Calm Yourself During an Anxiety Attack

Anxiety is an experience everyone feels from time to time. Panic attacks can be scary, but with a little mindful attention and practice, you can help relieve the symptoms, manage your anxiety, and prevent attacks from occurring in the future. This article will show you how to do all of that.

10 Second Summary

1. Breathe in for 4 seconds, hold for 2 to 3, and exhale for 5 to 6. More ↓
2. Focus on what you see, smell, hear, taste, and feel. ↓
3. Distract yourself. Count backwards, recite your favorite song, etc. ↓
4. Tense each muscle group for 5 to 10 seconds. ↓
5. Try guided imagery. Visualize something relaxing. Focus on the details. ↓
6. Do something. Paint a picture, listen to music, go for a walk, etc. ↓

Steps

Help Calming Down

Doc:Meditation Techniques,Stress Journal Entry,Ways to Calm Down

Calming Yourself in the Moment

  1. "Grounding" is a method used where in the midst of an attack you calm yourself down. First list five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.
  2. Breathe deeply. If you’re having a panic attack, chances are you’re beginning to hyperventilate. Even if you’re not, breathing deeply can help to reduce your stress and provide oxygen to your brain to help you focus.[1] When you feel an attack coming on, stop and slow down your breathing.
    • Try holding your breath to start. This can help reduce the feeling that you are choking or unable to breathe.[2]
    • After holding your breath, begin to breathe slowly from your diaphragm. Place one hand on your chest and the other on your abdomen. You should feel your abdomen rise and fall as you breathe, while your upper hand should remain fairly still. Make sure you are alone in the room and try to think about the sounds you are hearing.[3]
    • Take 4 seconds to inhale through your nose. Hold the breath for 2-3 seconds. Exhale slowly through your mouth for 5-6 seconds
    • Continue deep breathing for several minutes until you notice a difference in your muscle relaxation and clarity of thought.
  3. Focus on your senses. During a panic attack, your thoughts may feel jumbled up. You are likely feeling many sensations at once, which contributes to the sense of “overload.” This happens because your body has activated your sympathetic nervous system’s “fight or flight” mode, kicking your heart rate and breathing into high gear, tensing your muscles, and constricting blood flow.[4] Take a moment to slow down and notice each of your sensory experiences in turn. This process can help your brain unlearn its “automatic reactivity,” or the habit of reacting to stressors in a particular way, by breaking down information into individual components.[5]
    • Try taking an inventory of what is happening without judging anything as “good” or “bad.” For example, you might notice: “My heart is beating very fast. My hands feel sweaty. I feel like I’m going to throw up.”
    • Next, remind yourself that these symptoms are the product of anxiety. Avoid telling yourself that you have to “control” the symptoms -- this can make the panic worse.[6] Tell yourself that these symptoms are temporary and will pass.
    • Stay where you are as you make your catalogue of sensations. This will, over time, help your brain realize that the situation is actually not dangerous. Running away from the situation may create stronger associations in your brain between the situation and panic.[6]
  4. Use cognitive diversions. If you are in the midst of a panic attack, distract your mind from your fear through different mental diversions. For example, count backwards from 100 by 3’s, list the presidents in order, or recite the lyrics to your favorite song or poem. Force yourself to do one (or several) of these techniques until you have calmed down a bit.
    • It’s important that you not distract yourself by leaving the situation that has caused the panic. Ride out the panic attack where you are. Otherwise, you will likely train yourself to associate that place or situation with fear, which could trigger future attacks.[7]
  5. Practice progressive muscle relaxation. This is a process of slowly going through your body and tensing and relaxing each muscle group. It accomplishes two goals, by forcing you to concentrate on something other than your fear while simultaneously relaxing your muscles. Start with your muscles in your face, and then work your way down until you’ve relaxed all the muscles in your body.[8]
    • Tense the muscle group for 5-10 seconds, and then release the pressure. You can do this for the same muscle group multiple times, but doing it once should suffice.
    • Major muscle groups that you can tense and relax include your jaw, your mouth (frown/relaxed), arms, hands, stomach, buttocks, thighs, calves, and feet.

