We can think of panic attacks as a very high dose of fear flooding their system and leading them into overdrive (fight-or-flight). Anxiety or panic attacks can be caused by any number of factors, but usually the fear acts up when their brain has perceived some level of threat.
Often, these “threats” aren’t visible and may be imagined (i.e., rejection, imagining a worst case scenario), but the response is very real. Since the attack is coming from an abstract place, it’s important to ground your teen to the present moment. If they’re in public, you should take them to a quiet and safe space where they aren’t so overstimulated by their surroundings.
The 5-4-3-2-1 technique is one way to ground them. Have them list 5 things they can see, 4 things they can feel, 3 things they can hear, 2 things they can smell and 1 thing they can taste. Help them breathe, focusing primarily on breathing into their belly (diaphragmatic breathing) and slowly exhaling.
Once they’re more regulated, help them through the aftershock which often comes with exhaustion. For example, you can go through a distress tolerance list together. If your teen has a therapist, it will be helpful to encourage your teen to talk with their therapist about their panic attacks.
If they don’t have a therapist, consider connecting them with an anxiety therapist.