Supporting a Loved One Through PTSD or Panic Attacks

This cartoon (from Robot Hugs), in my opinion, illustrates the perfect way to handle every PTSD or anxiety episode. If I could actually live inside a blanket fort forever, I would.

Unfortunately, flashbacks, panic attacks, nightmares, intrusive thoughts, memories, triggers, and all those other lovely things that survivors have to live with don’t have the courtesy to always wait for blanket forts to be available.

It’s scary for the person experiencing the attack, but it’s also scary for any loved ones who are trying to comfort and support someone through an attack.

This post is for the supporters.

Often in the midst of the episode, the distressed person doesn’t necessarily have their full vocabulary and can’t articulate exactly what they need in that moment. Afterwards, they may avoid talking about it out of embarrassment, fear, or a desire to preserve the peacefulness of the present.

So how do you learn what is helpful?

If you’re like my partner, mostly through trial and error. However, this cartoon inspired me to draw up a list of tips, taking from my own preferences as well as those of some friends. They’re not universal, but they’re a starting point, I think, for the right mindset.

Safety

Usually when someone is having an episode, they’re not actually in danger. Their body just thinks they are in danger. The first step to helping anyone is to remind them of their safety. It seems obvious, but just telling them they’re going to be okay can alleviate some of the stress of what’s happening.

However, please note that reassuring someone they are okay is not the same thing as minimizing the trigger or their response. Making fun of the trigger, ordering them to stop, scoffing at their response—those will exacerbate the situation rather than help it, and you may find yourself on the do-not-trust list in the future.

Anchoring

Someone who is experiencing a flashback or panic attack needs to have something to hold onto, to bring them back to themselves, and to put them in the present moment.

Jess M. mentions that shuffling cards, counting toothpicks, and other similar tasks helps her.

Dani, in her post from Friday, writes how important breath is in grounding. “Tell me to breathe, and then deliberately breathe for me so I have a rhythm to focus on and match.”

To be honest, telling me to breathe would probably make me swear at you. I prefer to have the “first aid box” that my therapist inspired me to create.  It’s filled with a range of things like incense, pictures, or slips of paper with quotes on them. Depending on what my trigger is, different things will speak to me at different times.

Obviously, these anchoring techniques differ from individual to individual and from situation to situation, but the goal is to gently engage the senses in a way that brings them back to the “here and now.”

Touch (Use with extreme caution!)

Touch can be one of the most beneficial ways of supporting someone through an episode, or it can be one of the most impairing. Touch is going to be incredibly specific to personal preferences and situations.

Dani states, “Sometimes it grounds me and gives me a point of reference. But I need whoever is with me to pay very very close attention to my body language when they touch me. Often I’m not able to speak to tell you whether where your touching is okay, and probably the only hint you’ll get that your touch is bad is that I’ll tense up all over.”

I like to be touched for the most part, but if touch brought on the panic attack (someone hugging me from behind or touching me without permission), then touch makes me practically feral. Sometimes I like to be cocooned in my partner’s arms so that I feel like nothing else can get to me. Other times, I desperately need to feel like I’m not trapped.

If you’re close to the person you’re trying to support, chances are you know whether they prefer touch or not. If you don’t know the person all that well, it may be better to just avoid touch altogether.

However, regardless of whether you know them or not, it’s always best to ask permission before touching. “Is it okay if I put my hand on your back?” “Is it okay if I hug you?” “Is it okay if I hold your hand?”

This is particularly important for anyone who has a history of sexual trauma or abuse since touch has so often been used to hurt.

Recuperation

Once the storm settles down, there are still residual effects. Don’t expect things to jump back to normal immediately. Fatigue usually follows, both physically and emotionally.

Some people, like Dani, will prefer spectator activities that don’t require much engagement. Others, like Angela and Jess M. prefer absorbing activities like reading or organizing. I tend to go for animated movies with happy endings or card games. However, Keith, John, and Jess D. all expressed that quiet was important for their recuperation.

Dani highlights the importance of providing simple options to choose from and of introducing those options slowly. Perhaps start out with some quiet sitting or some calm music, then in a little while suggest a few non-taxing activities that the person typically enjoys. Blanket forts are good here if you can build one.

Talk

Like touch, talking can be either good or bad.

Carol P. tells me that questions make things worse for her.

Machelle expresses that, “Sometimes I go deep inside of myself and I don’t come out until I have ‘it’ figured out. Other times I need to talk, talk, talk it all out.”

It’s a good idea to ask if they want to talk about what they’re feeling, thinking, or experiencing. Give them a lot of space to speak up because it can take a long time for someone to work up the courage to talk about their anxieties or traumas.

