We all have seen people around us who get anxious and apprehensive about regular life situations. However, in some people, the apprehension and anxiety reach its peak and it brings about a lot of severe reactions from them. When a person loses sight and control of their anxiety, they usually go through a sense of panic. What they feel is completely different from the way they behave and it might confuse you. You may not understand exactly why this person is behaving in a strange manner. So first let us look at what you might see in a person experiencing a panic attack.

1. The first thing you might see if he/she starts shaking or trembling or they will start pacing continuously or they might cry uncontrollably

2. You will see that they start talking about negative consequences "If my work is not complete then what will I do?" " I am going to fail my semester" "He is going to break up with me and I am going to be left all alone" " I will never find anyone ever" "I will never get a job" "I am going to get fired from my job"These are the various ways the person will start talking

3. They might start yelling, shouting or even harming themselves in front of you if you are a close friend or a family member

You feel clueless as to what are you supposed to do when something like this happens. Your first impulse is to calm them down, but you don't know how. Then you try saying things like "It's all going to be alright and that everything will soon fall into place." "Don't worry everything will be fine" "Stop acting weird" "You are doing this to yourself". You might even slap them hard so that they stop being aggressive if it reaches that stage. You feel helpless and no matter what you say, it just doesn't seem to make any impact. 

You need to know what is happening in his/her mind. Let me give you an example. A girl is going through a rough relationship. She is failing her exams in college. She is late for an assignment submission and she asks her professor for more time. She has done this various times in the past, so her professor does not allow her to procrastinate further. She starts to feel overwhelmed and wants to do something about the situation but is unable to do so. She starts crying hard and starts creating panic in people around her. So, what exactly is happening to her? 

Let us break it down first. She is feeling several emotions simultaneously. She is ANGRY. She feels angry at her boyfriend for making her go through a tough time. She is angry at herself for not completing the assignment on time. She is angry at the professor for not allowing her more time. She is SCARED. She is afraid of losing her relationship. She is afraid of failing her semester. She is scared of her image being affected in front of the professor. She feels scared about her own reaction because she does not know what is happening to her. She feels MISUNDERSTOOD. She feels nobody can understand her situation. When people are around her and asking her why she is crying and behaving in this manner, she cannot explain it in words and hence has no idea what to say. Here, she expects that someone around her would just understand what she is feeling. What does she want? 

She wants TO UNDERSTAND what is it that she is experiencing and why. She wants COMFORT and someone to take the heat off of her. She wants ATTENTION because she feels lost in the crowd and lost in her emotions.She has magnified the consequences of these situations in her mind. This cognitive distortion (thought processes that are distorted or faulty leading to strong reactions) is called as MAGNIFICATION. In magnification, a person sees a very small inconsequential event as a huge one and does not see a way out of it at all. For example, in this case, the girl thinks "I will die if I break up with my boyfriend. He means everything to me." or " If I fail, then it is the end of my life. I will never be able to recover from this." So, now the most important question is how to deal with this?

STEP 1: Remind them to BREATHE

Often people in a situation like this, forget to breathe and calm down. Fast and shallow breathing cuts off oxygen supply crucial to the parts of the brain that require rational cognitive processes. So in a situation like this, just keep repeating "Relax, just take a deep breath". Do this at least 3 times. Let them take a few deep breaths. If the person is wearing something tight or has a tie on, you need to remind them to loosen their dress. While this is happening, remove all signs of stimuli (objects or people) around the person that might have triggered a panic attack. For example, if someone experiences a panic attack while watching a movie related to failure or heartbreak, or a song that reminds the person of a previously encountered fearful or anxiety-provoking situation, then it is best that this is removed from the person's vicinity. It is better if you just take the person to an open space like a balcony or terrace or a garden so that the person doesn't have to deal with the limit of the room they are in.

STEP 2: Offer a glass of WATER

Often drinking some water works as a distraction. When someone is experiencing a panic attack and has been sufficiently dehydrated, it may cause the body to have sensations of feeling light-headed or confusion. This sensation usually triggers a panic attack, though dehydration does not directly cause a panic attack. Also, usually if along with fear and anxiety, the emotion experienced is anger, then it creates a hot burning sensation around the throat. Drinking water takes care of both reasons.

STEP 3: Make them AWARE of what they are going through

As the person who is experiencing the attack is confused with what is happening to them, labelling their emotions might help them. However, first, you need to either hold them or hold their hand to reassure them that they are not alone. Then just say "I may not know what you are feeling, but I am here to listen to you. Are you feeling scared, sad, angry, anxious or all four together?" Allow them to exactly pinpoint what they're feeling and just listen to them. Labelling one's emotions is a good exercise when experiencing an intensely emotional situation. It allows one to process emotional information from oneself and helps in response rather than reaction. Let the person completely vent out and realise that the situation is not as big as he/she had imagined it to be. 

STEP 4: DO NOT give any ADVICE 

It is very important that you do not offer any advice or suggestion in this case. It is a natural reaction for us to say "It's alright everything will be fine. This is not the end of the world." or "You need to think positive. You are being negative right now." There is a chance you might just trigger another attack. Just be patient, and listen and just be there for them. Do not engage in a conversation at all because it ensures that the conversation goes to another level of anxiety and fear. The person thinks "You do not know everything is going to be fine. You are not living my life and you don't understand what I'm going through." Instead, just say "I'm listening" or "I understand". The person feels reassured that someone understands them and they are in a safe environment.

Follow these simple steps when someone goes through a panic attack. You will realise how quickly they overcome it at that moment. In case this continues, always contact a professional who can help them with their triggers and thought process.

Dealing with people who go through a tough time can be very stressful. The key is in doing the right thing at the right time and getting help for them when they need it.