Maybe you’ve felt it—the tightness in your chest, the thumping of your heart, the sweat breaking out on your temples. It’s not just ordinary nervousness—it’s a panic attack, a full-fledged expression of anxiety and stress that feels impossible to control.
But it’s not. There are effective, immediate ways to ward off a panic attack when you feel one coming on. “People who experience anxiety and panic attacks need to learn calming and coping strategies to reduce overall anxiety and manage panic symptoms,” says Dr. Barbara Nosal, MFT, LADC, executive director of clinical services at Newport Academy, where we teach teens dealing with substance abuse and mental health issues to self-regulate their mood states and stress.
The first indication that a person is experiencing anxiety or an impending panic attack is their physiological response, as the amygdala sets the fear response in motion. This shows up as an increased heart rate, blood pressure, and sweating, Nosal says.
The first intervention is to induce relaxation using breath and body awareness. The often-heard advice “just take a deep breath” and “relax” actually makes a difference, when we follow the directions literally.
A three-pronged reaction:
When we find ourselves in a situation that creates anxiety or panic, our reaction has three separate parts, Nosal says: physiological (increased heart rate, blood pressure, sweating); behavioral (the need to act out in some way); and subjective (negative thought processes).
“Though the intensity varies among individuals, reactions can escalate into a vicious cycle,” she says.
Relaxing and slowing the breath rate can have a powerful positive impact on all three of these areas—in both the short term and over time. The best way to approach this is to work with a therapist or counselor to create an individualized plan specifically designed for you.
“Relaxation techniques will reduce the physiological symptoms so that the person can regain a sense of being centered in the moment and grounded in their body,” Nosal says. “When you concentrate on the breath, you become centered in the present moment [and that helps you] avoid the urge to act out, which could result in negative consequences. Lastly, you can engage in more positive self-talk to avoid the fear-based messages that perpetuate the anxiety and panic.”
Practice when you're not panicking:
In the long run, the best way to avoid anxiety attacks is to incorporate relaxation and wellness into your life all the time, even when you feel just fine. Ongoing practice supports a reduction in the intensity, frequency, and duration of panic attacks, Nosal says.
“Therapists should work with clients on developing their coping strategy plan when they are not experiencing anxiety, so they can incorporate these into their everyday life as well as easily adapt when symptoms occur,” Nosal says.
What works best?
Practicing relaxation techniques such as progressive muscle relaxation, applied relaxation, and evenly paced diaphragmatic breathing. Nosal says that relaxation techniques empower individuals to have a sense of control over their symptoms, as opposed to exposure-type therapies that put individuals in situations that require them to re-experience fearful sensations and emotions until they become desensitized.
One simple way to generate a calming, even energy is breath counting. This surprisingly simple practice allows the body to find homeostasis. Count to four or five on the inhale and to four or five on the exhale, to allow the parasympathetic nervous system to ease into cruise control. After just three minutes of this gentle practice, stress levels decrease.
Identify, challenge, and change biased self-talk to reality-based positive beliefs. “Positive self-talk empowers the individual to tolerate and manage symptoms,” Nosal says. “The individual needs to gain awareness of their fear-based disempowering beliefs and how they can realistically change those beliefs.”
Make foundational lifestyle changes that contribute to overall well-being. If you know you have a tendency toward anxiety, commit to spending time each day or throughout the week doing relaxing and enjoyable activities, such as physical exercise, spending time in nature, or socializing with friends. Avoiding caffeine and mind-altering substances reduces symptoms of anxiety as well.