Mental Health First Aid: How to Help Someone Experiencing Anxiety or a Panic Attack
A person having a panic attack may look frightened, struggle to breathe, clutch their chest, shake, feel dizzy or say they are losing control. To a bystander, it can be difficult to know whether the person is experiencing anxiety, a panic attack or a physical emergency.
Mental health first aid is the immediate support given to someone who is developing a mental health problem or experiencing a crisis. It continues until appropriate professional help becomes available or the situation settles. It does not turn a friend, colleague or first aider into a therapist. The goal is to protect safety, reduce distress, listen without judgement and connect the person with appropriate care.
This Canadian guide to mental health first aid for panic attacks is for general educational purposes. It does not replace certified first-aid training, a medical assessment or advice from a qualified mental health professional.
Anxiety, a Panic Attack and a Medical Emergency Are Not the Same
Anxiety may build gradually in response to stress, uncertainty or a perceived threat. A panic attack is usually more sudden and intense. It may involve shortness of breath, dizziness, a pounding heart, chest discomfort and a powerful sense of losing control.
Although panic attacks are frightening, their symptoms can also resemble those of a heart attack, breathing problem, medication reaction or another physical condition. A first aider should never assume that serious symptoms are caused only by anxiety.
| Situation | How It May Appear | First-Aid Priority |
|---|---|---|
| Heightened anxiety | Worry, tension, restlessness, rapid breathing or difficulty concentrating | Reduce immediate demands, listen and ask what would help |
| Possible panic attack | Sudden intense fear, racing heart, shaking, sweating, dizziness, chest tightness or fear of dying | Stay calm, check for medical warning signs and reduce stimulation |
| Possible medical emergency | New chest pressure, collapse, severe breathing difficulty, confusion or rapidly worsening symptoms | Call 9-1-1 and do not assume anxiety is the cause |
This comparison is not a diagnostic tool. When the cause of the symptoms is uncertain, especially during a first episode, seek urgent medical assessment.
Common Signs of a Panic Attack
A panic attack can affect the body, emotions, thoughts and behaviour. Possible signs include:
- A racing or pounding heartbeat
- Fast breathing or a feeling of not getting enough air
- Chest discomfort or tightness
- Sweating, trembling or chills
- Dizziness, nausea, numbness or tingling
- Feeling detached from oneself or the surroundings
- Fear of dying, fainting or losing control
- An urgent need to leave or escape
- Difficulty speaking or processing questions
Not everyone will show every symptom. A person may also experience panic quietly without obvious outward signs. Observe the situation without labelling the person or trying to make a diagnosis.
One panic attack does not necessarily mean that someone has panic disorder. Panic disorder generally involves repeated or feared attacks that cause ongoing worry, avoidance or significant changes in everyday behaviour.
Advice: First Aid Is a Bridge, Not the Treatment
Immediate support may help someone through a distressing episode, but recurring panic attacks, avoidance of everyday places or persistent fear of another attack deserve professional attention.
For people seeking anxiety and panic attack counselling services in British Columbia, Yuliia Kovalova counselling provides professional support from a Registered Clinical Counsellor in Canada. A family doctor or nurse practitioner can also assess physical symptoms and discuss suitable treatment options.
A first aider should focus on immediate safety and support. Long-term diagnosis and treatment should be left to qualified health and mental health professionals.
How to Help Someone Having a Panic Attack
1. Check the Person’s Safety and Medical Risk
Begin by making sure the location is safe for you and the person. Look for injury, substance exposure, severe breathing difficulty, collapse, confusion or a change in responsiveness.
Ask short, simple questions:
- Are you having chest pain?
- Have you experienced this before?
- Do you have a medical condition I should know about?
- Is there anything that usually helps?
- Would you like me to call someone?
Do not delay calling 9-1-1 when the symptoms could indicate a medical emergency.
2. Approach Calmly and Ask Permission
Introduce yourself if the person does not know you. Speak in a calm, steady voice and use predictable movements.
You might say, “I am here with you. Would you like some help?” Asking permission gives the person a sense of choice during an experience that may feel out of control.
Avoid touching, hugging or moving the person without consent unless immediate safety requires it. Some people find physical contact reassuring, while others may find it overwhelming.