Managing Your Anxiety

  1. Acknowledge your anxiety. Although you want to reduce the anxiety you feel, you don’t want to ignore it. Ignoring or repressing emotions can make them more powerful and more fear-inducing. Acknowledge that you are afraid, and that there is nothing “wrong” or “bad” about you for that experience.[9]
  2. Try “stop and replace.” This is a process by which you stop your anxiety-producing thoughts and replace them with thoughts of something that brings you happiness or peace. This can help you avoid rumination, that broken-record thought cycle where you can’t seem to stop obsessing about something.[10]
    • For example, perhaps you’re having anxiety about an upcoming plane flight and you can’t stop thinking about what might happen should you crash. Focus yourself by saying “Stop” to yourself, either out loud or in your head.
    • Next, replace this with something calming and positive. For example, you could replace it with a thought about your vacation with your best friends and how much joy they bring you.
    • It can take a lot of repetition for this technique to work, so be patient and kind with yourself.
    • This technique does not work in the middle of a panic attack, because a panic attack may not have a clear thought or cause associated with it. It is helpful for managing general feelings of anxiety, though.
  3. Use guided imagery. Using guided imagery can help you relax and reduce your experience of anxiety.[11]
    • Think of a place in which you feel at peace and relaxed; this could be your home, a favorite vacation spot, or being held by a loved one.
    • As you think of this place, continue adding sensory details to the scene, so that you are focusing your entire mind on imagining it. Feel free to do this with your eyes closed or open, although closing your eyes may make the process easier. Think about what you can see, smell, touch, hear, and taste in your safe place.
    • When you feel anxiety coming on, visualize your safe place. Imagine yourself relaxed and calm in the spot you have prepared. Once you feel more relaxed, you can come back out of the visualization.
    • You can also ask yourself some questions. Is it a true and present danger? Most likely, you are using “what if” statements and panicking about something that has not yet/may not happen. Realize that you are experiencing fear, but that you are not in danger. Taking the danger out of the situation will help you to relax a bit.
  4. Write down your feelings. If you are prone to panic attacks or feelings of anxiety, keep a diary in which you can write entries explaining your feelings. Write what you feel, what you’re afraid of, what your thoughts and beliefs are about that fear, and how intense the experience is. Writing it down will help you to focus your thoughts, and reading over your entry or looking back can help you to better handle your anxiety.[12]
    • You may notice at first that it feels like you don’t have anything to say. Keep trying to examine the situations that trigger anxiety. Once you practice slowing down and thinking about the situations, you will be able to pick out thoughts and feelings that may have helped boost your anxiety.
    • Practice self-compassion as you write your entries. Avoid judging yourself or your thoughts. Remember: you can’t necessarily control what thoughts or feelings show up, and they are not inherently “good” or “bad.” You can control your reactions.
  5. Take care of your body. Taking care of your physical health will help you take care of your mental health, too. Healthy exercise and diet habits will not “cure” anxiety, but they can help you manage it.
    • Do a little exercise. Getting your body active, especially through aerobic exercise, releases endorphins that are responsible for increasing your feelings of peace and happiness.[13]
    • Avoid stimulants. Stimulants such as caffeine and nicotine can make you feel jittery and tense, and they can worsen existing anxiety.[7] Some people mistakenly believe that smoking will calm their nerves, but this is not true. Nicotine dependence can increase feelings of stress and anxiety when you don’t get enough of it, and smoking is incredibly bad for your health.[14]
    • Eat a balanced diet. There is no “magic food” that will cure or prevent anxiety. However, avoiding processed and high-sugar foods can help, as can eating plenty of lean protein, complex carbohydrates like whole grains, and fresh fruits and vegetables.[15]
  6. Do something. Sitting and ruminating over your anxiety will worsen your state and make it harder to overcome your panic. Distract your mind and body by performing a task; cleaning, drawing, calling a friend, anything that will keep you busy. Preferably, do something that you enjoy as a hobby.[16]
    • Try a warm bath or shower. Studies show that the sensation of physical warmth has a soothing, relaxing effect on many people.[17] Try adding a few drops of lemon balm, bergamot, jasmine, or lavender oil to your bath. These essential oils have a calming effect.[18]
  7. Use music therapy. Create a playlist of songs that you listen to to help you relax or that make you feel happy. Then, if/when you experience anxiety, you can listen to the music to help calm you. Use noise-cancelling headphones when possible to help you to concentrate on the music. As you listen, focus on different parts that are being played, the sound, and the lyrics that are being sung. This will help to focus your mind away from your fear.[19]
    • Try to listen to music with slow beats (around 60 per second) and relaxing lyrics (or no lyrics at all).[20] Music with faster beats or angry lyrics may stress you out further.[21]
  8. Get help from a friend. If you are in the throes of anxiety and can’t seem to get out, call a friend or family member for help. Have them distract you from your panic and analyze your fear so that you can overcome your feelings of stress. If you are prone to panic attacks, coach a friend in the different means of treating them so that they are well versed should you call for help.

