How to Help Someone Having a Panic Attack: 5-Step Caregiver Protocol, What to Say, and When to Call 911

DO THIS RIGHT NOW if someone near you is having a panic attack

If someone you know is having a panic attack right now, use this 5-step protocol immediately:

Stay calm yourself. Your nervous system regulates theirs. Soften your voice, slow your breath, sit at their level. Do not panic alongside them.
Tell them "This is panic. You are safe. It will pass." Use simple words. Avoid "Calm down" or asking "What is wrong?" Stay near but do not crowd them.
Help them slow their exhale longer than their inhale. Model slow breathing: inhale 4, exhale 6 to 8. Breathe visibly with them. Do not force it.
Ground them in the room. Ask them to name 5 things they can see. Touch a cool water bottle. Feel their feet on the floor. Keep your voice slow and low.
Wait it out. Peak is about 10 minutes. Full resolution 20 to 30 minutes. Stay with them until they say they are okay, then stay a bit longer. Do not leave them alone.

GO TO THE ER NOW

If the person is experiencing any of the following, call 911 (US) or 999 (UK) or 112 (EU) immediately. Do not assume it is panic:

Chest pain that is heavy, crushing, or radiating to their arm, jaw, or back
Severe shortness of breath at rest (not just rapid breathing, but inability to breathe)
Slurred speech, confusion, or difficulty speaking
One-sided weakness or numbness
Sudden severe headache (unlike any they have had before)
Fainting or loss of consciousness
Blue lips or lips turning pale/purple
Suicidal thoughts or statements ("I want to die," "I cannot do this anymore")
First-ever severe episode (cannot assume panic without medical evaluation)

See PAG row #17 (Panic Attack vs Heart Attack) for detailed guidance on cardiac red flags and how to distinguish panic from true medical emergency. A chest pain visit is the correct call, even if it turns out to be panic. Per Mayo Clinic and American Heart Association, cardiac disease must be ruled out first.

Direct Answer: How to Help Someone Having a Panic Attack

To help someone having a panic attack, stay calm, reassure them they are safe, help them slow their breathing with longer exhales, ground them in the room, and stay with them without crowding. Most attacks peak in 10 minutes and resolve in 20 to 30. Do not call 911 unless there are cardiac red flags (crushing chest pain, severe shortness of breath at rest, slurred speech, one-sided weakness, sudden severe headache, syncope, blue lips, suicidal ideation). Per the National Institute of Mental Health (NIMH) and Mayo Clinic, your calm presence is the most powerful tool.

What a Panic Attack Looks Like to a Bystander

Before you can help, you need to recognize what you are seeing. A person having a panic attack may display:

Rapid, shallow breathing or gasping - chest heaving visibly, mouth open, air hunger
Gripping or clutching their chest - hand pressed hard over heart or sternum
Trembling or shaking - hands jittering, legs wobbly, voice shaky
Sweating - cold clammy sweat on forehead, neck, or palms
Face color change - sudden pallor or flushing (sometimes switching between the two)
Wide eyes or staring - eyes larger than normal, fixed gaze, "deer in headlights" look
Unable or unwilling to speak - one-word answers, long silences, difficulty forming sentences
Pacing or restlessness - unable to sit still, fidgeting intensely, moving without purpose
Urge to flee - wanting to leave the room, get outside, or escape the situation
Sometimes crying or emotional overwhelm - tears, shaking shoulders, inability to stop
Sometimes silent and frozen - no visible crying, but body rigid, eyes glassy, breathing labored

Not all attacks look the same. Some people panic quietly; others vocally. Some pace; others go rigid. You might see one symptom prominently or a combination. The key signal is the abruptness and the visible distress - they shifted rapidly from calm to severely uncomfortable, and their body is in fight-or-flight mode.

The 5-Step Caregiver Protocol, Expanded

Use this whenever someone near you is in the middle of a panic attack.

Step 1: Stay Calm Yourself

This is the foundation everything else rests on.

Your nervous system directly impacts theirs. When you are calm, your body language, tone of voice, and breathing signal safety to them. When you are panicked alongside them, you amplify their fear.

