Panic attacks send adrenaline all over your body. When I have one, my heart races and my hands shake like someone’s doing brain surgery on me while I’m awake. The rest of my body might shiver or tremble with little seizures. My arms sometimes feel numb. It feels like someone replaced my heart with a thrumming hammer — and not a cool one handled by Chris Hemsworth, a really sh-tty one that might explode in my chest robot! Dick Cheney-style.
Since I can’t control when and where they’ll occur, I’ve had everyone from my brother (helpful!) to a random airline stewardess (not so helpful!) try to assist me when I’m panicking. Trying to help someone through a panic attack is really hard. I imagine seeing someone overcome with anxiety makes other people feel helpless and afraid. Should you rub their back? Should you sing to them? Should you call 911? It must be super difficult to know what to say. Here’s some hints about what you shouldn’t say to someone if you’re with them during a panic attack.
1. “You have nothing to be panicked about.”
We know. We know. We know. And because we know we have nothing to be panicked about, we panic even more. When I realize that my anxiety is unfounded, I panic even more because then I feel like I’m not in touch with reality. Scary.
Most of the time, a panic attack is irrational. Sometimes they stem from circumstances — a certain couch triggers a bad memory or being on an airplane makes you claustrophobic or a break up causes you to flip your lid — but mostly, the reasons I’m panicking are complex, hard to articulate or simply, unknown. I could tell myself all day that I have no reason to be having a panic attack and I would still be panicking. Sometimes, because I’m a perfectionist, I become even more overwhelmed when I think my behavior is “unacceptable” (as I often believe it is when I’m panicking). I know it’s all in my mind, but my mind can be a pretty dark and scary place when it gets going.
Alternate suggestion: Say, “I understand you’re upset. It is okay. You have a right to be upset and I am here to help.”
2. “Calm down.”
This reminds me of a MadTV sketch where Bob Newhart plays a therapist who tells his patients to simply “Stop it!” whenever they express anxiety or fear. As a sketch, it’s funny. In real life, it’s one of the worst things you can do to someone having a panic attack. When someone tells me to “stop panicking” or to “calm down,” I just think, “Oh, okay. I haven’t tried that one. Hold on, let me get out a pen and paper and jot that down, you jerk.”
One time, when I was having a particularly bad panic attack on an airplane, the stewardess came over and sharply told me that if I didn’t stop panicking, the plane would not be able to take off. On the one hand, she was right and I was a liability in the air. On the other hand, I then began panicking about how I was holding up the rest of the passengers. Her insensitivity worsened my condition. Instead of taking action so that they do relax, simply telling a panicking person to “calm down” or “stop it” does nothing.
Alternate suggestion: The best thing to do is to listen and support. In order to calm them down without the generalities, counting helps. My brother sometimes has me chant a mantra — doesn’t matter what the words are. The repetition is comforting.
3. “I’m just going to leave you alone for a minute.”
Being left alone while panicking makes my heart race even harder. The last thing I want is to be left by myself with my troubled brain. Many of my panic attacks spark from over-thinking and it’s helpful to have another person with me, not only for medical reasons (in case I pass out or need water) but also it’s helpful to have another person around to force me to think about something other than the noise in my head.
Alternate suggestion: It sometimes helps me if the person I’m with distracts me by telling me a story or sings to me. I need to get out of my own head and think about something other than my own panic.
4. “You’re overreacting.”
Here’s the thing: I’m not. Panic attacks might be in my head, but I’m in actual physical pain. If you’d cut open your leg, no one would be telling you you’re overreacting. It’s a common trope in mental health to diminish the feelings or experience of someone suffering from anxiety or panic because there’s no visible physical ailment and because there’s no discernible reason for the person to be having such a strong fear reaction.
The worst thing you can tell someone who is panicking is that they are overreacting.
Alternate suggestion: Treat a panic attack like any other medical emergency. Listen to what the person is telling you. Get them water if they need it. It helps me if someone rubs my back a little. If you’re in over your head, don’t hesitate to call 911. But please, take the person seriously. Mental health deserves the same respect as physical health.