But don’t push.

It’s not necessary for you, the supporter, to know what is going on in order to lend support. Sometimes, the fact that you’re willing to sit there in silence, comfortable with not knowing, is enough to get someone to open up. It’s like a signal that tells them that you’re not going to push them for information they don’t feel comfortable giving, nor are you going to become so impatient with their process that you leave them hanging.

But even if they never tell you what was going on in their world at the time, that’s okay. They need that space, that right to keep their truth to themselves. It may feel like you’re abandoning them in their emotions, but respecting them in their choice not to talk is more supportive than forcing them to disclose.

Plan ahead

I hope that this post has given you some ideas of how you can support your loved one through crises, but the most important thing you can do to support someone is talk about it ahead of time. Let them know that you are interested in supporting them and ask them to articulate what they need in those times. Maybe even compile a first aid box together.

(And if you’re the person in need of support, don’t be afraid to send this post to your supporters and start a discussion of what the best way to support you would be).

Disclaimer: These tips are based on my own preferences as well as the feedback of several others who volunteered information for this post. They are not based on an official model of crisis management and should not be used as professional training. Their value comes from the direct feedback of those who are living with PTSD or panic attacks, but they are neither universal nor comprehensive. If you have a loved one with PTSD or panic attacks, I encourage you to get some educational books as well. Having more information will help you be a better supporter. 

This post is copyrighted. While I love it when others share my blog, I’ve come across several places where over half of this blog entry has been copied onto other websites without proper authorization or citation. I don’t think it’s been done maliciously, but it does violate my copyright. A sentence or two as a quote is fine as long as it clearly references Sometimes Magical as the author/source, but if you wish to use a paragraph or more for any reason (and linking doesn’t seem to suffice for your needs), my authorization is needed. I’m willing to work with other blogs or websites that wish to use my material as long as the proper form is followed with regard to credit and permission. You can refer to my Copyright policy if you have any questions. This blog entry represents alot of hard work, both on my end and on others’. Please respect me and those who contributed to this post by not stealing or misusing our words. Thank you!❤

262 thoughts on “Supporting a Loved One Through PTSD or Panic Attacks

  1. […] common for people with PTSD and trauma backgrounds to be resistant to touch when they are struggling with stress.  However, […]

  2. Reblogged this on Finding Streams in the Desert and commented:
    This is a great post about helping someone through panic attacks. It echoes my own experience and explains what goes on in one’s head during the panic attack very well. I hope someone finds this helpful!
    ~Claire

  3. Just to reiterate what people have said about the first aid box and thank them for the idea- it’s great! Supporting a loved one through PTSD or panic attacks, we have a poem I read to ground them to “water the good.” We also have a love journal with quotes, pictures, ticket stubs, etc.

  4. crtruelove says:

    Reblogged this on C.R. Truelove and commented:
    As one who struggles a few times a day with panic attacks particularly when alone, I found these tips helpful and especially like the “First Aid Kit” idea.

  5. These tips are very helpful, especially taking note about protecting the panic attack victim against harm to themselves.

    • I didn’t actually express anything about protecting someone against harm to themselves. I talked about reassuring them of being in a safe place and helping them ground. In general, I don’t think it’s a good idea to recommend people “protect” someone from themselves in such instances because the harm of ineffectively trying to help by controlling, forcing, etc is very high. I prefer a trauma informed approach that emphasizes giving someone support and empathy in ways that maximize their freedom and choice. In fact, I would not trust someone who thought they needed to protect me from myself because my abuse history has been largely rooted in control that was framed as “doing what’s best”.

  6. Clarsa McElhaney says:

    Very good article. I wanted to add that it helps for someone to ask me today’s date. It’s a little out of left field. It’s objective; engages a part of my brain that isn’t about emotion. And it reminds me in a non-judgmental way that what I’m reacting to isn’t happening now. Which opens me to the possibility that maybe now, I’m safe. Telling me I’m safe while my mind still thinks I’m in the middle of something that happened decades ago is somewhat insulting. Like accusing me of over-reacting, it implies that I’m incompetent to evaluate the situation – which may be true, but then I most certainly am not safe, am I?

  7. Lily says:

    I’ve found that asking if I’m okay and if someone can help, and asking permission to do things can be tricky for me. Many people have used the fact that they “asked” as an excuse to manipulate my answer to whatever they want to hear, force me to go along with their agenda, imply that I as a person am not okay, or judge my situation, mental state, or needs. I love it when strangers are cautious and assume that my situation is none of their business unless I make a request. If I do make a request, that is a rare, big deal to me. It needs to be honored. If a stranger wants to do something to fix me, they need to assume that the answer is no, and respect that without even bringing it up.

