If someone with anxiety is in crisis, stay calm, stay nearby, and speak slowly using short, reassuring sentences. Ask what they need and help them move to a quieter, safer place if possible. Do not assume new or severe physical symptoms are caused by anxiety. Call emergency services if they may be in immediate danger, cannot stay safe, or have signs of a medical emergency.
First, check whether the person needs emergency help
An anxiety crisis may involve intense fear, overwhelming worry, or a sudden wave of physical symptoms. The person may struggle to speak clearly, feel unable to cope, or need help moving through the next few minutes. A panic attack can also cause a racing heartbeat, trembling, sweating, dizziness, nausea, and shortness of breath.
According to the NHS guidance on anxiety, fear, and panic, anxiety can affect both the body and the mind, and recognizing the cause of symptoms is not always straightforward. Avoid assuming that a person is experiencing anxiety simply because they have an anxiety history.
Call your local emergency number or seek emergency medical care if the person has warning signs such as:
- Severe or new chest pain or pressure.
- Severe difficulty breathing or breathing that is getting worse.
- Loss of consciousness, a seizure, or sudden confusion.
- Sudden difficulty speaking, walking, or moving normally.
- A suspected overdose, serious injury, or other immediate medical danger.
- An immediate risk of suicide, serious self-harm, or harm to another person.
MedlinePlus emergency care guidance identifies severe chest pain, severe shortness of breath, fainting, seizures, and sudden neurological changes among reasons to seek urgent emergency help. New, unusual, or severe symptoms should not be dismissed as anxiety. If you are unsure whether the situation is a medical emergency, contact emergency services or a healthcare professional for guidance.
How can you help someone through an anxiety crisis?
1. Stay calm and remain nearby
Your calm presence can help the person feel less alone while they are distressed. Approach them gently, introduce yourself if needed, and speak in a steady voice. If the environment is crowded or noisy, offer to move with them to a quieter, safer place. Do not force them to move if doing so could be unsafe or would increase their distress.
Give the person time to respond. They may find it difficult to process long explanations or answer several questions at once. Allow pauses and focus on one simple step at a time. If they ask for space, respect that request when it is safe to do so, while remaining available to help.
2. Listen without judging or minimizing their feelings
Ask an open, simple question such as, “What are you feeling right now?” or “What would help you feel safer?” Let them explain their experience without interrupting, arguing, or immediately trying to solve the problem.
You do not need to understand exactly why the person is distressed to acknowledge what they are experiencing. Statements such as “I can see that this feels overwhelming” and “I'm here with you” communicate support without dismissing their fear. Avoid telling them that they are overreacting, that there is nothing to worry about, or that they should simply calm down.
3. Offer simple ways to focus on the present
When a person is overwhelmed, it may help to bring their attention back to something simple and familiar. Ask whether they would like to sit somewhere comfortable, feel their feet against the floor, or name a few things they can see in the room. Offer one suggestion at a time rather than giving a list of instructions.
Gentle breathing may also help if the person finds it comfortable. You could invite them to breathe in gently through the nose and breathe out slowly through the mouth, without forcing deep breaths or insisting that they follow a particular rhythm. Stop the exercise if it makes them uncomfortable, and seek medical help if breathing difficulties are severe, new, or worsening.
The Cleveland Clinic's guidance on panic attacks recommends remaining calm, staying with the person, using short sentences, asking what they need, and helping them focus on the present. These supportive steps can help while the episode settles, but they do not replace emergency assessment when warning signs are present.
4. Reduce pressure and offer practical help
A person in crisis may not be ready to discuss the cause of their anxiety or make decisions about what to do next. Avoid asking them to explain everything immediately. Offer specific, manageable choices, such as whether they would prefer to sit down, contact a trusted person, or move somewhere quieter.
Do not touch, hug, or hold the person without permission unless immediate action is needed to prevent serious harm. Avoid crowding them, raising your voice, or allowing several people to question them at once. Do not give them alcohol, someone else's medication, or extra doses of prescribed medicine as a way to stop the crisis. If they have a clinician-provided crisis plan, help them follow it when appropriate.