How to stay calm:

Soften your voice. Speak slower and quieter than you normally would. Lower pitch calms the nervous system. Avoid high-pitched or sharp tones.
Breathe slowly and visibly. Your breathing is contagious. If you take slow, deep breaths, they may unconsciously mirror you.
Sit at their level. Do not stand over them. Sit on the floor, on the arm of a couch, or squat down. Eye-to-eye or slightly below eye level feels less threatening.
Keep your face neutral or warm. Do not look frightened or shocked. They do not need to manage your emotions on top of their panic.
Move slowly. Jerky movements startle the nervous system. All movements deliberate and calm.

If you feel your own anxiety rising, take 10 seconds alone (step into the next room, take three slow breaths) to ground yourself. Then return. Your calm is their lifeline.

Step 2: Reassure With Simple Language

What you say matters enormously. The wrong words deepen the panic. The right words begin to regulate their nervous system.

What to say:

Pick one or two phrases and repeat them:

"This is panic. You are safe. It will pass."
"Your body is panicking, but you are not in danger."
"I am here. You are not alone. It will be okay."
"This will peak and come down. I will stay with you."

Say these phrases slowly and calmly. Repeat them. Do not expect them to believe you immediately. The repetition itself is soothing, and your calm delivery contradicts their fear signal.

What NOT to say:

These phrases, though well-intentioned, often worsen panic:

"Calm down" - sounds dismissive and implies they should control something they cannot
"You are overreacting" - invalidates the very real physical sensations they are experiencing
"What is wrong? What happened?" - interrogation triggers defensiveness and more adrenaline
"Is something wrong?" - implies there is actually a problem, when panic is false alarm
"You are fine" or "You will be fine" - dismisses the current distress and sounds like you do not understand
"Just breathe" (without guidance) - too vague; they are already breathing, just wrong
"Think about [happy thing]" - they cannot cognitively override panic; the brain is locked in fear mode

Avoid logic, explanation, or reassurance that requires them to think hard. Their prefrontal cortex (rational brain) is offline. Stick to simple, repeated phrases that signal safety.

Step 3: Help Them Breathe (Longer Exhale)

Panic breathing is rapid and shallow. This drops CO2, triggering tingling, dizziness, and more panic. The antidote is slow exhalation breathing, which activates the parasympathetic nervous system (the brake pedal).

How to guide their breathing:

Model it visibly. Do not just tell them to breathe. Breathe with them where they can see you. Your breath is the guide.
Use the 4-6-8 count: "Breathe in through your nose for 4... hold for 1... breathe out slowly through your mouth for 6, 7, 8... hold for 1... repeat."
Make the exhale longer. The longer exhale is what activates calm. Inhale 4, exhale 6 to 8. Do not make it equal.
Repeat 6 to 10 times. That is about 2 to 3 minutes. Do not force it beyond that; you want it to feel natural.
Speak slowly to set the pace. Your voice paces their breath. Slow words, slow breath.

Why this works:

Per Zaccaro et al. (2018), slow breathing with a longer exhale activates the vagus nerve, which triggers parasympathetic response: heart rate slows, blood pressure drops, stress hormones decline, and the amygdala (the alarm center) quiets. Additionally, the slower breathing corrects the CO2 drop that causes dizziness and tingling. The nervous system biochemically shifts from panic to safety.

You are not telling them to be calm. You are activating their body's calm system.

Step 4: Ground Them in the Room

Panic lives in the body and catastrophic thought. The antidote is shifting attention from the internal panic sensations to the external, safe environment. This interrupts the panic spiral.

How to ground them:

Ask them to name 5 things they can see. Not abstract things - visible, concrete things in the room. "I see the wall. I see your hand. I see a lamp. I see the door. I see the floor." Their eyes are open, attention moves outside their body.
Have them feel their feet on the floor. "Press your feet down into the ground. Feel the pressure. The floor is holding you."
Offer a cool water bottle. The sensation of cold is grounding. They can hold it, feel the texture, maybe drink a sip.
Have them touch a soft blanket or comfortable texture. Tactile input grounds the nervous system.
Keep your voice low and slow. The auditory environment matters. Soft music or white noise is fine; loud noises spike anxiety.
Reduce light if possible. Dim the lights or move away from bright screens. High stimulation feeds panic.

The goal is to shift the attention loop from internal catastrophe ("My heart will explode," "I am dying") to external neutral reality ("I see a wall, I feel the chair, my feet are on the ground").

Step 5: Wait It Out (Do Not Abandon Them)

Panic has a lifespan. The peak is usually 10 minutes. Full resolution is 20 to 30 minutes. This is neurobiological and time-bound. You cannot speed it up with more reassurance or action. What you can do is stay, ground them, and model calm.

