I have had anxiety—and panic attacks specifically—since I was a child. I’m not sure why I’m wired this way, and although things like therapy and medication have been helpful, sometimes panic attacks come out of the blue. At these times, it’s just me and my panic, and it can be hard to know what to do.
The thing with panic attacks is that when you are in them, you can’t really think clearly—not at all. The high levels of adrenaline that are released make your thoughts race, your heart pound out of your chest, your breath quicken, and your bowels churn. You might feel trapped. Your nerves are on overdrive, and every sound or sensation can feel triggering.
It can be hard to describe a panic attack to someone who is not in one, but it’s like the feeling of being chased, like you are in grave danger—only your aren’t, not literally. You feel like you’re spinning, like your grip on reality is loosening. Once you are “in” a panic attack, it can be really hard to get out of it.
However, over the years (I’ve been having panic attacks for over 30 years!), I’ve amassed some tools that have helped me cope. These are things I learned about and practiced before a panic attack happened. I have them catalogued in my head so that I can use them when I feel a panic attack coming on, or even when I’m in the middle of one.
They are not a substitution for medication or medical care. Sometimes fast-acting anxiety medications are the best choice for you, and there is nothing wrong with that. But if you aren’t using medication, don’t have your meds with you, or would like some complementary practices, these are some helpful ones that have worked for me.
1. Breathing: Emphasize The Exhale
Everyone tells you to “just breathe” when you are experiencing a panic attack. But that can be difficult to accomplish, especially because panic attacks themselves actually make it more difficult to breathe. One technique I have learned is to focus on my exhale rather than my inhale.
According to Healthline: “Taking a deep breath in is actually linked to the sympathetic nervous system, which controls the fight-or-flight response. But exhaling is linked to the parasympathetic nervous system, which influences our body’s ability to relax and calm down.”
Bingo. Taking a deep breath in may feel impossible to accomplish when you are having a panic attack. Try lengthening your exhale instead. It can really help.
2. Hands-On Breathing
Another simple but highly effective thing I’ve done during panic attacks is to place a hand on my ribs or chest and feel the breath going in and out. This is a no-pressure type of thing. I don’t have to try to breathe better or slow down my breathing, but just observe it happening.
Usually, I find that my breath naturally slows down when I give it even this small amount of attention. It is also grounding simply to place my hands somewhere. In general, using your senses to ground yourself (in this case, the sense of touch), as well as focusing on one specific thing can help with panic attacks.
3. Panic Attack Meditation
I find that meditation isn’t helpful when I am in the middle of a panic attack. “Deepen your breath and just relax” does nothing but piss me off and make me more panicky. But I have a few meditations I listen to that are specifically geared toward panic attacks. They are so helpful.
I’ve downloaded a few apps to my phone that contain meditations specific to panic attacks. If I know I might be in a situation that triggers panic, I will make sure to bring my phone and headphones along. These meditations acknowledge what it’s like to be in the middle of a panic attack, validate your feelings, and walk you through techniques to come down from the panic. They are gold to me and have saved me more than once.
4. “Trace The Hand” Breathing Technique
I recently learned a very helpful technique for panic attacks referred to as “trace the hand” breathing. It’s often marketed toward children, but it’s equally effective for adults. Basically, what you do is take one hand, and trace your other hand’s fingers. You combine this with breathing. There are different ways to do it, but in the way I learned, you start at the base of your thumb and inhale, exhale when you get to the top of your thumb, inhale again when you get to the base of your pointer finger, and then continue the pattern.
It’s extremely soothing and grounding. This video can help you better understand the technique.
5. Finding My Person and Talking
I used to try to stay as silent as possible when I was having a panic attack. If I was with others, I would retreat into my own little world. I really didn’t want to come across as someone who was having an issue or was irrational. But as the years progressed, I found that sharing what is happening can be really helpful and is sometimes my ticket out of a panic attack.
Of course, I don’t share with just anyone. Only trusted friends or family. If I’m with my husband, I will usually tell him what’s going on. Just naming it and sharing it makes the threat feel less real. I have even started to tell my kids when I’m having a panic attack, though I usually just say that I’m feeling nervous and upset. I make sure they know it is not their responsibility to make me feel better, and that I will be okay. They are really cool about it, and I think it’s a good model for them to know that feelings and emotions are okay and can be talked about.
When I first started going to therapy, my therapist suggested that I write out a list of things to say to my panic attacks when they are happening. I thought she was bonkers at first, but then I started to find them really helpful.
First of all, putting myself “in conversation” with my panic reminds me that it is not me, but rather something that is happening to me. It’s good to distance myself from it a little. Then I will tell it to fuck off or take a hike, or whatever. I will also offer words of gentle soothing to myself. Just saying something like, “Wendy, that’s just your anxiety talking. You’re going to be okay,” can be really helpful. It sounds corny, but it works.
These are the things that have worked for me best. But there are so many other things you might try and that might work for you. Some people find that having certain essentials oils or scents that they carry with them and taking a whiff of one during a panic attack can help. Some have a piece of jewelry that they wear to remind them to breathe.
Do whatever works for you. Either way, it can be super helpful to make yourself a list, just like I did, of the things you can try when you’re panicking—a toolkit of sorts. You can carry it with you, along with any “equipment” (like scents, index cards with things to tell yourself, links to mediations that are helpful, etc.).
This way, when a panic attack hits, you don’t have to try to figure out what to do. You can just pick from your list. Again, these things are not guaranteed to work each time. If you are in the middle of very intense panic attack, they may take some time to work. And obviously some panic attacks require medication or medical attention.
Still, it can be very reassuring to know that you have a few things in your back pocket to try. Some of them have truly saved me when I needed them most.