Coping skills for anxiety and panic attacks
Have you ever experienced anxiety or even feelings of panic, and not known what to do about it? In this article, I’ll discuss some coping and grounding skills that you can use for moments of anxiety or panic attacks to bring you back down to a calmer state.
What is anxiety?
Anxiety can manifest differently for everyone. For some, anxiety shows up as racing thoughts, ruminating on the same worry or jumping quickly from stressor to stressor. Anything can trigger it–a work deadline, a stressful conversation with a family member. You may find yourself replaying social interactions after the fact, worrying about how others perceived you. Or you may feel anxious about what’s going to happen in the future, running through scenarios to try to prevent negative outcomes.
For others, anxiety can be a vibrating hum in the body, a sense of energy, restlessness, or muscle tension. You may feel a pit in your stomach or tightness in your shoulders; you might notice yourself sweating, feeling hot, or even feeling nauseous. You may not even know what you’re anxious about, but your body feels activated and uncomfortable, and it’s hard to focus on anything else.
You may have a background hum of anxiety all the time, or there may be moments when the worry spikes and takes over completely. Anxiety demands our attention and exhausts us, distracting us from the present and pulling us deeper into our own internal experiences.
What is a panic attack?
A panic attack is like anxiety with the volume turned all the way up. A panic attack usually has a very quick onset and lasts for a matter of minutes. It’s an abrupt surge of fear, mostly manifesting in the body. You may experience some or all of these symptoms:
Pounding or racing heart
Sweating
Shaking or trembling
Feeling short of breath or a sensation of choking
Chest pain
Nauseau
Feeling dizzy, light-headed, or faint
Hot or cold flashes
Numbness or tingling
Feeling detached from yourself or feeling that what is happening “isn’t real”
Fear of dying
Panic attacks can be overwhelming and very scary. Even after the panic attack ends, you may have some residual symptoms. People who have experienced a panic attack are often afraid of triggering another one.
Coping skills
Some body-based coping and grounding skills can help with anxiety and panic. Anxiety can narrow our focus so that all we can see and feel is what’s going on in our mind and body. What we want to do here is two things: 1. Cue the body to calm down and 2. Widen out the perspective and take in other sensory information. Then, we can approach the triggers from a calmer place.
Body-based relaxation strategies
Breathing exercises can be a helpful first step to calming the body. When we are anxious or panicking, we often take short, shallow breaths into our chest, causing carbon dioxide to build up and making us feel that we are gasping for air. Taking longer, deeper breaths with long exhales ensures that we are moving carbon dioxide out and getting oxygen in. Try a few of these patterns and see which works best for you.
Diaphragmatic breathing: place one hand on the chest and the other on the abdomen. Breathe in, and imagine there is a balloon in the abdomen that you are trying to fill. See if you can make the hand on your abdomen rise and fall. Try to make your exhale longer than the inhale.
4-7-8 breathing: Breathe in for a count of 4, hold for a count of 7, and exhale for a count of 8. Repeat.
Box breathing: Breathe in for a count of 4, hold for a count of 4, exhale for a count of 4, hold for a count of 4. Repeat.
3-6 breathing (antidote breath): This one can be especially helpful for panic attacks. Breathe in for a count of 3, and, pursing your lips into a pucker, breathe out through the mouth for a count of 6. Repeat.
Progressive muscle relaxation: Sometimes, our body is holding tension and we may not even be aware. Even if we are aware, it can be challenging to release the muscle tension. In progressive muscle relaxation, or PMR, we tense each muscle group one by one, hold it tight, and then release; then, we move on to the next muscle group. This can bring a sense of release and relaxation into the body. You can read directions on how to do PMR here and listen to a short recording here.
Mammalian dive reflex: Fill a bowl with icy cold water, hold your breath, and submerge your face for 30 seconds. Alternatively, hold ice packs to your face or finish a shower with 30 seconds of cold water. This causes our heart rate to slow and “resets” the nervous system. Read more about it here.
Butterfly tapping: Cross your arms over your chest so that your fingers rest on your upper chest, pointing towards your clavicle. Optionally, you can hook your thumbs together to form a sort of “butterfly” with your hands. Alternate tapping each hand against your chest. Play with different amounts of pressure and different rhythms to find what feels calming to you.
Sensory-based grounding strategies
Use your senses to ground yourself in the present. Follow the 54321 guidelines below, or use the tips here to focus on each sense individually. Focusing on our senses can help us pull ourselves out of our mind and body and out into the present.
54321: Using your senses, identify:
5 things you can see
4 things you can touch on your skin
3 things you can hear
2 things you can smell
1 thing you can taste
Smell: Try to take in the smells around you. Find things with strong smells to focus on, like foods, hot drinks, scented candles, essential oils, toothpaste/mouthwash, gum, etc.
Temperature: Play with temperature. Take a hot or cold shower, hold and drink a hot or cold beverage, go for a walk outside, run your hands under cold or hot water in the sink, hug a warm pet.
Touch and pressure: Focus on interesting textures, like soft blankets or a pet’s fur. Try using a weighted blanket or use objects around you to create pressure. Wear comfortable, loose-fitting clothing.
Taste: Sip a hot or cold beverage, chew gum, brush your teeth. Slowly dissolve a piece of chocolate in your mouth and try to notice all the sensations and tastes that come along with it.
Movement: Try gently moving your body. Go for a walk outside, climb stairs, or pace around a small area in your home and notice your feet touching the floor. Try a gentle yoga routine, or lie on your back with your legs up a wall.
Proactive coping skills for anxiety and panic
The best way to respond to anxiety is to try to prevent it. These tools and strategies can help stave off anxiety and panic when practiced regularly.
Mindfulness: A regular practice of mindfulness meditation can help with distress tolerance and can help you focus your attention where you want it to go.
Exercise: Regular exercise can get the body used to the physiological sensations of anxiety, like increased heart rate, sweating, and increase in body temperature. Yoga can be especially soothing to those with anxiety.
Healthy habits: Maintaining a good diet and sleep routines can help bolster your resources and help you be able to respond better when anxiety strikes.
Therapy: Using skills you learn in therapy can help stave off anxiety.
