What to do in case of a panic attack?

How can you stop a panic attack?

Share on PinterestAccepting and recognizing panic attacks is an important part of reducing their impact.

Below are 13 methods that can help to alleviate the symptoms of a panic attack.

1. Acceptance and recognition

A person may have experienced panic attacks in the past. During an attack, it can help to remember that they pass and cause no physical harm, though they are unpleasant. A person should acknowledge that the attack is a brief period of concentrated anxiety and that it will end.

If a person is experiencing an attack for the first time, it is advisable to visit a doctor as soon as possible. Some symptoms of panic attacks can indicate other events, such as heart attacks or strokes.

2. Deep breathing

Deep breathing can sometimes bring a panic attack under control. Rapid breathing can increase anxiety and tension, so instead taking long, slow breaths can help.

A person should breathe steadily, counting slowly to four while breathing in and to four when breathing out.

A feeling of tightness in the chest can cause a person to take short breaths during an attack. It is a good idea to breathe deeply from the abdomen, filling the lungs slowly and steadily.

3. Inhale lavender

Lavender essences have long been used to relieve anxiety and bring about a sense of calm relaxation. Inhaling the scent of lavender oil during a panic attack may help relieve some symptoms. A person can rub a small amount of oil onto their wrist or hand and inhale.

This oil is widely available online. Purchase it only from trusted retailers.

An individual should avoid lavender if they have recently taken a benzodiazepine medication. The two together can cause heightened drowsiness.

4. Medication

When a doctor prescribes a medication for use as needed, rather than as a regular dosage, the medicine is referred to as a PRN. These medications typically work fast.

Depending on the severity of panic attacks, a doctor may prescribe a PRN containing a benzodiazepine or a beta-blocker. Propranolol is a beta-blocker that slows a racing heartbeat and decreases blood pressure.

Benzodiazepines commonly prescribed for panic attacks include Valium and Xanax. This class of drugs can be highly addictive. The body may quickly develop a tolerance, and a higher dosage will soon be needed to achieve the same effect. People should use them sparingly.

5. Limit stimuli

Sights and sounds can often intensify a panic attack. If possible, find a more peaceful spot. This could mean leaving a busy room or moving to lean against a nearby wall.

Closing the eyes can make it easier to focus on breathing and other coping strategies.

6. Learn triggers

A person’s panic attacks may often be triggered by the same things, such as enclosed spaces, crowds, or problems with money. By learning to manage or avoid triggers, a person may be able to reduce the frequency and intensity of attacks.

7. Light exercise

Light exercise can help to stop panic attacks. Exercise releases hormones called endorphins that relax the body and improve the mood.

Walking can help to produce endorphins, and it can also remove a person from a stressful environment. The rhythm of walking may also help a person to regulate their breathing.

8. Mindfulness exercises

Panic attacks can make people feel detached from reality. The intensity of anxiety can overtake other senses. Mindfulness can help to re-ground a person and direct their focus away from sources of stress.

Below is one example of a mindfulness exercise. Each step should be completed slowly and thoroughly:

  • Look at five separate things, thinking about each for some time.
  • Listen for four distinct sounds, and examine what is different about each one.
  • Touch three objects. Consider the texture, temperature, and uses.
  • Identify two different smells. Do they trigger any memories?
  • Taste something. This could be a fingertip or a piece of candy.

9. Focus on an object

Concentrating on a nearby object can help a person stop a panic attack. A person who experiences attacks regularly may want to carry something for this purpose.

Focusing on one thing can reduce other stimuli. As a person looks at the item, they may want to think about how it feels, who made it and what shape it is. This can help to reduce the symptoms of a panic attack.

10. Try muscle relaxation techniques

Another symptom of a panic attack is muscle tension. Practicing muscle relaxation techniques may help to limit an attack. If the mind senses that the body is relaxing, other symptoms, such as rapid breathing, may also diminish.

Progressive muscle relaxation is a popular technique for coping with anxiety and panic attacks.

11. Picture a happy place

A person’s happy place should be somewhere they would feel the most relaxed. Every aspect of it should be pleasing.

When a panic attack begins, it can help to close the eyes and imagine being in such a place. Think of how calm it is there. Imagine bare feet touching the cool soil, hot sand, or soft rugs.

Thinking about a relaxing and calm environment can help a person to become relaxed and calm.

12. Repeat a mantra

A mantra is a word, phrase, or sound that helps with focus and provides strength. Internally repeating a mantra can help a person to come out of a panic attack.

The mantra can take the form of reassurance and may be as simple as, “This too shall pass.” Or, it may have a more spiritual meaning.

As a person focuses on gently repeating a mantra, their physical responses can slow, allowing them to regulate their breathing and relax muscles.

13. Tell people

If panic attacks frequently occur in the same environment, such as a workplace, it may be helpful to inform others and let them know what kind of support to offer.

If an attack happens in public, telling even one person can help. They may be able to locate a quiet spot and prevent others from crowding in.

The Key to Overcoming Panic Attacks

The surest path to overcoming panic attacks is to train yourself to respond to panic in accepting and calming ways.

This article will show you a specific, simple, and powerful set of tips for overcoming panic attacks. This material comes from my Panic Attacks Workbook.

If you prefer listening to reading, here’s a radio interview in which I discuss these steps.

As you read the steps described below, think about how they compare to what you usually do during a panic attack. The Panic Trick tells us that your gut instinct of how to respond to a panic attack will likely be to do something that makes the problem worse rather than better. The path to overcoming panic attacks requires responses that are quite different from what you usually do. If you keep doing the same thing, you’ll probably keep getting the same result. If you seek anxiety relief, you need to look for different methods.

