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. 

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