What to do:

Do not leave them alone. The presence of a trusted person who is calm is your most powerful tool.
Do not check your watch or phone. Do not communicate that you are waiting for it to be over. Be present.
Expect the peak to feel dramatic. Around the 5 to 10 minute mark, symptoms may intensify before they decline. This is normal. Say: "This is the peak. It will come down from here."
Watch for the shift. Their breathing may slow on its own. Their trembling may ease. Their face may lose the intense fear look. These are signs the wave is declining.
Stay 5 to 10 minutes after it seems over. Even after the acute symptoms ease, the person is fragile. Stay until they ask you to leave or until you are confident the episode is fully resolved.

What NOT to do:

Do not say "See? You were fine the whole time" - this dismisses the real terror they experienced
Do not interrogate them immediately about what triggered it - save that for later when they are recovered
Do not try to problem-solve or analyze the attack in the moment - their brain is not ready
Do not leave the room or say "I need to go now" - abandonment can trigger another attack or deep shame
Do not share the story with others immediately in front of them - they may feel exposed or mocked

What NOT to Do (These Worsen Panic)

Avoid these actions and phrases:

Do Not Say "Calm Down"

This sounds dismissive. The person is trying to calm down and cannot. Your judgment makes it worse. Instead: "I am here. Let us breathe together."

Do Not Crowd Them or Hover Too Close

Physical closeness from someone outside their intimate circle can feel claustrophobic during panic. Ask before touching: "Can I sit next to you?" or "Is it okay if I hold your hand?" Some people want touch; others find it suffocating.

Do Not Touch Them Without Asking

Even if you think you are being comforting, unwanted touch can feel threatening during a panic attack. Always ask first.

Do Not Call 911 Reflexively

If you know the person has panic disorder and there are no cardiac red flags, calling 911 can actually reinforce panic. It communicates that panic is an emergency, which teaches their brain that panic is dangerous. Unnecessary ER visits erode their sense of safety and increase health anxiety.

When 911 is appropriate: Chest pain, severe shortness of breath, syncope, slurred speech, one-sided weakness, suicidal ideation, or a first-ever severe episode. Otherwise, let the attack run its natural course.

Do Not Give Them Caffeine

"To help you stay alert" or any other reason. Caffeine spikes adrenaline and extends panic. Offer water instead.

Do Not Dismiss the Experience Afterward

Do not say "See, you were fine" or "That was not that bad." The panic was terrifying from inside it. Validation: "That looked really hard. I am glad it is over."

Do Not Interrogate During or Immediately After

"What triggered it?" can wait. The person is exhausted. Let them rest before discussing what happened.

Do Not Abandon Them Once Symptoms Ease

The temptation is to leave once the acute distress passes. This can trigger a second attack or deep shame. Stay, let them rest, and check in a few minutes later.

Helping Someone in Different Settings

Panic does not happen only at home. Here is how to help in specific environments.

At Home

Move them to a quiet space. Bedroom, bathroom (with the door open), or quiet corner of the living room.
Dim the lights. Bright light and screens intensify panic.
Offer a blanket. Comfort and warmth signal safety.
Have cool water nearby. Not too cold; room temperature is fine.
Sit with them on the floor or couch at their level. Not standing over them.

In Public (Store, Restaurant, Street)

Do not embarrass them by drawing attention. Quiet, discreet help is kindest.
Move them to a less stimulating space if they want to move. Bathroom, empty aisle, or quiet corner. Ask: "Do you want to move somewhere quieter?"
A small, enclosed space (bathroom stall, car) is actually okay. Contrary to intuition, a small space can feel safer during panic than a wide-open area.
Do not restrain them or prevent them from leaving. If they need to leave, leave with them. Do not argue.
After the peak, sit in the car or find a bench and let them rest before resuming activity.

At Work

Discreetly move them to an empty meeting room or private office.
Manage the social fallout later. Right now, privacy and calm matter.
Text their partner or emergency contact if appropriate. Do not call them publicly where the person can hear.
Tell them: "Take the afternoon if you need to. We can manage. You rest."
Do not pressure them to return to the desk or meeting immediately.
The next day, check in quietly. Do not broadcast what happened.