You can use these five steps to guide your responses during a panic attack. The regular use of this approach will go a long way towards your goal of overcoming panic attacks. I have adapted them, with some modifications of my own, from Anxiety Disorders and Phobias: A Cognitive Perspective, an excellent professional text by Beck, Greenberg, and Emery.

The Five Steps of AWARE

The five steps to overcoming panic attacks are:

Acknowledge & Accept

Wait & Watch (and maybe, Work)

Actions (to make myself more comfortable)

Repeat

End

Let’s take a look at what each step entails.

Acknowledge & Accept

All progress starts here. This is the most important single step to overcoming panic attacks.

Acknowledge

Here I acknowledge the present reality, that I’m afraid and starting to panic. I won’t try to ignore it, or pretend it’s not there. I won’t struggle to distract myself, tell myself to “stop thinking about it!”, or snap any rubber bands on my wrist.

I’m acknowledging simply that I am afraid, not that I am in danger. The thought that I am in danger is just another symptom of panic, not an important or useful thought.

Accept

Here I accept the fact that I’m afraid at this moment. I don’t fight the feeling; ask God to take it away; blame myself, or anybody else. I accept, as best I can, that I’m afraid in the same way I would accept a headache. I don’t like headaches, but I don’t bang my head against the wall in an effort to get rid of them, because that makes them worse. Overcoming panic attacks begins with working with, not against, my panic and anxiety symptoms.

How Can I Accept a Panic Attack?

What makes a panic attack acceptable (not desirable, but acceptable) is that, while it feels awful and fills me with dread, it isn’t dangerous. It won’t kill me or make me crazy. Someone pointing a gun at me, that’s not acceptable. I might get hurt or killed. If someone points a gun at me, I have to do whatever I can to change that: run, hide, fight, yell, bribe, or beg, because the consequence of being shot is so terrible that I must try to avoid it.

On the other hand – a policeman giving me a ticket, even if I don’t deserve it, I can live with that, and can hopefully keep my temper in check so I don’t make things worse for myself.

Accepting the symptoms, not resisting, is a powerful step to overcoming panic attacks.

What Can a Panic Attack Do to Me?

It makes me feel afraid, that’s what a panic attack does. And, if I’m having a panic attack, I’m already there! I’m already experiencing the worst that will happen. I just need to ride it out. That’s the surest path to overcoming panic attacks.

Why should I accept a panic attack? Because the more I resist panic, the worse it gets. The more I develop the habit of acceptance, the more progress I make toward my goal of overcoming panic attacks.

That’s Acknowledge & Accept. How does that compare to what you usually do during a panic attack?

Wait & Watch (and maybe, Work)

Wait

What I mean by “Wait” is this: don’t just do something, stand there. It’s similar to the suggestion “count to ten before you get mad”.

One of the hallmarks of a panic attack is that it temporarily robs you of your ability to think, remember, and concentrate. This step will buy you a little time to regain those abilities before you take any action.

When you react before you have a chance to think straight, what do you do? If you’re like most people, you probably flee, or struggle. You do things that actually make it worse. This is what people mean when they say things like “I know I’m doing it to myself” and the harder I try, the worse it gets.

Jumping into action too quickly is a big obstacle to overcoming panic attacks.

So, even though you have a powerful urge to leave, postpone that decision for a little bit. Don’t tell yourself you CAN’T leave – keep that option open so you don’t feel trapped – but put off the decision about whether or not to leave. Stay in the situation. You don’t need to run away to get relief. Let relief come to you.

Watch

Use the occasion to observe how the panic works, and how you respond to it. The best way to do this is to fill out a panic diary. The diary is a questionnaire which helps you notice important aspects of a panic attack, so you can respond more effectively over time. Feel free to download and reproduce it for your own personal use. You can also download a set of instructions.

My patients often report that just filling out a diary helps them to calm down. How does this work? It’s not that they’re distracted from the subject of panic, because the diary questions are all about panic. It helps you get a little distance from your emotions. It works because, while you complete a diary, you’re in the role of an observer, rather than feeling like a victim.

The best way to use the diary is to fill it out during the attack, rather than after. If you’re in a situation where writing is impractical, perhaps while driving a car, you can: use a digital recorder; have your support person read the questions to you and record your answers; or pull over for a few minutes to write.

What About “Work”?

If you’re in a relatively passive situation during the panic attack – a passenger in a vehicle, getting your hair cut, or waiting in a waiting room – “Wait & Watch” is all you need. If you’re in a more active role – driving a car or giving a presentation – then you also need to attend to the “Work” of conducting that activity. Do “Wait & Watch”, but also remain engaged in your task.

That’s “Wait & Watch (and maybe, Work)”. How does that compare to what you usually do during a panic attack?

Actions (to make myself more comfortable)

At this point, you’ve already gone through the two most important steps to overcoming panic attacks.

These steps, and all the steps necessary to overcome panic disorder and phobia, are covered in much more detail in my Panic Attacks Workbook.

What’s Your Job During an Attack?

It’s not your job to bring the panic attack to an end; that will happen no matter what you do. Don’t take my word for it. Review your personal history with panic attacks. Have you ever had one that didn’t end?

The fact is, every panic attack ends no matter what you do. If you respond in the most cogent way possible, and do a good job at bringing it in for a soft landing, that panic attack will end. And if you do everything the most unhelpful way possible – struggling and resisting and fleeing in ways that make the panic worse – that one will end also. Even the first panic attack a person has, when they have the least idea of what’s happening, those end as well.

