The other day I was trapped in an elevator. It was a hot and very crowded elevator. I noticed a woman crammed into the back corner in this dreadful space with her husband and 2 very small children and she was very clearly beginning to panic. There was a pregnant woman with an older child and her husband as well who was extremely calm and even joking. Then there were the rest of us that were somewhere in between the emotions of calm and total panic. I heard a man's voice say, "don't panic" in a relatively firm and somewhat harsh tone. The harsh tone may simply have been what it sounded like through my own anxious filter in that moment but nevertheless in was not a calming voice. The advice was clearly sound and rational because panicking in that situation is not useful but if you have ever experienced any kind of panic then you know that being directed simply not to panic is also not all that useful. It can even help to full the fire inside you. Of course we were rescued from the sweltering elevator in about 15 minutes and we all piled out into the cooler air to catch our breath, so this story has a happy ending. Some panic occurs as a result of an event like the one I described here but most often panic attacks happen with no obvious precipitating event. Whatever way it happens  it is at best unpleasant and at worst it is terrifying to the sufferer.

Here are some things you can do to help someone else get through a panic attack:

1)      Help the person to slow down their breathing. Have them take a deep breath and then let it out as you count to ten. Ask them to breathe in through their nose and out through their mouth.

2)      Have them do a simple physical task such as opening and closing a hand slowly. This can help them to refocus and distract them from the anxiety.

3)      Ask them to count with you by fives which is also a distraction.

4)      If there is an identifiable cause of the panic either remove it from the presence of the panicking person or move the person to another location away from the source. This is obviously not possible in an elevator.

5)      Talk to the person in a calm but clear voice (which means one that doesn't sound like you are experiencing panic). You can say "it's okay" but avoid statements such as "don't panic" or "there's nothing to worry about" or "your just having an emotional reaction." These statements are dismissive and can even exacerbate the genuine fear that is being experienced.

6)      If the person is unable to calm down after about 15minutes, or you are not completely sure what they are experiencing is in fact panic, then seek immediate medical attention.

Often people who experience recurring panic attacks are aware of what they need in order to calm down. If you want to help a friend or a mate who suffers from this type of anxiety ask them what they need. Ideally you can have this information prior to the onset of an attack. Some individuals like to be held tightly while others can't stand to be touched. Some people feel better if they are on their own and need to get distance and others don't want to be left alone.

It would be great to hear from some of you about what you find helpful when you are experiencing panic. Since everyone's anxiety is unique to them it is valuable to have a number of different tools to chose from when trying to restore a sense of calm.