Seeking Professional Help

  1. See a therapist. If you have severe panic attacks over an extended period of time, visit a local mental health professional for therapy and advice. You may have panic disorder or generalized anxiety disorder, both of which can be treated by a trained professional.
    • One of the most common and effective treatments for anxiety disorders is Cognitive-Behavioral Therapy (CBT). This type of therapy focuses on teaching you to identify and alter unhelpful ways of thinking and reacting to situations. You learn how to recognize when your thoughts are not aligned with fact and how to practice helpful ways of thinking and reaction.[22]
    • In some cases, your physician or psychiatrist may prescribe an anxiety-controlling medication if other means of controlling your panic don’t seem to have an effect.[23]
  2. Talk to your doctor. In some communities it can be hard to find a licensed mental health professional, especially if you’re on a low income or have a restrictive insurance plan. While most medical doctors cannot offer psychotherapy -- the exception being psychiatrists -- they can usually diagnose some issues, such as anxiety and depression, and prescribe medications.
    • Family doctors can also provide referrals to mental health providers in your area.
  3. Look for community clinics and other resources. If you think you cannot afford therapy, look in your community for low-cost options. There are several types of options that you may find.[24]
    • A federally funded health center may offer mental health treatment. You can search for a center here.
    • Ask therapists about sliding scales. Some therapists and clinics will offer a “sliding fee scale,” meaning that your fee is based on your income.
    • Many colleges and universities offer mental health services. Sometimes these are reserved for students, but some larger universities may also offer community clinics where mental health students in training can provide services under professional supervision. These clinics tend to be quite inexpensive.

Identifying a Panic Attack

  1. Check for physical symptoms. Panic attacks can happen to anyone, but they are far more common for people who have panic disorder, an anxiety disorder characterized by frequent attacks of intense fear and anxiety. They can be triggered by just about any situation, not only dangerous or threatening ones. Physical symptoms of a panic attack include:[25]
    • Chest pain. This is generally localized, rather than radiating across the left side of your body as with a heart attack.[26]
    • Dizziness or faintness
    • Choking
    • Nausea or vomiting. Vomiting is less likely with panic attacks than with heart attacks.
    • Numbness or tingling sensations
    • Rapid heartbeat
    • Shortness of breath
    • Sweating, clammy skin, or hot flashes
    • Trembling or shaking
  2. Check for other symptoms. In addition to physical symptoms, panic attacks are generally accompanied by other feelings. These may include:[25]
    • Intense feelings of fear
    • Fear of dying
    • Fear of losing control
    • Sense of doom
    • Sense of detachment
    • Sense of unreality
  3. Distinguish between a panic attack and a heart attack. The symptoms of a panic attack and a heart attack overlap in areas.[25] If you are in any doubt whether you are having a panic attack or a heart attack, call for emergency medical help. The symptoms of a heart attack include:[27]
    • Chest pain. In heart attacks, this often feels like a sense of pressure, fullness, or squeezing. It usually lasts more than a few minutes.
    • Pain in the upper body. Pain may radiate to your arms, back, neck, jaw, or stomach area in a heart attack.
    • Shortness of breath. This may happen before you experience chest pain.
    • Anxiety. You may feel fear or doom suddenly.
    • Dizziness or faintness
    • Sweating
    • Nausea or vomiting. Heart attacks are more likely to cause vomiting than panic attacks.[26]
  4. Distinguish between anxiety and a panic attack. Everyone has feelings of stress, even intense anxiety, from time to time. However, for most people this anxiety is triggered by an event or situation, such as taking a big test or making a significant decision. This anxiety usually disappears when the situation is resolved. People with anxiety disorders have a sense of anxiety more frequently and more consistently than others.[28] People with panic disorder experience frequent, severe panic attacks.[29]
    • A panic attack usually reaches its height within 10 minutes, although some symptoms may last longer.[29] Feelings of more generalized stress or anxiety may last longer but feel less intense.
    • A panic attack does not require a specific trigger. It may seem to come out of nowhere.