The end of a panic attack is a part of a panic attack, just as much as the start of one is a part of it. It’s not something you need to supply or make happen. The panic attack will end no matter what you do. Even when you don’t believe it will end, when you have the fearful thoughts that it will last forever, it still ends.

So what is your job during a panic attack? It’s a more modest task than you probably supposed. Your job is to see if you can make yourself a little more comfortable while you wait for the attack to end. And if you can’t even make yourself a little more comfortable, then your job is just to wait for it to end.

Here are a few techniques that my patients have found particularly useful while waiting for an attack to end.

Belly Breathing

Regardless of what else you do, do belly breathing. It’s also known as diaphragmatic breathing, but I think “belly breathing” is more descriptive. Many people think they know how to do deep breathing, but don’t do it correctly, so they don’t get good results. A good belly breathing technique is a very powerful tool in the work of overcoming panic attacks!

How to Talk to Yourself

Talk to yourself (silently!) about what is happening, and what you need to do. One question my patients find very helpful is this: is it Danger or Discomfort? Some of the other responses my patients like include the following:

1. Fine, let’s have an attack! It’s a good chance to practice my coping techniques.

2. Answer your “what if…?” fears by saying “So what? I’ll get afraid, then calm down again.”

3. It’s okay to be afraid.

Get Involved in the Present

People don’t panic in the present. People panic when they imagine something bad happening to them in the future or in the past. This is why your panic attacks are almost always accompanied by some “what if…?” thought. The reason you say “what if…?” is because what you fear is not actually happening!

Get back into the activity you were engaged in prior to the attack, and become involved with the people and objects around you. If you’re in a store, resume shopping, reading labels, comparing prices, asking questions, etc. It will move you closer to your goal of overcoming panic attacks when you bring your focus and energy back to the present environment. By this I mean, work with what is around you.

Work with Your Body

Identify, and relax, the parts of your body that get most tense during a panic attack. This typically involves first tensing, and then relaxing, the muscles of your jaw, neck, shoulders, back and legs. Do not allow yourself to stand rigid, muscles tensed, and holding your breath. That just makes you feel worse! If you feel like you “can’t move a muscle”, start with just one finger!

That’s “Actions (to make myself more comfortable)”. How does that compare with what you usually do during a panic attack?

Repeat

This step is here because you might start feeling better, then feel another wave of panic. Your first reaction might then be to think “Oh No, it didn’t work!”. The Repeat step is here to remind you that it’s OK if that happens. Just take it from the top again. It’s not unusual or dangerous. You may go through several cycles, and you just need to repeat the AWARE steps again, as often as you need.

How does that compare with what you usually do?

End

This is here to remind you that your panic attack will end; that all panic attacks end; that they end regardless of how you respond; that it’s not your job to make the attack end; and that your only job is to make yourself as comfortable as possible while waiting for the attack to end.

Have these statements been true for you? Don’t take my word for it. Review your own history of panic attacks and see.

Overcoming Panic Attacks

Want a copy of my Panic Attacks Workbook? It’ll take you through the steps, from A to Z, of how to handle panic attacks in ways that lead them to fade away, as well as how to overcome the phobias and avoidance that usually accompany panic. It’s pretty affordable, and you’ll find it here.

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Last updated on January 13, 2020

When I had my first panic attack at the age of 19, I believed with absolute certainty that I was in mortal danger. I lie in my dorm room bed for what felt like hours, clutching my pounding heart and gasping for air. Fifteen interminable minutes later, it was as if it had never happened, and I felt relatively normal — but that wouldn’t be the last incident. I went on to have many more panic attacks, and have since been diagnosed with a panic disorder (PD). I’m among two to three percent of Americans with PD; while 18.1 percent of Americans have anxiety disorders in general — the most common mental illness. Since that day, I’ve treated my condition both with therapy and medication.

Despite managing my PD, I do still suffer the occasional panic attack, but with professional guidance (a must), I’ve learned that there are simple things I can do to stop a panic attack in its tracks. I talked with mental health professionals to discuss why my own techniques work and what more those of us living with panic attacks can do.

A panic attack comes out of nowhere and is not an anxiety attack

Though we tend to use the terms “panic attack” and “anxiety attack” interchangeably, it’s worth noting that professionally speaking (and when referencing the Diagnostic and Statistical Manual of Mental Disorders, aka, DSM–5), there’s actually no such thing as an anxiety attack, per se.

“Anxiety is an excessive persistent worrying over an imminent event that can last a while. A panic attack is a burst of intense fear that typically lasts fewer than 30 minutes,” Dr. Carolyn Rodriguez, assistant professor of psychiatry and behavioral sciences at Stanford tells NBC News BETTER. She says that she would never use the term “anxiety attack” to define any such event, noting that the term is something of a “lay approach”.

Additionally, when panic attacks are linked to a panic disorder, they come out of the blue with no apparent trigger, but anyone can experience a panic attack. “If you’re afraid of heights for instance, and are up on the roof, you might have a panic attack.” The difference here is that in this case, the panic attack has a clear cause, whereas with a panic disorder there’s no obvious culprit in the environment.

Know the signs of a panic attack

“Often, when you don’t know the physiological signs of a panic attack you may feel more scared imagining you’re having a heart attack,” says Annie Wright, LMFT and the owner and clinical director of Evergreen Counseling. “Read up on the signs of a panic attack so you know what you’re dealing with.”