In a Car

If the person is driving: Tell them to pull over safely immediately. Do not wait for a rest stop. Shoulder, parking lot, side street - somewhere safe and still.
If they are a passenger and having panic: Tell the driver to pull over calmly. "Your partner is having a panic attack. Let us pull over and help them."
Once stopped: Do not drive. Breathe with them, ground them, wait it out.
After 20 to 30 minutes: Check if they can drive or if someone else should drive.

In Bed at Night (Nocturnal Panic)

Sit up together. Lying down during panic can feel suffocating. Help them sit up against pillows.
Keep the room dark but not pitch black. Enough light to see the room but low stimulus.
Breathe with them slowly. Your calm breathing is especially powerful at night.
Do not turn on bright lights or check the time obsessively. This signals urgency.
Reassure them: "Your body is panicking, but you are safe in bed. I am here."
After the peak eases, stay until they feel ready to lie back down, then stay a bit longer.

During a Flight

Alert a flight attendant discreetly. They are trained and can often provide a quiet space or move seats.
Move them to an aisle seat or less crowded area if possible. Claustrophobia intensifies in middle seats.
Use the 4-6-8 breathing: Breathing exercises work especially well in the enclosed space of a plane because movement is limited.
Ground them using the senses: "Look out the window. Feel your feet on the floor. Listen to the engine hum."
Do not tell them to think about crashing or dying. Avoid fear-based reassurance.
After the peak, keep them distracted (movie, book, conversation) or let them rest.

With a Child (Ages 5 to 18)

Get to their eye level. Sit down so you are not towering over them.
Use calm, warm language. "Your body is having a big feeling. That is okay. I am here."
Do not shame them. Avoid "Stop crying" or "Be brave." Their feelings are real.
Name what they are feeling: "I see you are shaking. Your heart is racing. Your body is scared."
Ground them through a favorite toy or object. Holding their stuffed animal or favorite blanket is grounding.
Offer hand-holding if they want it. Many children find hand-holding calming.
Keep explanations simple. "Your body thinks there is danger, but there is not. You are safe."
After the attack, rest, do not immediately resume normal activity. Let them recover.
See a pediatrician or child therapist. Panic attacks in children warrant professional evaluation. Per the American Academy of Pediatrics, childhood panic is treatable with cognitive behavioral therapy and, if needed, medication.

With Your Romantic Partner (Special Case)

The dynamics shift when it is your partner. See section below on Partner-Specific Support.

After the Attack: Recovery Support (The First Hour and Beyond)

The acute attack is over, but the person is not fully recovered. This is the aftercare phase.

Immediately After (First 10 to 30 Minutes)

Do not interrogate. Resist "What happened?" or "Did something trigger it?" They are exhausted.
Offer hydration and food if they want it. "Water? Do you want to eat something?"
Offer a blanket or comfortable clothes. Post-panic bodies often feel cold.
Validate the experience. "That looked exhausting. You did really well breathing through it. I am glad it passed."
Let them rest without judgment. Some people want to talk immediately; others need silence. Ask: "Do you want to talk or just rest?"
Stay in the same room but do not hover. You are present but giving them space.

30 Minutes to 2 Hours Later

Light food and more water. The body is recovering from adrenaline surge. Digestion was suppressed; the parasympathetic system is re-engaging.
Do not replay the attack. Do not say "You were fine the whole time" or "That was not even bad." Their experience was real and terrifying from inside it.
Let them move at their own pace. Some people want to resume normal activity; others need the rest of the day quiet.
Check in: "How are you feeling? What would help right now?"

Later (Hours to Days After)

Schedule a proper check-in conversation, not in the immediate aftermath. This gives both of you space and time to process.
Do not use the attack as evidence against them. Do not hold it over them or use it to argue later.
Suggest professional support gently. "Have you talked to a therapist about panic? I think it would help."
Normalize the experience. Panic attacks are common and highly treatable. They are not a sign of weakness or mental illness; they are a treatable medical condition.

Long-Term Support: Teaching Someone to Help Themselves (and You)

If the person you support has recurrent panic attacks, long-term support involves a shift in your role. You cannot be the person who prevents every panic attack or rescues them from every one.

Do Not Become the Reassurance Source

This is the most important principle for long-term recovery.

If you are the person who talks them down every time, they become dependent on your reassurance. Per Craske (2009), inhibitory learning (the foundation of CBT for panic) requires them to learn through their own experience that panic is survivable and not dangerous. When you are always the rescuer, they do not learn self-efficacy.

