Here are a few tips that have helped me when I’ve been having high anxiety slash panic attacks.
I use all of these on a regular basis. Some of them are effective right away, some of them I have to try several of them before I find one that is effective, and sometimes none of them work. It really depends on the day, my mood, and any number of other factors. Some of these you can do anywhere, at any time, and some you may have to plan ahead for.
Since anxiety is a body-up experience what helps the most will be whatever brings you into the present moment and out of your body experience.
ANYWHERE AND EVERYWHERE
Start first with your breath. And I know that may seem simplistic but it’s not just inhaling and exhaling, it’s how you inhale and exhale that will be key to bringing your awareness away from your body and into the moment.
- Take a deep breath in and count to four, and then on the exhale, count to eight. Count to six if eight feels too long. The exhale should be longer than the inhale because this is what triggers the parasympathetic system, this is counter to the sympathetic (fight-flight-freeze) response that comes with anxiety and panic attacks. Take in several deep breaths and let out the exhale as slowly as you can. If it helps, purse your lips as if you were blowing up a balloon or blowing through a straw, this will help to make the exhale longer than the inhale.
So I know that sometimes breathing doesn’t help as much as it could. Either it comes too fast or you just can’t focus on it. No worries, it is a starting point, and is always worth a try.
- If you’re able to, get up and take a walk, or start pacing if your space is limited, or climb a flight of stairs. This is a physcial way to try and expend some of the energy that comes with the anxiety. It does require several minutes of walking or pacing, and may require a few flights of stairs before you start to reduce the anxiety. You may have to walk or pace faster in order to feel the full effect of the energy being expelled though. If you are able to, do it so that you start breathing hard from exertion. This can be done pretty much anywhere, as long as you have the freedom and space to do so.
- Shaking out your hands and arms can also help to expend some of the energy. If you’re able to, shake out your whole body–hands, arms, feet, legs etc.
- If you don’t have the space and freedom to move around then you can still try tensing and relaxing muscle groups. For example, clench and release your fists several times, or tense and shrug your shoulders several times, you can tense and release your thigh muscles, and your calves by stretching and relaxing your feet. This can be done pretty much anywhere, at any time, however, it may take several tries of tensing and relaxing before you start to notice a reduction in your anxiety.
- If you are near a washroom, at your house, or a close friend or family member’s house, then go to the bathroom and splash cold water on your face. Do this several times, and with the water as cold as you can tolerate it. This will shock the nervous system, and can help reduce the tension and agitation that comes with anxiety. Cold showers also can do this, however, a shower might be best done at home.
Getting outside of the body, we next have naming and/or counting that you can try…
The best thing about naming or counting is you can do this wherever you are, inside or outside, sitting at home, at a friend’s house, or outside travelling on public transit. I can’t speak to whether any of these can work while driving as I don’t drive. However, if you are able to do any of these safely while driving then I hope it helps.
- Start looking around you and naming things you see. For example, if you’re in a living room, just start naming what is in the room: a couch, a chair, the tv, coffee table, carpet, television, remote control, lamp, bookcase, it doesn’t matter what you name, just name it. In your head or out loud, doesn’t matter.
- If you’re in a car or on the bus or subway, start naming things around you. For example, that man sitting across from you on the bus has dark hair and is wearing a blue shirt and blue jeans and has on black running shoes, and that woman has dark hair and is wearing a red dress and a black jacket and has red shoes on, she is carrying a red purse over her shoulder, and so on.
- If you’re not able to focus on one person or it feels too much like staring, then start naming or observing everyone around you. For example, that man has a black coat, that woman has a red coat, that other woman has a blue coat and blue hat, etc.
- If you don’t want to name things, or you’re unable to focus enough to name things, then start counting. How many people are around you wearing black pants, or how many people have dark hair, or how many people are on their cellphones, or you could look out the window and start counting all the red cars you see, or count how many four door sedans you pass, or start naming the stores you see or count how many people walking, or how many people walking wearing running shoes.