Dr. Rodriguez recommends scouring the Anxiety and Depression Association of America’s website, which covers all the symptoms:

  • Palpitations, pounding heart or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feelings of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, light-headed, or faint
  • Chills or heat sensations
  • Paresthesia (numbness or tingling sensations)
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or “going crazy”
  • Fear of dying

Rodriguez adds that it’s critical to also get a physical exam to rule out other problems.

Write out the facts and mantras on an index card and keep it on you

One of the tools that has helped me is knowing that even the most vicious panic attack can’t kill me. Dr. Rodriguez recommends writing this fact down on an index card or in your phone to read when you feel one coming on. “Panic attacks are not life-threatening,” she says. “Write this down. And maybe add the note to yourself, ‘You have survived panic attacks before. You will survive this one.’”

Dr. Prakash Masand, founder of the Center for Psychiatric Excellence, recommends writing down some positive mantras to get you out of a catastrophic thought pattern. “Or better yet, prepare your own. When you have the negative thoughts of gloom and doom, write down some positive and more realistic rebuttals.”

Visualize your panic as a wave

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“When you begin to feel panic sensations, instead of trying to shut them out, visualize each feeling as a wave which you are riding until it comes to rest on the shore,” says Dr. Chuck Schaeffer, a strength-focused psychologist. “Anticipate the wave passing and becoming less and less intense as it crests. Remind yourself that just because you might feel like you’ll drown beneath the wave, it doesn’t mean you can’t swim. You might also remind yourself that the panic sensations are just passing waves on the constant, powerful ocean that is you.”

Dr. Rodriguez seconds this metaphor, adding that the waves will rise and fall, and that typically a panic attack peaks at 10 minutes and then abates.

Use your smartphone for distraction

My Words With Friends addiction is a tad out of control, but it sure comes in handy when I’m feeling eclipsed by panic.

“Games like crossword puzzles and word searches ,” says Dr. Masand. “The idea is it can act as a distraction to the fear or the body symptoms of anxiety. Our smartphones offer a plethora of great coping tools and this is something the majority of us already carry with us. Download some games that will distract you and get your mind off of the unpleasant symptoms you are feeling. You can also download relaxing music and guided relaxation sessions.”

Slow, deep breathing is key, but you should practice every day

Long, deep breaths calm your body down, but they can be tricky to implement if you’re not used to doing them. Dr. Schaeffer suggests that to make this practice easier, you should do it daily — anxious or not.

“Practice full-body breathing every day,” he tells NBC News BETTER. “Breathe in deeply through your nose and imagine your whole body filling up with air like a balloon. Next, make your mouth small like you are exhaling through a straw. Slowly exhale through your mouth until you feel like all the air has completely emptied from your body. Repeat this about 10 times and notice any changes in your heart rate or body tension. Once you are comfortable with this kind of breathing, use it during a panic attack to slow your heart rate and calm down.”

One-Minute Meditation Routine

July 20, 201701:13

Carry essential oils, a plush fabric, and other multisensorial objects

One of the worst symptoms of panic attacks in my experience is that sense of “unreality” — like I’m somehow outside my body. Dr. Rodriguez recommends carrying items with you that can help engage your senses to help ground you.

“Things like essential oils (try lavender or peppermint) can help bring you back into your body,” she says, adding to carry a soft, fuzzy piece of fabric or even feel your own shirt. “Feel it, think about it, listen to it.”

“Other ways of anchoring yourself during an attack include rubbing your hands or bare feet on a surface such as a chair, couch or rug,” says Dr. Schaeffer. “Put an ice cube in a paper towel and squeeze it as hard as you can in one hand for a minute until you can feel the coldness and discomfort. Switch hands and repeat until you have the same sensations in your other hand.”

When in Doubt, Shout It Out! 8 Drug-Free Ways to Battle Anxiety

Between work, bills, family, and trying to stay healthy, the everyday pressures of life can turn you into an anxious mess. Maybe you were an anxious child who grew into an anxious adult, or maybe you developed anxiety later in life. Regardless of when symptoms began, it’s possible that your mind is in overdrive, and you’re always waiting for the rug to be pulled out from under you.

You’re not alone. According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental illness in the United States, affecting 40 million adults. Like so many others looking for relief, you may have turned to medication for help. Although antianxiety drugs can ease your anxiety, the serenity can come with a price tag in the form of side effects. Trouble sleeping, decreased libido, jumpiness, and increased hunger are some of the most common inconveniences of treating anxiety with drugs.

The good news is that popping pills isn’t the only way to get your fears and nerves under control. Here are eight simple and effective ways to battle anxiety without medication.

1. Shout it out

Talking to a trusted friend is one way to cope with anxiety. But there’s something even better than talking: screaming at the top of your lungs. As a kid, you were probably taught not to shout and told to use your “inside voice.” But as an adult, you can make your own rules. So if you’re dealing with pent-up frustrations and anxiety, let it out.

This doesn’t mean putting fear in others so they feel on edge like you. We’re talking about a healthy release of emotions in a controlled environment. The more you fight anxiety, the more overwhelming it can become. Instead, embrace anxiety as a part of your life, and then let it go. Scream at the top of your lungs, punch a pillow, stomp your feet, or pound your chest. Do whatever helps you get it out! One Los Angeles-based yoga teacher even developed a class called Tantrum Yoga that encourages yogis to try these unconventional methods as a way to release emotion that “gets stuck in our bodies and could turn into stress, disease, etc.”