What should you do if the person mentions suicide or self-harm?
Take statements about suicide, self-harm, or not wanting to live seriously, even if the person has previously experienced anxiety without expressing these thoughts. Ask directly and calmly, “Are you thinking about suicide?” or “Are you thinking about hurting yourself?” Asking directly about suicide does not increase suicidal thoughts or behavior, according to the National Institute of Mental Health (NIMH).
If the person says they may act on these thoughts, has a plan to hurt themselves, or has already attempted suicide, arrange urgent help. Stay with them if it is safe for you to do so. Contact emergency services if danger is immediate, and do not leave the person alone while waiting for help if you can safely remain with them.
When safe and practical, help reduce access to medicines, weapons, or other items they might use to harm themselves. Do not put yourself at risk, physically struggle with the person, or promise to keep suicidal thoughts or plans secret. Involve a trusted support person and a qualified crisis or mental health service.
If you are in the United States, the 988 Suicide & Crisis Lifeline guidance for helping someone else recommends listening without judgment, taking statements about suicide seriously, and connecting the person with appropriate support. Call or text 988 for crisis support in the U.S. In other countries, contact the relevant local crisis service or emergency number.
What should you do after the immediate crisis passes?
When the person begins to feel more settled, avoid expecting them to return to normal immediately. Ask what they need next and whether they would like help contacting someone they trust. They may want some quiet time, practical assistance, or support getting home safely. Agree on a manageable next step rather than trying to resolve every concern at once.
Encourage professional assessment if the episode is new, unusually intense, recurring, or difficult to manage. A primary care doctor or qualified mental health professional can review the symptoms, medical history, timing, and other relevant information to determine what support is appropriate. Physical conditions can sometimes produce symptoms that resemble anxiety, so a healthcare professional may need to rule out other causes.
Prompt follow-up is particularly important if the crisis interfered with daily activities, the person feels unable to cope, or symptoms are worsening. The NHS guidance on anxiety and panic recommends seeking medical help when anxiety, fear, or panic is difficult to manage or self-help measures are not helping.
If the person already sees a therapist, doctor, or psychiatrist, encourage them to discuss what happened with that professional. With their permission, you could help them arrange an appointment, communicate concerns, or make a plan for obtaining support if another crisis occurs. Do not change their medication or treatment plan on their behalf.
How can you support a child or teenager during an anxiety crisis?
Children and teenagers may have difficulty explaining what they are feeling or understanding why their body is reacting strongly. They may cry, become restless, seek repeated reassurance, withdraw, or struggle to describe their fears. Listen patiently, use age-appropriate language, and offer simple choices instead of expecting them to explain their feelings in detail.
For a child or teenager, involve a trusted parent, caregiver, or other responsible adult when appropriate. If the young person may harm themselves, is in immediate danger, or has concerning physical symptoms, seek urgent professional help. Do not assume that an episode is harmless or simply a behavior problem.
If anxiety repeatedly affects a young person's sleep, school attendance, relationships, or everyday activities, arrange an assessment with a healthcare professional who can advise on age-appropriate support. During an immediate crisis, however, focus first on safety, reassurance, and getting the right help.
What if the person does not want help?
If there is no immediate danger, avoid forcing a conversation or insisting that the person accept every suggestion. Tell them you are concerned, explain what support you can offer, and leave the door open for further discussion. They may be more willing to consider help once they feel less overwhelmed.
If they are at immediate risk of serious harm, have attempted suicide, or show signs of a medical emergency, do not rely on their reassurance that everything is fine. Contact emergency services or an appropriate crisis service and explain what you have observed. Prioritize safety while protecting your own safety as well.
How can you prepare for another crisis?
If the person has experienced previous crises, ask about their preferences when they are feeling well. They may be able to explain which words help, which situations make them more distressed, whether they have a written crisis plan, and whom they would like contacted in an emergency.
With their agreement, keep important contact details accessible and discuss when to seek professional or emergency help. A clear plan can reduce uncertainty for both the person experiencing anxiety and the people supporting them. Remember that a plan should not delay emergency care when serious warning signs appear.