I’m breaking a little bit with the theme of Depression Awareness Month this week to talk about a topic that is closely related to depression, and that is anxiety. The two often go hand-in-hand like a vicious chicken-and-egg kind of cycle where one leads to the other and vice versa. Our bodies can only sustain the heightened energy required for anxiety for so long before they crash and burn, often leading to exhaustion and then a bout of depression.
Sometimes anxiety levels are so high that they result in what is commonly referred to as an anxiety attack. (This is similar to, but not quite interchangeable with a panic attack, I will address the differences below). If you are wondering whether you might be experiencing an anxiety attack, check out the list of symptoms below.
Symptoms of an Anxiety Attack
Below are a list of some symptoms that you might experience if you are having an anxiety attack, right before you run to the bathroom to hide (not that I’ve ever done that). Everyone is different, so your symptoms might be different than a friend’s. You might experience only some of these symptoms, or many of them, all at once or at different times.
Feelings of apprehension and worry
Mental, emotional & physical distress
Heart palpitations or an increased heart rate
Chest pain or tightness
Shortness of breath
Feeling like you’re choking or you throat is tight/constricted
Sweating (including sweaty palms)
Hot flashes or chills
Upset stomach, knot in your stomach, abdominal pain, or nausea
Shaking or trembling
Feeling weak in the knees
Tingling, numbness or feeling the “creepy crawlies” under your skin (note: this may be a sign you are hyperventilating)
Dizziness, lightheadedness or faintness (ditto, above)
Difference Between an Anxiety Attack & a Panic Attack
The terms anxiety attack and a panic attack are often used interchangeably, but are not quite the same. Although “anxiety attack” is a term that many people use to refer to these symptoms, it is not actually a diagnosable condition, according to the diagnostic and statistical manual (the Bible of psychological disorders), whereas a panic attack is. However the differences are far less than the similarities, and have mostly to do with onset and severity.
Anxiety attacks can often build up slowly over time with rising stress levels and can be triggered by specific external stressors. For example, a looming deadline at school or work, an upcoming presentation, or relational tensions at home. Sometimes they might be mild, other times they might be more severe.
Panic attacks, on the other hand, frequently come seemingly out of the blue with no discernible cause. This can leave a person fearful of when they might experience their next panic attack, leading to another vicious cycle of worry and apprehension.
Panic attacks, while including many of the symptoms above, have an increased level of severity that includes a fear of dying or losing control, and often also includes a sense of detachment from the world or from oneself.
Despite these differences, the tips below can be used for relief with either.
Short Term Relief for Anxiety Attacks
The best way to manage anxiety attacks is to start learning your signs of escalation so that you can catch things before they get to a full blown attack and proactively take steps to calm yourself down. However, the only way to do that is if you to have gone through the full cycle a few times and paid attention to what leads up to the attack and what has helped you in the past to calm back down.
Keep in mind that although it often feels so overwhelming you think you won’t survive, an anxiety attack will not kill you. Ride the wave, and eventually it will pass.
What To Do When You Have an Anxiety Attack
Here are some strategies you can use in the moment when you are having an anxiety attack to calm yourself down and find relief from your symptoms. This is by no means a comprehensive list, but these are some of my go-to strategies that work well for myself and my clients:
One of the things that can often happen when we have a panic attack is that our breathing becomes rapid and shallow, which, if left unchecked can lead to hyperventilation which intensifies other symptoms. Start by simply noticing your breathing, the pace, the quality of the breath. Try to slow each breath down by a second on the inhale and a second on the exhale, and then another second, and another until each inhale and exhale is several seconds long and you start to notice the spaces in between the breaths. Once you have stabilized your breath, try a technique known as box breathing or square breathing: breathe in for the count of 4, hold for the count of 4, breathe out to the count of 4, and then hold for the count of 4 before drawing another breath. The military teaches their soldiers this method (known to them as “tactical breathing”) for combat situations. If it can work for them in the middle of a fire-fight, it can work for you.