3. Reduce Noise, Crowding and Stimulation
Where it is safe to do so, offer to move to a quieter location with fewer people, bright lights or competing conversations. Ask onlookers to step back and give the person physical space.
Do not restrain the person or block their path. Feeling watched, trapped or surrounded may increase panic.
4. Use Short, Reassuring Sentences
During intense panic, complicated explanations and multiple questions can be difficult to process. Speak slowly and communicate one idea at a time.
Helpful phrases may include:
- You are not alone.
- I am here with you.
- Tell me what would help right now.
- We can take this one step at a time.
- Would a quieter place help?
- Would you like me to contact someone you trust?
Acknowledge the experience without making medical promises. Saying, “This feels frightening,” is safer than insisting, “There is nothing wrong.”
5. Support Calm, Comfortable Breathing
Invite the person to follow your slower breathing pace or count gently with you. Encourage comfortable, unforced breaths rather than very deep breaths.
You might say, “Would you like to try slowing your breathing with me?” The person should remain in control of the exercise.
Do not command the person to take repeated large breaths. Forceful breathing may increase dizziness or make the person feel more distressed. If focusing on breathing makes the situation worse, stop and try a grounding exercise instead.
6. Offer a Simple Grounding Exercise
Grounding techniques can help redirect attention to the immediate environment. Ask permission before beginning and keep the exercise simple.
You could invite the person to:
- Press both feet gently into the floor
- Notice the support of the chair beneath them
- Name several objects they can see
- Describe the temperature or texture of an object
- Listen for a few sounds in the room
- Focus on one calm and familiar point in the environment
The aim is not to force the symptoms to disappear. It is to help the person reconnect with the present moment and feel less overwhelmed.
7. Stay With the Person and Continue Monitoring
Stay nearby until the symptoms ease, a trusted support person arrives or emergency professionals take over. Give the person space, but do not leave when their medical or emotional safety is uncertain.
Continue watching for worsening chest pain, severe breathing difficulty, fainting, confusion, weakness, seizures or a change in responsiveness. Call 9-1-1 if any of these signs appear.
What to Say and What to Avoid
| Helpful Language | Language to Avoid |
|---|---|
| I am here. What do you need? | Just calm down. |
| This is frightening for you. | You are overreacting. |
| Would a quieter place help? | Everyone gets anxious. |
| Would you like to slow your breathing with me? | Take a huge breath. |
| Would you like me to call someone? | There is nothing wrong with you. |
| We can take this one step at a time. | You need to stop doing this. |
Avoid arguing with the person, asking many questions at once or pressuring them to explain what triggered the episode. Do not offer alcohol, recreational substances or medication that was prescribed to someone else.
When to Call 9-1-1
Call 9-1-1 when the person has symptoms that may indicate an urgent medical emergency, including:
- New or unexplained chest pain or pressure
- Severe or worsening difficulty breathing
- Collapse, fainting or loss of consciousness
- A seizure
- Confusion or an inability to respond normally
- Sudden weakness, numbness or difficulty speaking
- A serious injury
- Possible poisoning, overdose or harmful substance exposure
- Symptoms that are unusual for the person
- A first episode with severe or unexplained symptoms
Call 9-1-1 when you cannot determine whether the symptoms are caused by panic or a physical health problem. It is safer to seek urgent help than to dismiss a serious condition as anxiety.
Call 9-1-1 as well if the person is at immediate risk of harming themselves or another person. Stay nearby when it is safe and follow the emergency dispatcher’s directions.
When to Call or Text 9-8-8
If the person talks about suicide, says they do not want to live or mentions self-harm, take the comments seriously. Ask directly and compassionately whether they are thinking about suicide.
Across Canada, people can call or text 9-8-8 for suicide crisis support 24 hours a day, seven days a week. A person who is worried about someone else can also contact 9-8-8 for guidance.
Call 9-1-1 when there is an immediate danger, a suicide attempt is in progress or urgent medical assistance is required.