2. Get moving

Exercise is probably the last thing you want to do when your mind’s in overdrive. You may worry about post-workout soreness and being unable to walk or sit for the next two days. Or your mind might go to the worst-case scenario and you fear overexerting yourself and having a heart attack. But in reality, exercise is one of the best natural antianxiety solutions.

Physical activity raises endorphins and serotonin levels to help you feel better emotionally. And when you feel better on the inside, your entire outlook improves. And because your brain can’t equally focus on two things at once, exercise can also take your mind off your problems. Aim for at least 30 minutes of physical activity three to five days a week. Don’t think you have to struggle through a painful workout. Any type of movement is good, so put on your favorite jam and move around the house. Or grab a mat and break out into your favorite yoga poses.

3. Break up with caffeine

A cup of coffee, chocolate, or an ice-cold Coke might help you feel better. But if caffeine is your go-to drug of choice, your anxiety could worsen.

Caffeine gives the nervous system a jolt, which can boost energy levels. But when under pressure, this nervous energy can induce an anxiety attack. Now, the idea of giving up your favorite caffeinated beverage might raise your heart rate and induce anxiety as you read this, but you don’t have to stop cold turkey or give up caffeine completely. It’s all about moderation.

Rather than four cups of coffee a day, scale back to one or two normal-sized cups a day —normal as in 8 ounces, not 16 or 32 ounces. Give it a test run and see how you feel. As you wean yourself, slowly introduce other beverages into your diet such as decaffeinated herbal tea, which can calm your mind and nerves.

4. Give yourself a bedtime

With your busy schedule, there’s no time for sleep, right? Some workaholics brag about only needing three or four hours of sleep a night, as if to say, “I’m more determined and committed than everyone else.” But no matter what you might tell yourself, you’re not a robot. Humans need sleep to function properly, so unless you beamed in from some nearby planet, this also applies to you.

Whether you deal with insomnia, purposely limit your amount of sleep, or you’re a self-professed night owl, chronic sleep deprivation makes you susceptible to anxiety. Do yourself (and everyone around you) a favor and get eight to nine hours of sleep every night. Develop a bedtime routine to read a book or do something relaxing before bed. The better prepared you are to get a good night’s sleep, the better quality of sleep you’ll have, which leads to a better morning as well.

5. Feel OK saying no

Your plate is only so big, and if you overwhelm yourself with everyone else’s personal problems, your anxiety will also worsen. We’ve all heard the adage, “There’s more happiness in giving than receiving.” But nowhere in this sentence does it say you should sit back and let others infringe on your time.

Whether you’re driving someone around on errands, picking up their kids from school, or lending an ear about their problems, you’ll have little strength to care for your personal affairs if you spend almost all your energy caring for others. This doesn’t mean you should never help anyone, but know your limitations, and don’t be afraid to say “no” when you need to.

6. Don’t skip meals

If anxiety causes nausea, the thought of eating food is as appealing as eating dirt. But skipping meals can make anxiety worse. Your blood sugar drops when you don’t eat, which causes the release of a stress hormone called cortisol. Cortisol can help you perform better under pressure, but it can also make you feel worse if you’re already prone to anxiety.

The fact that you need to eat doesn’t justify stuffing just anything in your mouth, so this isn’t an excuse to overindulge in sugar and junk food. Sugar doesn’t cause anxiety, but a sugar rush can cause physical symptoms of anxiety, such as nervousness and shaking. And if you begin to obsess over a reaction to sugar, you could have an out-all panic attack.

Incorporate more lean proteins, fruits, vegetables, and healthy fats into your diet. Eat five to six small meals throughout the day, and avoid or limit your intake of sugar and refined carbohydrates.

7. Give yourself an exit strategy

Sometimes, anxiety is due to feeling out of control. You can’t always be in the driver seat of your life, but you can take steps to identify your triggers and cope with circumstances that cause anxiety.

Does the thought of going into a social situation or meeting new people make you want to jump off a bridge? As everyone at a party engages in exciting conversations, maybe you see yourself holding up the wall and counting down the seconds until you’re put out of your misery. You drove with friends and can’t leave, so you spend the entire night looking like the punchbowl attendant. It’s this fear that makes you decline invitations and sleep through the weekends.

But what if you had an exit strategy in place before leaving the house? For example, instead of carpooling with your party animal friends, you could drive yourself. This way, you can leave if your anxiety starts to build and you can’t handle another minute of awkward interactions. The more in control you feel, the less anxiety you’ll have.

8. Live in the moment

Other than the words on this page, what are you thinking about right now? Are you worried about a meeting you have next week? Are you stressed about meeting your financial goals? Or maybe you’re obsessing over whether you’ll be a good parent — although you have zero kids and have no plans to conceive in the near future.

If you answered “yes” to any of these questions, you’ve just uncovered part of the problem. Like many others with anxiety disorders, you have trouble living in the moment. Instead of worrying about today, you’re already thinking about tomorrow’s problems. And depending on the severity of your anxiety, you might be stressing about yesterday’s mistakes.

You can’t control the future, and you can’t borrow a time machine and change the past, so here’s a thought: Take each day as it comes. Not to say you can’t be proactive and head off problems. But don’t put too much focus on what has been and what will be that you create anxiety for yourself. Mindfulness and meditation are rooted in living in the moment and have been proven to ease anxiety. Try practicing for a few minutes a day and increase the duration over time. The best part? You can do it anywhere: in bed, at your work desk, or even on the commute home.