5-Sense Grounding Exercise
Sometimes when we feel anxious we get stuck in our heads, listening to the worry tape that plays on repeat, without even realizing the stories of doom and gloom that it’s playing. One way to get off the anxiety merry-go-round from hell is to bring ourselves back to our bodies through our physical senses, walking through each one and noticing what data they are collecting. I find this exercise has an added calming effect if you do it outside in nature (note: this could just be your backyard, or the park down the street, or the 5 foot x 5 foot patch of grass with a tree planted in the center of the sidewalk outside your office).
5 – Sight: Begin with your sense of sight. Look around you and find 5 things in your environment that you can see. Describe them in detail, as though you were trying to explain them to a blind person. Notice colors, shapes, light, shadow, etc. The more details you take note of, the better the exercise will work.
4 – Hearing: Same as above; but this time close your eyes. Try to identify 4 different sounds you hear and describe them in detail. You might need to slow down a bit to notice more subtle or quieter sounds. This will bring you deeper into the present and out of the clutches of anxiety.
3 – Touch: Find 3 ways to interact with your physical environment using your sense of touch. Run your fingers through the grass. Feel your bottom in the chair. Notice the texture of your shirt. Feel the sun warming your face. Etc.
2 – Smell: Seek out 2 things you can smell. Maybe it’s freshly mown grass, the scent of detergent on your clothes, or the obnoxious amount of cologne the guy in the cubicle next to you is wearing.
1 – Taste: Is there something you can safely taste? (please do not use this as an invitation to sample the mushrooms growing in your backyard!) Try a drink or food nearby. If nothing else is available, simply notice the taste of the inside of your mouth. You might be surprised that you can actually detect a hint of the sandwich you had for lunch lingering there.
Reach Out for Connection
One of the most common things that happens when we experience an anxiety attack is that we withdraw so that no one else sees us turn into a trembling pile of sweaty clothes and tears. This might seem like it protects us from humiliation, but the downside is that we withdraw further into our own heads, which gives the scary stories more power. If you have a trusted friend, coworker or family member, reach out to them for support when you feel your anxiety rising. Sometimes the connection alone is enough to bring us back down to reality, and if they are nearby, a hug or some physical contact will also release oxytocin, which will further calm your nervous system.
There are more relaxation techniques than I can list here, and everyone has their own personal favorites.
You can try mindfulness techniques like progressive relaxation (just Google it or search on YouTube and you’ll find a whole host of guided exercises)
Or go the route of creating a calming atmosphere for you to be in by reducing stimulation:
Turning down bright lights
Avoiding noisy environments
Taking a bath
Listening to calming music
Listening to binaural stimulation (make sure you use headphones, these come in nature sounds, music tracks, etc. but need to alternate between ears to be effective)
Using some lavender essential oil (naturally calming for our system)
Drinking a cup of chamomile tea and savoring the flavor
Taking a walk in nature (reduces stress hormone cortisol)
Or my personal favorite: swinging in a hammock
Test out different strategies to find out what works best for you in your moments of panic and high anxiety. Each person will be different, and what works for you might not for someone else. Make a list of what works, and keep it nearby for those moments when you don’t have the wherewithal to do one of these techniques. Boom, you can just pull out your list and use it to help talk you down out of your panicked state.
Long Term Strategies for Reducing Anxiety Attacks
The strategies above are helpful in the moment when you are having an anxiety or panic attack, but they are also helpful to practice ongoing, even when you feel calm. It’s kind of like learning to drive a car: the first time you do it you’ll have to concentrate really hard to keep it between the lines, even in the calmest of conditions. But the more you practice, the easier it will get and the more muscle memory you will develop so that when something intense happens (like a car cuts you off, or you feel an anxiety attack coming on) your body already knows how to respond.
If anxiety attacks are a common occurrence for you, then reaching out for support might help you get them under control. Anxiety therapy is very effective at helping to reduce symptoms of anxiety, including anxiety and/or panic attacks. I have helped many people find relief from their anxiety symptoms and I’d be happy to talk with you about yours. I offer free 30-minute consults where we can discuss what’s happening in your life right now and how we can find you some relief. Click the button below to set up a free consult call.
For more information on anxiety therapy, visit the Anxiety Treatment page.