In conditions of war, prolonged stress and uncertainty, panic attacks and acute stress reactions are becoming common occurrences in the lives of many Ukrainians. Khristina Yasinska, psychologist and head of the psychological support sector at the Ukrainian Red Cross, explains how to recognise a panic attack, what to do if someone close to you is experiencing stress or has been through a traumatic event, and how to provide first psychological aid.
First psychological aid for panic attacks
A panic attack is a sudden onset of intense fear or discomfort that usually peaks within 10-15 minutes. However, it may seem to the person that the attack lasts longer. It is important to be able to recognise the symptoms, especially if the person themselves is not aware of them.
‘A panic attack can manifest itself as rapid heartbeat, trembling, cold sweat, a feeling of suffocation or pressure in the chest area, as well as fear of losing control or dying,’ explains Khristina Yasinska. ‘Sometimes the symptoms are confused with a heart attack, so if the condition does not improve, call an ambulance.’
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Practical tips for helping someone during a panic attack:
Stay calm. Your calmness will help the person feel safe. Do not panic or be afraid with them.
Address the person by name, if you know it, or introduce yourself and explain your purpose. For example: ‘I am Andriy, I am here to help you. You are having a panic attack, but you are safe.’
Speak briefly and clearly. Ask simple questions that can be answered with ‘yes’ or “no”: ‘Can you hear me?’, ‘Do you know where you are right now?’
Reassure them that they are safe. If this is true, say: ‘You are in a safe place right now. I will stay with you.’
Breathing exercises:
Breathing through a straw. Ask the person to inhale through their nose and exhale through a straw, counting slowly (inhale for 4 counts, hold for 2, exhale for 4). Do this together with them.
Horse breathing. Together, exhale with your lips vibrating, as if imitating the sound of a horse’s ‘br-r-r’. This calms the nervous system.
Physical contact: Allow the person to hold your hand or elbow to feel supported. Suggest that they squeeze your elbow tightly, then relax — this helps to distract them from their panic. It is important that you only touch the person with their consent.
Grounding: Ask the person to describe the objects around them, to feel their feet on the ground, or to lean against a wall or tree. This brings them back to the ‘here and now.’
Walk: If possible, walk briskly with the person; this will help reduce anxiety.
What should you definitely not do?
‘Don’t say “Calm down,” ‘Don’t worry,“ or ‘It’s all in your head,”’ warns Christina. ‘Such phrases create a feeling of misunderstanding and only increase anxiety.’ Do not hold or shake the person, do not force them out of the room. All actions must be voluntary.
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Experiencing rocket attacks, explosions or other extraordinary events is often accompanied by an acute stress reaction — a temporary state of shock, disorientation, silence or aggression.
‘After trauma, a person may be emotionally “closed off”, confused or angry. It is important not to leave them alone and to be there for them,’ says Khristina.
How to help in the first minutes after trauma:
Make sure it is safe. If the threat continues, evacuate the person to a safe place.
Stay calm. Panic only makes the situation worse.
Active listening and acknowledging feelings: ‘I can see that you are very scared. It’s terrible, but you are not alone.’ Avoid phrases that may make the person feel ashamed or guilty.
Grounding techniques: Ask them to name three objects around them, feel their feet on the floor, touch a surface with their hand.
Breathing exercises mentioned above.
Giving choices: Ask what the person needs right now — water, a blanket, to sit or stand up. Small decisions help restore control.
Be there, but don’t push. Especially if the person is silent or ‘shut down’ — give them time, don’t force them to talk.
What not to do:
Do not force the person to recall the details of the event, do not use phrases such as ‘Pull yourself together!’ or ‘It’s just shock.’ Avoid taking photos or videos.
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First psychological aid for civilians and colleagues in distress – general principles
First psychological aid (FPA) is immediate support aimed at stabilising the emotional state, restoring a sense of security and control, and providing information about further assistance.
“Anyone can provide PFA, not just specialists. The main thing is to know the basic principles,” says Khristina.
The main goals of first psychological aid are
To ensure physical and psychological safety.
To stabilise the emotional state and reduce acute stress.
To restore connection with reality and regain control.
Provide information about resources and possible assistance.
Encourage social support and self-help.
What should you do?
Look: Assess the situation to see if there is any danger to you or the victim.
Listen: Be attentive to the person’s feelings and speak calmly.
Guide: Provide information about resources and help them seek support.
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Practical tools without special training:
Breathing exercises.
Grounding techniques.
Restoring a sense of security (gentle physical contact, comfortable surroundings).
Support through simple words: ‘I am with you,’ ‘You are not alone,’ ‘The air raid siren has stopped.’
How to help different age groups?
Children: Need close contact (if it is your child) or acquaintance with the adults responsible for them. It is important to maintain a routine, encourage play and creativity, and allow them to express their emotions.
Teenagers: Respect for autonomy, patience, openness to communication.
Elderly people: May need practical help (mobility, medication), support and repetition of information.
When to seek professional help?
If symptoms of stress persist for more than a week, or signs of post-traumatic stress disorder appear — recurring anxious memories, nightmares, avoidance, excessive vigilance — it is worth contacting a psychotherapist or psychologist.
Conclusion from a psychologist
‘First psychological aid is not magic or treatment, it is the first step that helps to stabilise a person, restore their sense of security and support,’ concludes Khristina Yasinska. “In times of war and crisis, it is important for all of us to know how to support each other. After all, any of us can find ourselves in a stressful situation and need help.”
We would like to add that the Ukrainian Red Cross currently has almost 80 psychologists who provide support to those affected by war and crisis events.
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