- If naming and counting seem a little too focused for you in the moment, then try A, B, C-ing. For example, start with A and then start naming countries, or cities, or foods, or boys’ names, or girls’ names. For example: A=apple, or A=Allison, or A=Afghanistan, B=banana, or B=Brenda, or B=Berlin, and so on
It doesn’t matter what you name or count, just keep counting or naming. Do it for a few minutes or more, and you should feel your anxiety at least start to reduce.
There are a few tricks you can try that are usually best to be done at home, mostly because they are not very travel-friendly skills, and may require some alone time to do.
- An ice pack, placed by your neck or face, is also effective in shocking the system into reducing anxiety. Do this for as long as you can tolerate. Keep a couple of gel ice packs in your freezer, if you can. Frozen vegetables can also work in a pinch, just try not to let them totally thaw.
- Holding an ice cube in your hand can be a very useful distraction skill. You will need to hold it until it starts to hurt because this is what will shock the system and distract you out of your mind and into your body, specfically whichever hand you are holding the ice cube in.
*If you are sensitive to cold then I wouldn’t suggest using any of the cold water or ice pack methods, and to try some of the other suggestions.
There are several things that you can plan ahead with in order to help manage or reduce anxiety.
- One way that can help you change your breathing, is to chew gum and blowing bubbles with the gum. This can be very helpful with releasing tension in the jaw. As does sucking on a mint or candy. Unless you’re near a store where you can get some, this you will have to plan ahead to have on hand. I carry both gum and mints with me because I never know what will help.
- If you don’t like chewing gum, and prefer candies or mints, this can still help, as you can focus on the mint or candy in terms of texture and taste. What does it taste like, what does it feel like, is it smooth or rough in texture, can you smell anything, is it a hard candy or a soft candy? And with a mint or candy you can see how long you can hold it in your mouth without chewing on it or swallowing it. This can help distract you, especially if holding it in your mouth starts to create a physical reaction, like it starts to feel like burning on the inside of your mouth if you hold it one place too long.
- If you need something more tangible and/or cerebral to distract you and take you out of your body, particularly if you like words or numbers, I recommend crosswords, word seek or sudoku, whichever suits you. There are also kids phonics books you can get that are easy enough to focus on in the moment, but not too hard that it won’t distract you. This would be for the word and numbers people. And it would also require having to bring it with you, so I recommend carrying a pocket size, if you can find one, so you can have it on hand or bringing it with you when you know you’re going somewhere that can raise your anxiety.
- For the non-word lovers who still need something tangible, there are Rubik’s cube, wooden puzzles, metal puzzles and rings, and yo-yos, fidget spinners, silly putty, play doh, or a slinky can be helpful but they mean carrying with you at all times and that isn’t always feasible. Plus things to fidget with tend to be more to keep anxiety stable and are not always helpful when anxiety spikes or becomes a panic attack. They certainly don’t hurt to have on hand either way if you can.
- Small plush toys, keychains or pieces of fabrics can be helpful to soothe and distract.
This isn’t a comprehensive list, as there are so many things that can help manage and reduce anxiety, and it can be very personal or specific to the moment. One way to help you find what might work for you, is the next time you are feeling anxious, think about what do you think would help you in this moment? If you could have something or do something in this moment that might help you reduce the anxiety you’re feeling, what would that be? Would you prefer something tangible or do you want something that doesn’t require external stimuli? Would you prefer something you can taste or something you can touch?
It will probably take some time and practice to find what works for you and that’s okay. Listen to yourself and whatever works for you, works for you, and that is all that matters. Be patient and try not to discount anything. Sometimes what works for you can surprise you, or it might seem “weird”. Don’t worry about that, as long as you’re not hurting anyone else, or encroaching on their space, then do what works best for you.
Remember that this may only reduce your anxiety. The goal is to try and at least manage whats going on for you in this moment, until you are able to get home, or wherever you feel safe. Mix and match, test and practice, you never know what will happen or when, and you never know what will work or won’t. Be prepared ahead when you can, and hopefully some of these might help you with your anxiety.