Panic Attack Guide

Panic Attack — Hyperventilation & Anxiety

Proper mental health first aid for panic attacks and hyperventilation to restore calm and regular breathing.

Assess Cardiac Risk First

Panic attack symptoms (racing heart, shortness of breath, chest tightness, numbness) closely mimic a heart attack. If the person has a history of heart disease, or if chest pain radiating to the jaw/arm persists, treat as a cardiac emergency and call 911 / 112 immediately.

Step-by-Step Instructions

1

Recognize the Symptoms

Identify common panic indicators: hyperventilation (rapid, shallow breathing), trembling, sweating, racing pulse, choking sensations, and an overwhelming feeling of dread or loss of control.

2

Move to a Safe, Quiet Area

Gently lead the person away from crowds, bright lights, loud noises, or triggers. Find a calm, comfortable place where they can sit down.

3

Guide Slow, Controlled Breathing

Encourage them to take deep breaths. Demonstrate the technique: inhale through the nose for 4 seconds, hold for 2 seconds, and exhale slowly through the mouth for 4 seconds. Focus on breathing together.

4

Apply Grounding Techniques

Help connect them back to reality with the 5-4-3-2-1 sensory method. Ask them to name: 5 things they see, 4 things they can touch, 3 things they hear, 2 things they smell, and 1 thing they taste.

5

Provide Quiet, Calm Reassurance

Speak in a soft, steady, and quiet tone. Keep sentences short: "You are safe," "I am here with you," "This feeling is temporary and will pass shortly." Do not invalidate their fear.

6

Stay with Them Until It Passes

Stay beside them. Do not crowd their space or make them feel trapped. If hyperventilation or severe symptoms do not improve after 20 to 30 minutes, consult a doctor.

Do's and Don'ts

Do's

  • Keep your voice calm, low, and reassuring
  • Practice box breathing or deep breathing exercises
  • Use grounding techniques to shift their focus
  • Assure them that they are safe and this will pass

Don't's

  • Don't tell them to "calm down" or "it's all in your head"
  • Don't crowd around them or restrict their personal space
  • Don't make them breathe into a paper bag (no longer recommended)
  • Don't leave them unattended during severe panic

Aftercare & Recovery

Let them rest and give them a glass of water. A panic attack drains physical energy, and they may feel exhausted afterwards.
Suggest discussing these episodes with a therapist or healthcare provider to establish helpful coping mechanisms.
Establish regular mindfulness practices, meditation, and exercise to strengthen stress resilience.