Tips

  • Chamomile may help some people feel relaxed and calm. However, some people may be allergic to it and it can interact with medication, so it’s a good idea to consult your doctor before using chamomile.[18]
  • If you panic late at night, pace around the room and breathe in and out deeply.
  • Exercise regularly, learn relaxation techniques which are effective at reducing stress and sleep for a longer time. Sleep is absolutely necessary for those with anxiety, and something you should never skip on purpose.
  • Even though it can be very obvious to some people, always remember your family is there to love, care, and support you. Don't be afraid to talk to them about your problems, even if it is embarrassing.
  • Don't try to sleep if you're in the midst of a panic attack, as being under high stress can make it more difficult to sleep. If you try to relax, at least a little (via deep breathing or another calming technique) before you sleep, both of the effects of the relaxing technique and getting plenty of sleep can help you calm down significantly.
  • Try to make lists of things (favourite songs, movies etc.) or just count or sing the alphabet. This takes your mind off things involving your anxiety and forces you to focus on something else.

Warnings

  • If your attacks are frequent, seeking professional help sooner is better. Delaying treatment may only make the problem more severe.
  • If you are not sure whether you are having a panic attack or a heart attack, seek emergency medical care at once.

Related Articles

Sources and Citations

  1. ↑ http://www.psychiatry.org/panic-disorder
  2. ↑ http://umm.edu/health/medical/altmed/treatment/relaxation-techniques
  3. ↑ http://my.clevelandclinic.org/health/diseases_conditions/hic_Understanding_COPD/hic_Pulmonary_Rehabilitation_Is_it_for_You/hic_Diaphragmatic_Breathing
  4. ↑ http://www.psychologistworld.com/stress/fightflight.php
  5. ↑ http://scan.oxfordjournals.org/content/2/4/259.full
  6. ↑ 6.0 6.1 https://www.adaa.org/sites/default/files/CBT-for-Panic-Disorder.ppt
  7. ↑ 7.0 7.1 http://www.nhs.uk/conditions/stress-anxiety-depression/pages/coping-with-panic-attacks.aspx
  8. ↑ http://www.anxietybc.com/sites/default/files/MuscleRelaxation.pdf
  9. ↑ http://mentalhealthsf.org/six-simple-habits-that-defeat-anxiety/
  10. ↑ https://counselling.anu.edu.au/brochure/10-best-ever-anxiety-management-techniques
  11. ↑ http://prtl.uhcl.edu/portal/page/portal/COS/Self_Help_and_Handouts/Visualization
  12. ↑ https://www.psychologytoday.com/blog/shyness-is-nice/201404/how-keep-thought-diary-combat-anxiety
  13. ↑ http://www.adaa.org/living-with-anxiety/managing-anxiety/exercise-stress-and-anxiety
  14. ↑ http://www.mentalhealth.org.uk/help-information/mental-health-a-z/s/smoking/
  15. ↑ http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/expert-answers/coping-with-anxiety/faq-20057987
  16. ↑ http://www.anxietycoach.com/overcoming-panic-attacks.html
  17. ↑ http://journal.frontiersin.org/researchtopic/1627
  18. ↑ 18.0 18.1 http://umm.edu/health/medical/altmed/condition/anxiety
  19. ↑ http://www.webmd.com/anxiety-panic/tc/panic-attacks-and-panic-disorder-other-treatment
  20. ↑ http://blogs.psychcentral.com/panic/2012/02/the-most-relaxing-tune-ever-according-to-science/
  21. ↑ http://www.unr.edu/counseling/virtual-relaxation-room/releasing-stress-through-the-power-of-music
  22. ↑ http://www.adaa.org/finding-help/treatment/therapy
  23. ↑ http://www.adaa.org/finding-help/treatment/medication
  24. ↑ http://www.adaa.org/finding-help/treatment/low-cost-treatment
  25. ↑ 25.0 25.1 25.2 http://www.nlm.nih.gov/medlineplus/ency/article/000924.htm
  26. ↑ 26.0 26.1 http://www.calmclinic.com/panic/panic-attack-or-heart-attack
  27. ↑ http://www.mayoclinic.org/diseases-conditions/heart-attack/in-depth/heart-attack-symptoms/art-20047744
  28. ↑ http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
  29. ↑ 29.0 29.1 http://www.nimh.nih.gov/health/topics/panic-disorder/index.shtml
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