How to Be a Calm in the Storm: Recognising a Panic Attack in Public and Offering Help
A Practical Guide to Spotting and Supporting Panic Attacks in Public
You’re in a queue at the supermarket, waiting for a train, or simply walking through a park. Suddenly, the person next to you seems to be in profound distress. They might be clutching their chest, breathing rapidly, or looking around with sheer terror in their eyes. Your first instinct might be concern, but it’s often followed by uncertainty. What’s happening? Is it a medical emergency? What should I do?
In our fast-paced world, cases of anxiety and panic attacks are, unfortunately, becoming more common. Knowing how to recognise the signs and offer calm, effective support is a powerful skill—a form of mental health first aid that can make a world of difference to a stranger, a friend, or a loved one. This guide will equip you with the knowledge to be that calm presence in someone else's storm.
What Does a Panic Attack Actually Look Like?
First, it's crucial to understand that a panic attack is a sudden, intense surge of overwhelming fear and anxiety. It’s the body’s emergency "fight-or-flight" system firing off when there's no real danger. The symptoms are very real and incredibly frightening for the person experiencing them.
Recognising one is the first step to helping. Here are the common signs to look for:
- Physical Symptoms: Heart palpitations or a racing heart, sweating, trembling or shaking, shortness of breath or a feeling of being smothered, chest pain or discomfort, nausea or abdominal distress, chills or hot flushes.
- Cognitive Symptoms: A feeling of dizziness or lightheadedness, derealisation (feelings of unreality) or depersonalisation (feeling detached from oneself), fear of losing control or "going crazy," and an overwhelming sense of impending doom.
- Behavioural Signs: The person may suddenly stop what they are doing. They might try to leave the situation abruptly or seek escape. They often have a wide-eyed, terrified look and may be unable to communicate clearly.
It’s important to note that many of these symptoms, like chest pain, can mimic a heart attack. If you are ever in any doubt whatsoever about the person’s physical health, always err on the side of caution and seek emergency medical help immediately.
Your Step-by-Step Guide to Helping Someone Through It
If you’ve recognised the signs of a panic attack, your calm intervention can be a lifeline. Remember the acronym A.C.T. – Assess, Connect, Talk.
1. Assess & Approach
- Check Safety: First, quickly ensure the immediate area is safe for both of you (e.g., not in the middle of a busy road).
- Introduce Yourself: Approach calmly and gently. Make eye contact if they can manage it, but don’t stare intensely. A soft gaze is reassuring.
- What to Say: Use a low, soothing voice. Try something like: "Excuse me, I'm [Your Name]. You seem like you might be having a tough time. Can I sit with you for a minute?" Always ask for permission. Don’t touch them without asking.
2. Connect & Comfort
- Stay Calm: Your calm presence is the most powerful tool you have. Your steady demeanour signals to their nervous system that there is no actual danger.
- Use Grounding Techniques: Gently help bring their focus away from their internal panic and back to the external environment.
- The 5-4-3-2-1 Method: Encourage them to identify (aloud or in their head): 5 things they can see, 4 things they can feel (e.g., the ground beneath their feet, the fabric of their shirt), 3 things they can hear, 2 things they can smell, and 1 thing they can taste.
- Simple Breathing: Panic causes rapid, shallow breathing (hyperventilation). Don’t just say "breathe deeply." Instead, try modelling it. Say, "Let's try to slow our breathing down together. Breathe in with me for four seconds... and now out for six." The long exhale helps activate the body's relaxation response.
3. Talk & Reassure
- Validate, Don’t Dismiss: Never say "calm down," "just relax," or "it’s all in your head." This minimises their experience. Instead, use validating phrases:
- "What you're feeling is really scary, but it is temporary. You will get through this."
- "I'm here with you. You're safe. This is a panic attack, and it will pass."
- Ask How They Prefer to Be Helped: Some people need quiet, others may find a calm, distracting conversation helpful. Ask, "Would you like me to just sit here quietly with you, or would you like to talk about something else?"
What NOT to Do
- Don’t make a scene or draw a crowd.
- Don’t invalidate their experience.
- Don’t offer food or drink (they could choke), unless it’s a small sip of water once they’ve calmed down.
- Don’t assume you know what they need—always ask.
After the Storm Has Passed
Once the acute symptoms have subsided, the person will often feel exhausted, embarrassed, or vulnerable. Reassure them that this is normal. You can ask if there’s someone you can call for them or if they need help getting home. Simply staying with them until they feel grounded and ready to move on is a final, kind act of support.
Frequently Asked Questions (FAQs)
Q: How is a panic attack different from an anxiety attack?
A: While the terms are often used interchangeably, there's a subtle difference. Panic attacks come on abruptly and intensely, often without a clear trigger, and peak within minutes. Anxiety attacks often build more gradually in response to a perceived stressor and can linger for a longer period. The symptoms can be very similar, so the support techniques remain the same.
Q: What if the person thinks they are having a heart attack?
A: This is a very common fear. Reassure them by saying, "The symptoms of a panic attack and a heart attack can feel very similar. It's always okay to get it checked out to be safe." If the chest pain is crushing, radiates to the arm or jaw, or is accompanied by vomiting, call emergency services immediately.
Q: Should I offer medication if I have some, like anti-anxiety pills?
A: Absolutely not. Never offer anyone medication that is not prescribed to them. This is extremely dangerous and could have serious legal and health consequences.
Q: What if I try to help and they get angry or tell me to go away?
A: Don’t take it personally. In their state of fear, they may not be able to accept help. Respect their wishes. You can simply say, "No problem, I'll be right over here if you change your mind." The fact that you noticed and offered is still a meaningful gesture.
Equipping yourself with this knowledge doesn’t make you a therapist, but it does make you a more empathetic and capable human being. In a moment of sheer terror, your calm presence can be the anchor someone needs to find their way back to safety.
Did you find this guide helpful? Share it with your friends and family—you never know who might need to read it, or who might be there to help you one day.
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