7 Steps to Help Someone Manage a Panic Attack or Meltdown

Anxiety Attack Coping Skills for Grounding in Public/Shared Spaces

“I can’t do it, Kevin! I have to get off. I have to get OFF!” said the visibly distressed woman to her partner, as she bolted off of the elevator.

As the three of us were getting onto the elevator a few floors earlier, I could tell she was unsettled and I could see the man she was with was tentative as well – he seemed to be trying to support his partner while also unsure how to navigate the situation. She faced away, into the corner of glass at the back of the elevator, as he offered a reassuring hand on her back and we began to descend.

Bing! The elevator stopped four floors down, about half way to our final destination. She tensed up, adjusted her mask, and seemed to brace for impact. Two more people entered the large elevator. Then, in an instant, it happened. She exclaimed her immediate need to leave and bolted for the exit, right as the elevator doors began to close.

It could have been any number of things. Maybe she hadn’t slept or was coping with physical pain or difficult news. Maybe she was Highly Sensitive, Autistic or otherwise Neurodivergent and feeling flooded. Maybe the pandemic had left her fearful of close quarters. I wondered what had happened but, more importantly, I felt for both the woman in distress and the man struggling by her side.

I’m often asked how partners, parents, and friends can use panic attack grounding techniques for their loved ones who might experience distress – especially in shared spaces.

How to show up for someone in supportive ways during a wave of angst can be a challenge. Here are some panic attack coping skill tips that might help. Feel free to add these tips to your repertoire of how you show up for someone you care about or, if you’re someone who sometimes struggles with distress in outside environments, pass this along to the people who are often with you in these places.

Panic Management Tip #1: Read the room

If your loved one appears to be having a meltdown, scope out the exits, quiet corridors or corners, or even restrooms. When they’re distressed, they might not be able to survey the space and find places to get reprieve themselves. You can be the eyes and ears so that, if they need quiet or privacy, you can help them get situated.

Panic Management Tip #2: Be their advocate

If you’re in a bar or restaurant and some panic sets in and a hot tea or cool water could feel supportive, order it. My favorite go-to if you need to create some extra space or set some boundaries with outsiders is a warm and soft but confident, “Now isn’t a good time” followed by your request. For example, in the story above, for example, Kevin might have offered to those boarding the elevator a simple, “Now isn’t a good time, would you mind grabbing the next one?” Other examples might be “Now isn’t a good time, would you mind giving us a little space?”, or “Now isn’t a good time, could you come back later?” Of course, the other party is free to say no, but I find they usually don’t push back or ask questions, and even if they do, you’ve shown the person you’re with that you’re there for them and that they are the priority at that time.

Panic Management Tip #3: Carry a coping kit

Just like carrying regular first-aid supplies (band-aids, OTC pain meds, etc.) can be helpful, emotional first-aid supplies can be helpful when an anxiety attack arises. Carrying snacks or candies/gum, fidget toys, sunglasses or an eye mask, a soft shawl, or a sheet of bubble wrap for popping can sometimes be helpful. I also like to carry less common sensory things like a tiny bottle of lotion, a little jar or sachet of ground coffee or spices, or a mini notebook and pens.

Panic Management Tip #4: Offer low-key, private support

If verbal communication, touch, and eye contact aren’t comfortable for them in the current situation (or overall) but they’re engaging with their phone or tablet, send them a text. You know them best, so you can decide whether a simple, caring emoji is best or a longer statement like “I’m here for you when and if you need anything. You can wave me over, text me back or say my name. Whatever you need.” is best. Which leads me to the next strategy/tip…

Panic Management Tip #5: Discuss and plan proactively

Of course, one of the best ways to navigate panicky meltdown situations, and perhaps the most important, is to “cope ahead” by talking about what those experiences are like with your loved one. Finding out what might trigger states of distress can help you stay alert and be prepared.

Learning what might help, or make things worse, ahead of time is huge. They might carry special items like a stress ball, candies, or a fast-acting medication with them that are hard to find during distress – and knowing about these can help you help them.

They might feel supported, or might feel overwhelmed, if you offer a gentle back rub or hand to hold – so find out ahead of time what is acceptable/comforting for them. Even just inviting the conversation can help your child, parent or co-worker know that you’re a safe and understanding ally when they experience distress. So, invite them to talk about it and let them know that you care, you aren’t judging them, and you want to know whatever will be most helpful to them when the need arises.

Panic Management Tip #6: Care for your own nervous system

When you notice your loved one is starting to feel panicked, find your own stillness and inner calm. Feel your feet planted firmly on the ground. Do what you need to so you’re at your most solid. Use your own coping skills so you can keep your own sense of alarm and angst at bay. Slowly sip your beverage and/or find the serene places within the venue with your eyes. Slow your own heart rate by taking some slow and deliberate, but gentle, deep breaths. You’ll be amazed at how effective the natural co-regulation process can be, and that this feeling of safety and calm can extend to your loved one.

Panic Management Tip #7: Incorporate your expertise

Of course, bring in your own lived experience and expertise too. The most important strategy might be to apply what’s worked for you or them in the past during a panic attack. Take some time to sit with your memories and recall times when you’ve effectively supported someone through distress, or the person you care about has successfully coped with distress to really build up your toolkit.

One more word of wisdom…

Whether you have rejection-sensitivity dysphoria or just struggle with how to handle it when your effort to support someone through intense anxiety doesn’t land, remember that this process is trial and error. Either you’ve helped or you’ve learned more about them (including what doesn’t help), and usually if you stay in it and try other techniques, you’ll have done both. The important thing is that you CARE and that you are TRYING.