Instead:

Teach them the 5-step protocol so they can use it independently
Encourage them to practice breathing and grounding when they are calm, so these tools are available under stress
Support professional treatment (CBT-Panic, medication) rather than becoming the treatment
Step back gradually so they build confidence in their own ability to manage panic

Encourage Professional Treatment

Panic is highly treatable. Cognitive behavioral therapy for panic (CBT-Panic), sometimes called Panic Control Treatment (PCT), has strong evidence for effectiveness. SSRI or SNRI medications also work well, especially combined with therapy.

Offer to help them find a therapist trained in CBT for panic
Attend one appointment with them if they want (many therapists allow this)
Do not replace the therapist with yourself

Learn Their Preferences and Create a Shared Plan

Everyone has different panic preferences. Ask them:

During a panic attack, do they want you present or nearby? Some people want you sitting right there; others want you in the next room.
What phrases help them? "This is panic" might work. So might "I am here" or "It will pass." Dial in what actually lands.
What grounding technique works best? 5-4-3-2-1? Holding ice? Breathing? Names things? Everyone is different.
Do they want to stay in the situation or leave? If they are at work, do they want to go home or stay at their desk?
Touch yes or no? Do they want hand-holding, shoulder pressure, or no touch?
After the attack, do they want to talk or be left alone? Some people need to process immediately; others need silence.

Write this down. Create a simple "Panic Response Plan" together:

"If I am having a panic attack:

I want you to [stay with me / give me space / hold my hand / etc.]
Say to me: [phrase that helps]
Help me by [grounding technique]
Do NOT [what makes it worse]"

Print it, put it on the fridge. When panic hits, there is no guessing.

Talk About It When Everyone Is Calm

Do not wait until panic strikes to discuss how to help. Talk when you are both calm, rested, and thinking clearly.

"I want to support you when you have panic attacks. What helps? What does not?"
"If you start panicking at work / at dinner / while driving, how do I help?"
"Are you seeing a therapist? How can I support your treatment?"

Partner-Specific Support: Agreements and Shared Protocols

If you are the partner of someone with panic disorder, you have a unique role. You are not the therapist, but you are a consistent presence.

Create a Code Word or Signal

Agree on a discreet signal for "I feel panic starting." Examples:

"Code red" (works anywhere, in public or private)
Squeezing your hand twice
A specific phrase: "I need to breathe"

This allows them to signal distress without having to say "I am having a panic attack," which can feel embarrassing in public.

Agree on Touch Preferences in Advance

Do not discover this during the attack.

Yes to: holding hands, gentle back rub, sitting together
No to: being held, being touched on the chest, being embraced from behind
Maybe: depends on intensity

Talk this through. Then honor it.

Agree on Whether to Stay or Leave

If they are panicking at a dinner party, a movie, or a public event, agree in advance:

Do you leave immediately?
Do you stay 10 minutes and reassess?
Does one of you leave and the other stays?
Do you ask to move to a quieter part of the venue?

There is no one right answer. But agreement prevents you from having to navigate it during the crisis.

Practice the Breathing Together When Calm

Before the first panic attack with you, practice the 4-6-8 breathing together at home. Get synced. So when panic hits, your breathing is already a familiar rhythm, not new instruction.

Debrief Afterward

Not immediately, but hours or days later:

"How was that for you?"
"Did my response help? What would have helped more?"
"Are you okay to keep living together while this is getting treated, or do you need space?"

Relationships can strain under panic. Check in on the relationship itself, not just the panic.

Remember: You Are a Support, Not the Treatment

Your partner needs professional help. You cannot fix panic. Therapy and sometimes medication do. Your role is to be calm, consistent, and supportive while they do the real work of treatment.

Self-Care for Caregivers: Do Not Burn Out

Panic attacks in someone you love are taxing. You may feel helpless, afraid, or exhausted. Your own nervous system can become sensitized to their panic.

You Cannot Regulate Them Without Regulating Yourself

Breathe. Use the same 4-6-8 breathing you teach them. It works for you too.
Decompress after their attack. You do not have to be calm the whole time. Afterward, step outside, call a friend, journal, or cry if you need to.
Talk to your own support. Tell a trusted friend, therapist, or family member how this affects you.
Do not personalize their fear. When they panic, it is not about you or something you did. It is their nervous system misfiring.
Set healthy limits. You can be a support without making their panic your responsibility. You are not their therapist.