Takeaway

Anxiety is a beast, but it is possible to win the battle without medication. Sometimes, overcoming worry and nervousness is simply a matter of modifying your behavior, thoughts, and lifestyle. You can start with a drug-free approach, and then speak with a doctor if your symptoms don’t improve or worsen. These drug-free, antianxiety tactics can even help you complement your medication regimen. Do what works for you, and know that anxiety does not control your life.

The Anxiety Trick

The Anxiety Trick is behind most of the trouble people have with chronic anxiety. Have you struggled to overcome an anxiety disorder, only to get disappointing results, or even feel worse over time? You’re being fooled by the Anxiety Trick.

This is a terribly common occurrence, and people mistakenly blame themselves for it. Here’s a more accurate, and helpful, way to understand this common and frustrating problem.

What is an anxiety disorder? It’s you getting tricked into feeling powerful fear in the absence of any danger.

It’s because there’s no danger that people seek help for these fears. People recognize that they’re getting afraid when they’re not in danger. If they were actually in danger, they would just protect themselves as best they could, and be better off for it.

With an anxiety disorder, people get afraid when they’re not in danger. Their struggle to protect themselves from fear leads them down a path of increasing trouble. That’s the anxiety trick.

How does this happen, that you feel fear in the absence of danger? This is the Anxiety Trick at work.

How You Get Tricked

* If you have Panic Disorder or Agoraphobia, you keep getting tricked into believing that you’re about to die, go crazy, or lose control of yourself.

* If you have Social Phobia,you keep getting tricked into into believing that you’re about to look so unreasonably nervous in front of people that you will be completely humiliated and be cast aside by your community.

* If you have a Specific Phobia, you keep getting tricked into believing that you’re likely to be overcome by some external object (like an elevator) or animal, or by your fear of it.

* If you have OCD, you keep getting tricked into believing that you’ve set in motion a terrible calamity. You might fear that your neighborhood will burn because you left the stove on, or that your family will get poisoned because you mishandled the insecticide.

* If you have Generalized Anxiety Disorder, you keep getting tricked into believing that you’re about to be driven mad by constant worrying.

In each case, the episode of fear passes without the expected catastrophe. You’re none the worse for wear, except that you’re more worried about the next episode. The details seem different, but it’s the same anxiety trick.

What is the Anxiety Trick?

The Anxiety Trick is this: You experience Discomfort, and get fooled into treating it like Danger.

What do we do when we’re in danger? We only have three things: Fight, Flight, and Freeze. If it looks weaker than me, I’ll fight it. If it looks stronger than me, but slower, I’ll run away. And if it looks stronger and faster than me, I’ll freeze and hope it doesn’t see so good. That’s all we have for danger.

When people experience the fear of a panic attack, or a phobic encounter, or an obsessive thought, they instinctively treat it as a danger. They try to protect themselves, with some variation of Fight, Flight, or Freeze.

How People Get Tricked

People’s natural instincts to protect themselves are what lead them to get tricked. See if you recognize your responses in these examples below.

A person with Panic Disorder gets tricked into holding her breath and fleeing the store (highway, theater, or other locale), rather than shifting to Belly Breathing. and staying there until the feelings pass.

A person with Generalized Anxiety Disorder gets tricked into trying to stop the unwanted “what if?” thoughts, rather than accepting them and taking care of present business as thoughts come and go.

A person with Social Phobia gets tricked into avoiding the party, or hiding in the corner if he attends, rather than say hello to a stranger and see what happens.

A person with OCD gets tricked into repeatedly washing his hands, or returning home to check the stove, rather than accepting the intrusive thoughts of contamination and fire and returning his energies to the present activities at hand.

A person with a dog phobia gets tricked into avoiding the feelings by avoiding all dogs, rather than spending time with a dog until the feelings pass.

What Maintains the Anxiety Trick?

You might wonder, why don’t people come to see this pattern, of repeated episodes of fear which don’t lead to the feared outcome, and gradually lose their fear?

The answer is this. They took these protective steps, and there was no catastrophe. They tend to believe that these steps “saved” them from a catastrophe. This thought makes them worry more about “the next time”. It convinces them that they are terribly vulnerable and must constantly protect themselves.

The actual reason they didn’t experience a catastrophe is that such catastrophes are typically not part of a fear or phobia. These are anxiety disorders, not catastrophe disorders. People get through the experience because the experience isn’t actually dangerous. But it’s understandably hard for people to recognize that at the time. They’re more likely to think they just had a “narrow escape”. This leads them to redouble their protective steps.

It’s the protective steps which actually maintain and strengthen the Anxiety Trick. If you think you just narrowly escaped a catastrophe because you had your cellular phone, or a water bottle; or because you went back and checked the stove seven times; or because you plugged in your iPod and distracted yourself with some music, then you’re going to continue to feel vulnerable. And you’re going to get more stuck in the habit of “protecting” yourself by these means.

This is how the problem gets embedded in your life. You think you’re helping yourself, but you’ve actually been tricked into making it worse. That’s how sneaky this Trick is.

This is why my patients so often say, “the harder I try, the worse it gets”. If the harder you try, the worse it gets, then you should take another look at the methods you’ve been using. You’ve probably been tricked into trying to protect yourself against something that isn’t dangerous, and this makes your fear worse over time.

How Can You Overcome
The Anxiety Trick?

The thing that makes fears and phobias so persistent is that virtually anything you do to oppose, escape, or distract from the anxious feelings and thoughts will be turned against you, and make the anxiety a more persistent part of your life.