Other Canadian support options include:
- Kids Help Phone at 1-800-668-6868
- Text CONNECT to 686868 for Kids Help Phone support
- Hope for Wellness Help Line at 1-855-242-3310 for First Nations, Inuit and Métis people
- HealthLink BC at 8-1-1 for non-emergency health information in British Columbia
What to Do After the Panic Attack
Once the person feels more settled, continue to respect their choices and privacy. Do not demand an immediate explanation or push them to resume normal activities before they are ready.
Helpful follow-up steps include:
- Ask what they need rather than making assumptions
- Offer to contact a trusted friend, family member or health professional
- Encourage medical assessment after a first or unusual episode
- Help arrange safe transportation when necessary
- Respect confidentiality and avoid discussing the incident unnecessarily
- Check in later without creating pressure
- Encourage professional support when panic attacks are recurring
For ongoing symptoms, the person may benefit from speaking with a family doctor, nurse practitioner, registered clinical counsellor, psychologist or another qualified provider.
Treatment for recurring panic attacks may include counselling, cognitive behavioural therapy, lifestyle support and, when appropriate, medication prescribed by a qualified health professional.
Mental Health First Aid at Work or School
Workplaces, schools and community organizations should prepare for mental health emergencies before a crisis occurs. A practical response plan can help staff provide consistent and respectful support.
A mental health emergency plan may identify:
- Staff members with first-aid or mental health first-aid training
- Quiet and private spaces
- Emergency and crisis contact numbers
- Privacy and confidentiality expectations
- Procedures for contacting family members or support people
- Options for arranging safe transportation
- Steps for connecting someone with professional care
- Procedures for documenting serious incidents appropriately
The role of a workplace or school first aider is not to diagnose an anxiety disorder. The role is to recognize distress, protect immediate safety, communicate respectfully and connect the person with appropriate assistance.
Frequently Asked Questions
How long does a panic attack usually last?
Many panic attacks reach their most intense point within several minutes and may last approximately five to 20 minutes. Symptoms can sometimes continue longer. Duration alone should not be used to decide whether symptoms are harmless.
Should I hug someone who is having a panic attack?
Only with clear consent. Some people find physical contact reassuring, while others may feel trapped or overstimulated. Ask before touching the person.
Should I leave the person alone?
Generally, stay nearby until the person feels safer or another responsible person takes over. Give them physical space, but do not leave when medical risk, self-harm risk or their ability to remain safe is uncertain.
Can a panic attack feel like a heart attack?
Yes. Chest discomfort, sweating, shortness of breath, dizziness and a racing heartbeat can occur during both a panic attack and a heart attack. A first aider should not try to diagnose the cause. Call 9-1-1 when symptoms are new, severe, unexplained or concerning.
Should I give the person medication?
Do not offer medication that belongs to someone else or suggest that the person change a prescribed dose. If the person has an established treatment plan or prescribed medication, allow them to follow the instructions provided by their health professional.
Contact emergency services if the person cannot respond normally, may have taken an unsafe amount or shows signs of an overdose or serious reaction.
What is the difference between an anxiety attack and a panic attack?
The term anxiety attack is commonly used to describe an intense period of anxiety, but it is not always used as a formal clinical diagnosis. Anxiety may build gradually and be connected to a particular stressor. A panic attack is typically sudden, intense and accompanied by strong physical and emotional symptoms.
Can panic attacks happen without an obvious trigger?
Yes. Some panic attacks occur in response to a recognizable source of stress, while others appear unexpectedly. A person may not be able to explain what triggered the episode, and a first aider should not pressure them to identify a cause.
What is the most important thing to remember?
Stay calm, take the symptoms seriously and do not provide care beyond your level of training. Support the person, check for urgent danger and connect them with appropriate professional help.
Calm Support Can Make a Meaningful Difference
Helping someone through anxiety or a panic attack is less about finding perfect words and more about remaining steady, respectful and focused on safety. Check for medical danger, ask what the person needs, reduce stimulation, communicate simply and remain present.
Mental health first aid cannot replace diagnosis or treatment, but it can reduce isolation and help someone reach appropriate care. In Canada, remember the primary support pathways: call 9-1-1 for immediate danger or urgent medical concerns, call or text 9-8-8 for suicide crisis support, and contact qualified health or counselling professionals for ongoing care.