Coaching practices for What to Do When Someone's Having an Anxiety Attack

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Does this sound like the set of challenges you might be facing?

  • I always wait until I’m already in full panic to try to calm down, and by then it’s too far gone for anything to work
  • The second I feel my heart pound or my chest tighten I clench up and try to force it to stop, and the fighting just cranks it higher
  • The second I feel my heart race or my chest tighten I throw everything at making it stop
  • Even once the worst of it passes, I can’t get back into the room
  • I can feel it starting to build

Practices that may help

  1. Use grounding before anxiety peaks, not after
    Start the technique at the first sign of anxiety — not once the wave is overwhelming.
    The 5-4-3-2-1 Grounding Technique
  2. Allow the sensations without resisting
    Let the physical feelings of anxiety be present instead of bracing against them.
    The DARE Response to Anxiety, Made Practical
  3. Allow the sensations instead of fighting them
    Do not try to stop the racing heart, the dizziness, the breathlessness — allow them and observe.
    Panic Surfing
  4. Engage with the present moment
    Once the edge comes off, redirect attention fully into an activity or your surroundings.
    The DARE Response to Anxiety, Made Practical
  5. Deploy 4-7-8 as an acute anxiety interrupt
    Four cycles of 4-7-8 breathing can interrupt a building anxiety response before it escalates.
    4-7-8 Breathing, Made Practical
  6. Use a 30-second micro-grounding version for public settings
    In public or meetings, a single-sense version — three named things you can see — takes 30 seconds and shows nothing.
    The 5-4-3-2-1 Grounding Technique
  7. Rapid relaxation: achieve a relaxation response in 20–30 seconds
    Deploy a practiced, condensed relaxation sequence the moment anxiety begins rising.
    Applied Relaxation, Made Practical
  8. Rehearse the response before you need it
    Learn and practice the four steps in low-stakes moments so they are available under pressure.
    The DARE Response to Anxiety, Made Practical
  9. Interoceptive awareness
    Practice noticing and naming body sensations neutrally, so they stop reading as alarms.
    The Anxiety Toolkit, Made Practical
  10. Stay in the situation for the full arc
    Leave only after the attack has peaked and begun to subside — not in the middle, no matter how strong the urge.
    Panic Surfing

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