What’s the best way to respond when someone tells you they are having a panic attack or feeling severely anxious? There are many forms of anxiety disorder, including generalised anxiety disorder, agoraphobia, obsessive compulsive disorder, panic disorder, social phobia and PTSD. While social phobia is characterised by the ‘intense fear of humiliation in social settings’, panic disorder is often linked to a sudden and unpredictable feeling of terror.

Some common features of anxiety disorders are panic attacks or episodes, and the avoidance or fear of specific places or situations (crowds, or driving, or taking public transport). Panic attacks usually last for four to six minutes and can include a racing heartbeat, dizziness, nausea, numbness, trembling, sweating, chills or hot flushes, difficulty breathing, a sense of unreality and chest pains. According to SADAG, ‘Women are affected twice as frequently as men’ – more great news about being a woman today.

Here are a few suggestions for how to support a friend or loved one when they’re going through an episode or attack:

1. Curb the ‘What If?’ thoughts by helping them to focus on the present

The feeling of fear is disproportionate to the actual situation. You can help bring the the person going through the attack back into the present by encouraging them to focus on manageable tasks, for example, naming the objects or colours around them, or counting backwards from 100 in threes.

2. Confront it by naming or labelling the experience

Call it what it is (anxiety, a panic attack) and don’t wish the attack away. Accept it and encourage your friend to give it time to pass. SADAG suggests asking your friend to rate the feeling of fear or anxiety from zero to 10. Then encourage them to keep track of how it fluctuates and notice that it will not stay at the highest level for too long. Remind your friend that they will be okay – it’s an attack and it’s going to pass.

3. Ask and affirm, don’t assume

Ask the person what they need right now, and ask what you can do. They may be able to guide you and, for example, ask for help getting out of the building or for help with a specific need. Don’t make assumptions. It can sometimes help to affirm or support them with words of encouragement, or just affirmation – ‘we’ll stay here as long as you need to’ – depending on the person. You can also affirm them by acknowledging small victories; things that may seem unremarkable but are a huge deal for someone with an anxiety disorder, like making it to the shops. It’s important to commend small steps and not enable avoidance.

4. Don’t dictate or be dismissive

You can encourage breathing slowly, but don’t dismiss what is happening by saying things like ‘just relax’ or ‘calm down’. If they could, they would. Don’t say disparaging things like ‘you’re just being irrational’ or ‘you have to do x’ – that will likely make it worse. Be patient.

5. Don’t be a martyr

Do not panic when you see someone having a panic attack. You might understandably be concerned, but compounding it does not help. Do not sacrifice your own well-being or health to help someone with anxiety. This will cause resentment. It’s important to remain functional.

6. Help them to get help

Remember that the person may need professional help, and you can encourage them to do something about their anxiety.  Anxiety disorders may not be caused by a single condition or situation. The disorder could come about as a result of hereditary factors, brain chemistry, life experiences, or a combination of all three. It can be aggravated by certain physical or environmental triggers, so it may help to know what those are for the affected person. Cognitive Behavioural Therapy and medication in severe cases are the advised treatments.

In this story, we referenced SADAG a lot – if you need more information about specific types of anxiety disorders and how to diagnose them, we recommend downloading their excellent guide here.

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If you’ve got input on more ways to support someone struggling with anxiety, DM us on twitter or email our online editor at abigail[at]assocmedia.co.za.

More: 5 ways freelancing can effect your mental health