This is why people notice “the harder I try, the worse it gets”. They’re putting out fires with gasoline.

If you come to see that you’ve been putting out fires with gasoline, you may not have any idea what to do next. But the first step is always the same: put down the buckets. Stop throwing gasoline on that fire.

This is where the cognitive behavioral methods of desensitization and exposure come in. They’re intended as methods by which you can practice with (not against) the symptoms, and become less sensitive to them. As you lose your fear of the symptoms, through this practice, that’s when the symptoms will fade.

All too often, people get the idea that exposure means going to a place or situation where you’re likely to get anxious, perhaps a highway or an elevator, and take a ride without getting anxious. That’s not the point! The point is to actually go there and feel the anxiety, being sure to stay there and letting the anxiety leave first. This is what Claire Weekes called floating.

The way to disarm the Anxiety Trick is to increasingly spend time with anxiety, to expose yourself to the thoughts and sensations, and allow them to subside over time.

What can you do to make the experience of exposure more tolerable? You can use the AWARE steps as a general guide for how to conduct yourself while doing exposure. If you want a more specific, step by step guide for overcoming panic attacks and phobias, my Panic Attacks Workbook is full of tools and techniques that will help you keep moving forward. If your problem is Generalized Anxiety Disorder, or involves a lot of worrying without regular panic attacks, The Worry Trick is a book that will help you reduce the role worry plays in your life.

Always keep in mind that exposure is practice with fear, and do nothing to oppose, avoid, or distract from the fear during exposure.

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© 2010-2020 David Carbonell, Ph.D. Anxiety Coach® is a registered mark.
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Last updated on January 13, 2020

Anxious About Everything? 6 Ways to Cope with Anxiety

This guest article from YourTango was written by Dr. Tina Tessina.

There is always something on TV to scare us. Hysterical articles in the media sell papers and attract eyeballs to websites, but usually exaggerate facts. If you listen without evaluating what you’re being told, it’s easy to become frightened. There’s a reason why I don’t usually waste time and energy on panic and drama.

I see the negative results of panic every day. People get upset, they’re afraid of emotional consequences and they overreact, which can actually create the consequences they fear.

Panic is an overreaction to a real (or even imagined) problem. Frightening yourself beyond the real need to deal with a problem puts your body into fight or flight mode as though your life were immediately threatened.

Emotional panic can create a shutdown of feelings, so you’re in a state of shock. You cannot think clearly, make good responses or decisions. In panic, we do not retain information, absorb what we hear or accurately assess the situation. Panic is the worst thing you can do in a real emergency, and if the situation is not dire, panic will make it worse.

Panic is a natural startle reaction that gets exaggerated and becomes prolonged. People often learn to panic because, in early childhood, panic can get us out of responsibilities. Freaking out, crying, throwing temper tantrums, or shutting down are all panic responses small children use which cause some competent adult to take over and become the hero.

This can be okay once in a while, but as this pattern repeats, it becomes rescuing and codependency. Panic creates drama, unnecessary and damaging exaggeration of the problem, which leads to dysfunctional responses and overblown family drama.

We admire people who don’t panic. Our new President is admired for being “no drama Obama” because he retains his ability to think clearly, take his time and make effective decisions even when the people around him are panicking. People who can stay calm usually come out OK, because they think clearly.

So, what do you do in a scary or upsetting situation? Teach yourself how not to panic, so you can think clearly and handle the problem effectively. Practice these techniques to teach yourself to stay calm when the situation is threatening or the people around you are obviously in a panic.

More from YourTango: The Key To Eliminating Anxiety (Without Medication!)

Resolve Your Anxiety Today

To learn to let go, you may find these few steps can help resolve your fear and anxiety.

1. Learn to recognize the signs of your own panic.

If you feel the telltale signs of panic, which include a racing or pounding heartbeat, flushing of the face or body and mental confusion, you are in a state of panic. If you are shouting, saying unreasonable things, or just saying whatever comes out of your mouth, without thinking about consequences, you are also in a state of panic.

2. Take some deep breaths.

Deep breathing will calm your body and burn off the adrenaline that’s been released in the panic. Slow down, count to ten and focus on thinking clearly and factually rather than reacting emotionally.

If you don’t understand how to do deep breathing, you can learn how to do a deep breathing exercise here.

3. Take responsibility to figure out what you’re afraid of.

Unless you’re in immediate, direct danger, what’s scaring or upsetting you is probably not as urgent as you think. Make a list of what you’re afraid of that help you move beyond free-floating anxiety and you will begin to think more clearly.

4. Check the facts.

Is what’s on the news really true? Do we have an epidemic, or only 11 confirmed cases in Calfornia? Does the source you’re listening to have something to gain by putting you in a panic? Are they trying to sell you something, get federal funding, or get elected? Are you reacting to someone else’s panic? Get some facts about whatever is frightening you. Is there a real, immediate threat or is it just wise to be cautious? Is your partner actually going to abandon you, or is he or she just angry about something?

5. Make a decision and take some action tackling each fear.

If it’s a health fear, perhaps better hygiene or a talk with your doctor will resolve it. If it’s a relationship fear, finding out what your partner is really thinking, instead of guessing, will probably make more sense.

Get a flu shot, go for relationship therapy or have a good talk with your partner or family member.

More from YourTango: Is Social Anxiety Disorder Wrecking Your Marriage?

6. Sell yourself on a positive outcome.

Think of all the possible great outcomes of the changes you’re making. Consider what you will learn, and how much better your life and relationships will be without the panic.