Build Your Own Resilience

Get enough sleep. You cannot regulate another person's nervous system when yours is depleted.
Exercise. It lowers your baseline anxiety and increases your capacity to stay calm in crisis.
Eat regularly. Blood sugar crashes tank your ability to be patient and present.
Have your own life. Do not cancel all plans or withdraw from your own friendships and activities.

Know When to Step Back

If you are burning out or if your relationship is being damaged by you becoming the sole support system, it is time to encourage them toward professional help more firmly.

"I love you and I want to support you. And I think you need a therapist, not just me."
"I am exhausted. We both need professional help here."
"Your treatment is important. Let us find you a CBT therapist and a psychiatrist."

Resources for Learning More

Mental Health First Aid USA

Mental Health First Aid USA is a national program that trains people to recognize and respond to mental health crises, including panic attacks. A brief 8-hour course teaches the ALGEE model (Assess, Listen, Give First Aid, Encourage, Encourage Professional Help) and is available in most US states. Website: mentalhealthfirstaid.org

National Alliance on Mental Illness (NAMI)

NAMI offers peer-led support groups, family courses, and educational resources on panic disorder and anxiety. Their "NAMI Family Support" course is designed for family members and friends. Website: nami.org

Anxiety and Depression Association of America (ADAA)

ADAA maintains directories of therapists trained in cognitive behavioral therapy and exposure therapy for panic disorder. They also offer webinars and support groups. Website: adaa.org

Therapist Directories

Psychology Today (psychologytoday.com): Filter by "Panic Disorder" and your location to find local therapists
ADAA Therapist Directory (adaa.org/find-help): Specialists in evidence-based anxiety treatment
SAMHSA National Helpline (1-800-662-4357): Free, confidential referral to local treatment services

Crisis Support

If someone is suicidal or in acute crisis:

National Suicide Prevention Lifeline (US): 988 (call or text)
Crisis Text Line (US): Text HOME to 741741
International Association for Suicide Prevention: https://www.iasp.info/resources/Crisis_Centres/

FAQ: Common Questions About Helping Someone With a Panic Attack

Q: What should I say to someone having a panic attack?

A: Use simple, repeated phrases: "This is panic. You are safe. It will pass. I am here." Avoid "Calm down," "You are fine," or "Just breathe." Stick to reassurance, not logic or interrogation. Repeat the same phrases. Repetition is calming.

Q: Should I touch them or hold their hand?

A: Ask first. "Is it okay if I hold your hand?" or "Can I sit next to you?" Some people find touch comforting; others find it suffocating during panic. Honor their preference. If they say no to touch, respect that. Your calm presence is enough.

Q: When should I call 911?

A: Call 911 if there are cardiac red flags: crushing chest pain, jaw or arm pain, severe shortness of breath at rest, slurred speech, one-sided weakness, sudden severe headache, syncope (fainting), blue lips, or suicidal ideation. If you know the person has panic and there are no red flags, let the attack run its course. False ER visits can reinforce panic.

Q: Can I make a panic attack worse?

A: Yes. Saying "Calm down," hovering too closely, calling unnecessary ambulances, or leaving them alone can worsen panic. The worst thing is invalidation: "You are overreacting" or "There is nothing wrong with you." Validation and calm presence minimize worsening.

Q: How long should I stay with them?

A: Stay through the peak (about 10 minutes) and at least until acute symptoms ease (20 to 30 minutes total). Do not leave right when they feel better; stay 5 to 10 minutes longer. Leaving too early can trigger a second attack or shame.

Q: What if they are embarrassed afterward?

A: Normalize it. "Panic is medical. It is not your fault. It is not weakness. It is treatable." Do not minimize ("You were fine the whole time") or over-dramatize. Keep it matter-of-fact. Let them know you see them, not their panic.

Q: What if they have panic attacks frequently?

A: Encourage professional treatment. Frequent panic usually indicates panic disorder, which is highly treatable with CBT-Panic and medication. Your role shifts from crisis support to supporting their treatment (helping them find a therapist, going to appointments with them if invited, not replacing the therapist with yourself).

Q: Can I have a panic attack from helping someone?

A: Yes. Panic is contagious if you are not careful with your own nervous system. If you feel your anxiety rising while helping someone, take a brief step away, breathe slowly, ground yourself, then return. You cannot regulate someone else without regulating yourself first. Your calm is your tool.