Panic Attack Help Social Workers
Panic attacks can be a truly harrowing experience for both the client and clinician. Working in clinical social work, your likelihood of encountering someone who experiences panic attacks is significant. As a Social Worker, knowing effective panic attack help strategies is important. A recent US survey suggested that panic attacks are common, showing a lifetime prevalence of approximately 28% and 12-month prevalence of approximately 11%.¹
How I Help a Client During a Panic Attack
Once a client of mine had a panic attack in session, and I had to find a way to help them manage their attack. I’d be lying if I said the scenario wasn’t nerve-wracking for me (which I processed in supervision and took steps to care for myself afterward), but I was able to help my client navigate an intense moment by using the tips I’ve offered you here.
Helping someone decrease the severity and/or duration of a panic attack requires a careful combination of attitudes and techniques that, in tandem, help promote a sense of safety and can generate a mental/emotional gravity to help the client regain some stability and sense of control.
Effective Panic Attack Help
To provide effective panic attack help, you should familiarize yourself with the signs of a panic attack.
The National Institute for Mental Health describes a panic attack in the following way:
Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger. A person may also have a strong physical reaction during a panic attack. It may feel like having a heart attack. Panic attacks can occur at any time, and many people with panic disorder worry about and dread the possibility of having another attack.
The Mayo Clinic’s page on the symptoms of a Panic Attack and Panic Disorder state:
Panic attacks typically include some of these symptoms:
- Sense of impending doom or danger
- Fear of loss of control or death
- Rapid, pounding heart rate
- Trembling or shaking
- Shortness of breath or tightness in your throat
- Hot flashes
- Abdominal cramping
- Chest pain
- Dizziness, lightheadedness or faintness
- Numbness or tingling sensation
- Feeling of unreality or detachment
Panic Attack Help for People Who Have Never Had Panic Attacks Before
One of the trickiest things about panic attacks is that if someone has never had one before, they may feel or believe they are having a heart attack, as some of the symptoms present similarly. Speaking slowly and clearly, the first thing to ask the person is if this has happened before, if they are diabetic (some symptoms resemble hypoglycemia or low blood sugar, which can be medically serious) and if they have a heart condition.
If the person tells you that he or she has never experienced this state before and/or has a serious heart condition, seek medical attention immediately.
If he or she is diabetic, have him check his glucose level if able, or at least eat something sweet or drink some juice, as some symptoms may be related to low blood sugar.
As is the case across the mental health profession, is better to err on the side of caution and rule out medical reasons for symptoms first.
Working with a Client Effectively During a Panic Attack
- Don’t attempt to argue away the panic attack or become confrontational – use empathic language and convey understanding. Validate the panicked person’s experience, and affirm your support and presence -“I hear you, and I hear how awful this must feel right now.”
- Adopt a tone of gentle reassurance – don’t try to minimize or reduce the person’s feelings or experience – “you’re safe, I’m here, I’m not going anywhere.”
- Remind the person: “This feeling won’t last forever. You will be ok.” This is especially important, as during panic attacks it is common for the sufferer to experience a detachment from sense of time or reality, and a deep dread that their panic will last forever.
Additional Tactics for Effective Panic Attack Help
Panic attacks are not about seeking attention! In fact, drawing more attention, or being surrounded by multiple curious or concerned parties is likely to amplify the panic symptoms and the person’s feeling of dread and loss of control.
Avoid involving more people if you can. Often what a panicked person needs most is space, room to breathe, and one trusted, empathic, and validating voice that conveys understanding and safety. Furthermore, be aware of your physical proximity – sometimes moving close to a person or gently putting a hand on their shoulder can be calming, sometimes triggering.
If you feel the intuition to connect through a supportive touch, ask the client clearly and plainly: “Would it help if I sat next to you?” “Would it help if I put my hand on your shoulder?” Be prepared for them to decline or even reject this, and roll with the situation.
Find a safe space – some place quiet and beautiful, preferably out of extreme temperatures.
Often a person’s breathing is impacted by their panic episode, and they begin to hyperventilate. When we enter a panicked state, our breathing becomes rapid and shallow, which further signals our body to be stressed, hyperalert, and convinced of danger.
Guide the client through some deep breathing techniques such as belly breathing and yogic nasal breathing – these types of breathing activate our parasympathetic nervous systems, which has a soothing effect.
Grounding Techniques Can Also Be Really Helpful
Use some grounding techniques. Grounding techniques are a form of mindful distraction that can help pull a person’s racing, spiraling thoughts into focus on tangible, concrete objects of reality that are pleasant or beautiful. Think trees, flowers, but use whatever you have.
Once, a client entered a panic attack in the middle of our session while exploring her experience with trauma, and the grounding object I used was one of the pillows on the couch next to her. Employing a gentle and non-judgmental poise and warm, clear tone, I asked her easy, mundane questions rooted in her sensory experience, shifting the process from her mind to her bodily experience of the here and now.
These are the Questions I Asked My Client During a Panic Attack
- “Can you hear my voice? I am right here with you. You are in a safe space right now.
- Do you see the pillow next to you?
- Let’s take a deep breath together. Tell me about the pillow.
- What color is it?
- What shape is it?
- Tell me about the embroidery on the pillow.
- Can you touch the pillow? What texture does it have?
- Do you want to hold the pillow? What does that feel like?
- Does the pillow need to be fluffed? (at this point, the client’s process had begun to slow and stabilize enough that she was able to engage some levity, and gave a soft chuckle)
How Does This Panic Attack Strategy Help?
By shifting her focus to something immediate and concrete, we breached the spiral that had caught her mind. Think of an anchor to a ship in a storm. Once the panic attack had subsided, we were able to process the episode, and collaboratively identify what was effective panic attack help and what wasn’t. We were able to formulate coping strategies the client could take forward.