  8. Michelle says:

    Reblogged this on Reading, Drinking and Dancing with a Chaser of Snark and commented:
    This is really a fantastic explanation, in clear terms, of how to support someone living with PTSD.

  9. […] this article (which you should definitely read) they briefly discuss a first aid kit. It can be filled with […]

  10. bangel517 says:

    I just came across this article and I love it! It speaks right to my anxiety

    Can you give me more information on the “first aid box”? I would love to work with my therapist and create one.

    • The goal is to decorate a box in whatever way makes you happy and fill it with something soothing for every sense. Examples might include a bell (sound), incense (smell), herbal tea (taste), silly putty (touch), and pictures of places you like (sight). It’s pretty simple in instruction because it’s supposed to be very personalized. No one’s box will look like another’s.:)

  11. Victoria Ramirez says:

    Hello my name is Victoria my husband has anxiety he sometimes gets them frequently I’ve been very good at getting him out of it by talking with him getting his mind off it lately I have been panicking and going blank I don’t know what to talk about I just need help tips to strike up a conversation to help him get threw

    • Since I don’t know your husband, it would be really hard for me to know what would be helpful for him. As you can see from this post, it’s mostly about finding out from him what works. If the anxiety has gotten bad enough that it’s debilitating, a counselor would be the best option I could recommend because they can get to know him better than a stranger on the Internet and offer some suggestions of ways to work through the anxiety. While I’m happy to talk about what has worked for me and what others have told me works for them (which I do in this post), I am not in a position where I can advise someone I’ve never met about the precise nature of their loved one’s anxiety.

  12. 6031patrick says:

    Thank you for this. My wife was recently diagnosed with PTSD which for me has brought clarity about her actions in the last months. Being able to do something, even small, to help will be a relief. I feel so helpless against this.

    • Mark Hatting says:

      I don’t know your wife, but as a man married to someone with PTSD, I can say with near-100% confidence that your wife feels helpless against it, too. Open communication about it can help in ways neither of you thought possible, because it helps to make sense of what goes on. Clarity is powerful, and reassuring your wife’s safety and control during panic attacks and/or flashbacks can go a long way with getting through it successfully. PTSD is something a survivor deals with 24/7, and every day brings a level of uncertainty of things once certain, but you and your wife don’t have to face it alone. Support is out there.

  13. […] Supporting a Loved One Through PTSD or Panic Attacks […]

  14. Mark Hatting says:

    When it comes to PTSD survivors, make sure that they always are able to control the circumstances around them. Asking permission to touch is a great way to reassure control, and it can help the survivor stay grounded.

    Trauma always occurs during circumstances outside a survivor’s control and safety, so maintaining the survivor’s safety and control is a crucial to getting through a trigger and/or panic attack successfully.

  15. Diane Hinchey says:

    Thankyou, this explains why I’m the way I am. My family have made fun of me, taken advantage of me, & basically treated me like I’m Crazy Trash. They have put expectations on me ridiculed me whenever they could. Since I can remember, it’s been this way with my immediate family, & it hasn’t let up. So I stay away from them, & I’m better when I do. Could I please copy your article on my page? It may help others understand. Thankyou for sharing.

  16. Lynn says:

    I am an EMT and just got certified in mental health first aid. I also have Complex PTSD. May I share this with my fellow EMT’s? I know all of these things but cannot articulate it to my squad mates. We have been getting a lot of anxiety calls and I know that if you have never experienced an anxiety attack you have no idea what it feels like. While we can’t do some of these things as EMT’s, understanding what it is like is helpful. Thank you.

    • Feel free to share with them. If they have a budget for extra training, psychological first aid may be an evidence-based and useful tool.

    • Peace Hollow says:

      I actually think you have an advantage to help folks in EMT situations, much more so than co-workers who haven’t walked a mile in your shoes. And you don’t know if many of the EMT’s have PTSD either, and are having the same thoughts as you. Maybe that’s how or why they got into that line of work, was to help people because they know what it’s like? I’d consider picking a team member that you think would be receptive, understanding, and trustworthy to talk about your concerns and see where it goes. Ask them the same questions, if it would help or hurt to share with the squad. It could be a general topic for a squad meeting, without you being the focus. Do you have training meetings? I would think so. I have PTSD, and I’m learning that more people have it than I would have thought. Domestic Violence and Abuse seems to be a saturated environment for the conditions of PTSD. Hope this helps. ~Savannah

  17. […] Source: Supporting a Loved One Through PTSD or Panic Attacks […]

  18. […] Supporting a loved one through PTSD or panic attacks […]

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