. My steady presence helps.”

How to survive a panic attack

Many people have panic attacks or panic episodes. Panic might be one of the most misunderstood experiences in mental health. This is because many people don’t understand where panic is rooted in the brain and what that brain placement means. In the next post I will write about the meaning of panic attacks and how to support a loved one in a panic attack. For this post, here are immediate techniques you can try.

IMMEDIATE PANIC ATTACK TECHNIQUES

(Fast-acting methods to reduce panic and re-regulate)

1. Physiological Sigh (double inhale)

How to do it:

• Inhale once through the nose

• Take a second quick inhale on top

• Exhale slowly and fully through the mouth
  → Repeat 1–3 times

Why it works:
Rapidly reduces CO₂ and calms the autonomic nervous system by engaging the parasympathetic “brake.”
Source: Huberman Lab, Stanford Neuroscience; Zelano et al., 2016

2. Orienting (Somatic Experiencing®)

How to do it:

• Let your eyes slowly scan the environment

• Notice colors, shapes, light, or movement

• Gently turn your head as you do this

• Let your body follow what feels interesting or settling

• If rocking or swaying or other movement is spontaneous during this that’s fine too

Say to yourself:
“I’m here. I can look around. There’s no immediate danger.”

Why it works:
Engages the superior colliculus and ventral vagal system (Polyvagal Theory), signaling to the brain that you are safe.
Source: Peter Levine, SE International; Porges, 2011

3. 5-4-3-2-1 Grounding

How to do it:

• 5 things you see

• 4 things you can touch

• 3 things you hear

• 2 things you smell

• 1 thing you taste

Why: Brings you back to the present moment using sensory input, diverting focus from fear cycles.
Used widely in trauma-informed CBT and DBT

4. Box Breathing

How to do it:
Inhale – Hold – Exhale – Hold (4 seconds each)
→ Repeat 4–6 times

Why: Regulates breath rhythms and stimulates vagus nerve, reducing physiological arousal.
Navy SEALs, mindfulness protocols, HRV research

5. Cold Water or Ice Hack

How to do it:
Splash cold water on face or hold ice to palms or neck.

Why: Triggers the mammalian dive reflex, slowing heart rate and bringing attention back to the body.
Clinical anxiety relief; parasympathetic activation

6. “Feel Your Feet” Grounding

Press feet firmly into floor.
Wiggle toes, shift weight, sense contact.
Say: “These are my feet. The floor is holding me.”

Why: Activates proprioception, helps shift out of freeze or dissociation.
Somatic Experiencing®, Polyvagal Theory

7. “Name It to Tame It”

Say: “This is a panic attack. It will pass. I am safe even though it feels scary.”

Why: Puts language to emotion, engaging the prefrontal cortex to regulate the limbic system (amygdala).
Dan Siegel, “The Whole-Brain Child”