Pamela feels her heart flutter suddenly. Then, perspiration runs down her face. She feels dizzy and worries, “Oh no, oh no, oh no, what’s happening?” In a flash, her worry turns to paralyzing panic, and she speed-dials her husband.
“I think I’m having a heart attack,” she exclaims when he answers.
Her husband’s voice is steady. “Remember what the doctor said last week at your appointment? He ran all those tests. Everything checked out fine, including your heart. He said it’s just anxiety.”
Just anxiety? Pamela’s husband reassures her he’ll see her soon. Knowing this, her heart rate begins to slow, and her nervousness abates.
Panic is a strange animal. The person feels the effects of extreme fear in the mind and the body but is not in danger. About one in ten adults in the U.S. have a panic attack over a 12-month period, and 30 percent of adults in the U.S. will have at least one during their lifetime, research shows. Women are twice as likely as men to have a panic attack. The average age of onset is the late teens or early 20s, but people of all ages have panic attacks, including children.
So how can you help someone who is panicking? Consider these ways.
1.) Know what panic is and is not.
A panic attack is an intense form of fear with two primary markers: anxious body sensations like a racing heart or trouble breathing and anxious thoughts. Disorienting, overwhelming, embarrassing, and defeating, panic can become all-consuming and interfere with work, travel, and everyday tasks like grocery shopping.
To an outsider, panic seems irrational. And it is! The panicking person fears her anxious thoughts and scary body sensations that make no sense to her. She comes to fear fear itself. When I had a full-blown panic attack while driving home on the expressway, which I detail in my minibook Help! I Get Panic Attacks, a well-meaning loved one attempted to help me by reasoning with me. Listen to this back and forth:
Friend: “You know you’re a good driver. You won’t get in an accident.”
Me: “I know, that’s not the problem. I’m terrified I’ll have another panic attack.”
Friend: “You shouldn’t be afraid. You’re thinking irrationally.”
Me: “I know it’s irrational! I just can’t stop.”
Rather than persuade me to get back out on the expressway, my friend’s counsel felt like salt in a wound. What I most needed in the moment was for someone to come alongside me, encourage me (1 Thess. 5:14), and show me the way out of fear. As you seek to help someone who is panicking, remember that Christian platitudes will often fall flat. Reminders about Jesus’s “fear not” statements (Matt. 10: 29-31, Mk. 6:45-52, Lk. 12:22-34, Jn. 14:27) or Paul’s call to “be anxious for nothing” (Phil. 4:6) run the risk of compounding the sufferer’s pain. The panicking person desires freedom from anxiety most of all! If she could think her way out of it, or “pray harder,” and be done with it, she would. But overcoming panic isn’t that simple. It’s a process that requires a caregivers understanding and patience.
2.) Recognize the mind-body connection.
This may sound backwards at first: the counseling goal cannot be the elimination of anxiety. Why? Because this goal is both unrealistic and unuseful. The Apostle Paul felt anxiety (1 Cor. 2:3-5). So did David (Ps. 55), Esther (Est. 4:13-16), and Abigail, too (1 Sam. 25). Since you and I—and every person on the planet!—dwell in fallen bodies in a fallen world, our anxieties will never be fully eradicated on this side of Heaven.
As caregivers, we want to help sufferers to better understand panic from a biblical perspective. This means affirming that fear can be experienced both in the mind and the body. Fear is a good, God-given emotion that helps keep us safe when threatened. We might jump back from a curb when a car zooms close or run to a toddler at the water’s edge. But in panic mode, the person is “filled with fear” (1 Peter 3:6b) and overcome by the fight-or-flight stress response of the sympathetic nervous system. Consider Psalm 55:4-8, which accurately describes what a panic attack feels like physically and spiritually:
“My heart is in anguish within me; the terrors of death have fallen on me. Fear and trembling have beset me; horror has overwhelmed me. I said, ‘Oh, that I had the wings of a dove! I would fly away and be at rest. I would flee far away and stay in the desert.’”
In your care of panicking people, it can be helpful to recognize how a panic attack progresses and to understand its involvement of both the body and soul. Consider this common progression:
- Something happens, either external (i.e., sufferer notices a shadowy figure or hear a strange sound) or internal (i.e., sufferer recalls a difficult conversation or feel nervous for no obvious reason).
- Sufferer then experiences an unwelcome mild, unexpected physical sensation, such as heart palpitations, dizziness, or perspiration, or an anxious thought, such as, What if I have an undiagnosed, terminal illness? or What if I lose my mind and go berserk?
- Next, sufferer likely hyper-focuses on the meaning of his/her anxious thoughts and feelings rather than dismissing them as no big deal.
- Sufferer catastrophizes and dwells on the worst-case scenarios.
- All these anxious thoughts and feelings create more anxious thoughts and feelings.
- A panic attack ensues!
Thankfully, the Scriptures speak to how believers can overcome the intense fear of panic. This Spirit-empowered process involves facing fears and taking small steps by faith—both of which can be realistic and useful counseling goals to set.
3.) Face fear and take small steps.
Facing fear means telling oneself what’s true (Phil. 4:8) and then acting on it, a step at a time. So what might that look like in the everyday life of the person we’re caring for? First, counsel the sufferer to monitor self-talk. Is the person’s words full of truth or scare talk? Scare talk sounds like, “Oh no, oh no, no, no, no. What if I pass out? What if I lose my mind? I’m going to die.” Scare talk worsens panic, whereas truth can help to mitigate it.
Second, help the sufferer to speak truth to his or her soul as did the psalmist in Psalm 42.
“Why are you cast down, O my soul,
and why are you in turmoil within me?
Hope in God; for I shall again praise him,
my salvation and my God.”
For a panicking person, truth-filled self-talk could sound like: “This is just an anxious feeling. This is just an anxious thought. This is discomfort. It is not dangerous. God is with me. I am safe in his care.”
Third, encourage the sufferer to practice facing her fears! The panicking person stays stuck because she doesn’t actively do what she is avoiding. For example, the fearful flyer practices facing her fears by choosing to go on flights. She might begin by first watching planes take off and land. Then, she might graduate to a short flight accompanied by a loved one, followed by longer flights. Based on the put-off and put-on principle (Eph. 4:17-32), as the panicking person puts off fear and puts on active faith (Heb. 11)—despite how she feels—her mind is renewed and her body’s adrenaline-fueled “alert” system will relax (Ro. 12:2).
At the end of the day, helping someone who’s panicking takes encouragement and patience while helping her to understand the nature of panic, the mind-body link, and strategies to speak truth to her soul. She is suffering. She wants freedom from her panic attacks. And you can offer the support she needs to face her fears in faith and dependence. It took me years to learn that all my panicked thoughts and body sensations were distorted—that I was safe. My mind and body calmed when I faced my fears and took small steps to victory (Ps. 27:1, 1 Jn. 5:4).
Editor’s note: Hear more from Lucy on this topic by listening to Christine Chappell’s interview with her, Hope + Help for Panic Attacks.