With a calmer outlook, you’ll be able to make better decisions and create a more successful outcome. I wish you peace, within yourself, within your family, within the world.

More related content from YourTango:

  • Anxious Parenting: Are You Guilty Of It?
  • It’s Over! Dealing With The End Of A Relationship
  • Relationship Anxiety: Fear Eyes Or Clear Eyes?

Anxious About Everything? 6 Ways to Cope with Anxiety

When you are having a panic attack, use the acronym “BRAVE” to remember five great strategies for dealing with panic attacks.

1. Body knowledge. Learn the facts about panic. A panic attack is your body preparing you to deal with danger (F3-fight-flight-freeze response gets activated). If there is no danger – your body is giving you a false alarm.

2. Realistic thinking. Try not to panic about panic. Remind yourself that the panic is not harmful. Your body is having a false alarm – your F3 system has kicked into gear at the wrong time – the alarm will stop ringing in time. Panic is hard but harmless. Think of it like a migraine headache – real and uncomfortable but not life-threatening. You can cope and function during a panic attack.

3. Acceptance. Accept that once your body’s alarm system has been triggered, it will take a while before it settles down. Your body can’t un-release adrenaline once you realize it’s a false alarm. It will take a while for your body to return to normal. Once your sympathetic nervous system gets revved up, it will take a while for your parasympathetic nervous system to settle things down, like slowing down a fast-moving train.

4. Validation. Validate your experience. Panic attacks are real and very uncomfortable. But they are not deadly and you do not have to let them stop you. You may be suffering but you are also strong.

5. End. Remind yourself that panic attacks end. They do not last forever. It is not your job to stop or end a panic attack. It is your job to ride the wave of panic. Surf it or dive into it. Trying to fight or end panic tends to make it worse. You can handle the panic attack.

If you try the BRAVE techniques and you don’t see a change in a healthy direction, don’t quit. These are just five tips, and there are many more things people can do to manage panic attacks. Panic is treatable.

To learn more about panic attacks, please click here.

Learning more can help you manage and BRAVE your anxiety when panic attacks. Anxiety Canada has lots of free resources to help you learn about panic, panic disorder, and the evidence-based strategies for dealing with them.

Disclaimer: Tips provided in this blog post are not meant to replace evidence-based psychotherapy or pharmacotherapy for anxiety disorders. If panic attacks are causing you a lot of distress or interfering with your life, consult with a trained health care provider.

Author: Dr. Melanie Badali, R.Psych.

How to deal with panic attacks

A panic attack is a feeling of sudden and intense anxiety.

Panic attacks usually have physical symptoms. These can include shaking, feeling disorientated, nausea, rapid and irregular heartbeats. You may also experience dry mouth, breathlessness, sweating and dizziness.

The symptoms of a panic attack are not dangerous but can be very frightening. They can make you think that something catastrophic is just about to happen.

They can feel as though you are having a heart attack, or that you are going to collapse or even die.

Most panic attacks last somewhere from 5 minutes to half an hour.

How to handle a panic attack

It’s important not to let your fear of panic attacks control you.

Panic attacks always pass and the symptoms are not a sign of anything harmful happening. Tell yourself that anxiety is causing the symptoms you’re experiencing.

Ride out the attack. Try to keep doing things. If possible, don’t leave the situation until the anxiety has subsided.

Confront your fear. If you don’t run away from it, you’re giving yourself a chance to discover that the thing that you are fearful of happening is very unlikely to happen. Or be as bad as your anxiety predicts it will be.

As the anxiety begins to pass, start to focus on your surroundings and continue to do what you were doing before. Remind yourself, the thing you panicked would happen didn’t happen. Or wasn’t as bad as you thought it would be.

If you’re having a short, sudden panic attack, it can be helpful to have someone with you. They can reassure you that it will pass and the symptoms are nothing to worry about.

Breathing exercise for panic attacks

If you’re breathing quickly during a panic attack, doing a breathing exercise can help. Follow these steps:

  1. Breathe in as slowly, deeply and gently as you can, through your nose
  2. Breathe out slowly, deeply and gently through your mouth
  3. Some people find it helpful to count steadily from 1 to 5 on each in-breath and each out-breath
  4. Close your eyes and focus on your breathing

You should start to feel better in a few minutes. You may feel tired afterwards.

Preventing panic attacks

You need to try to work out what particular stress you might be under that could make your symptoms worse. It’s important not to restrict your movements and daily activities.

Things you can do

  • Doing breathing exercises every day will help to prevent panic attacks. It will also help to relieve them when they are happening.
  • Regular exercise helps to manage stress levels, release tension, improve your mood and boost confidence.
  • Eat regular meals to stabilise your blood sugar levels.
  • Avoid caffeine, alcohol and smoking – these can make panic attacks worse.
  • Panic support groups have useful advice about how you can manage your attacks. Knowing that other people are experiencing the same feelings can be reassuring.
  • Psychological therapies like Cognitive behavioural therapy (CBT) can identify and change the negative thought patterns. It’s these thought patterns that are feeding your panic attacks.

Related topics

Talking therapies

Healthy eating active living

Panic disorder

If you feel constantly stressed and anxious, particularly about when your next panic attack may be, you may have panic disorder.

People with panic disorder may avoid situations that might cause a panic attack. They may also fear and avoid public spaces. This is known as agoraphobia.

There’s no quick fix, but if your attacks are happening time after time, seek professional help.

Content supplied by the NHS and adapted for Ireland by the HSE.

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