I have dealt with anxiety attacks for a couple of years, at times severe enough to be debilitating.

So, there are many elements, but I will first and foremost the thing that helped me was getting checked out by a doctor. The problem with anxiety attacks (at least for me) is the symptom I once saw described as “a feeling of impending doom”. Basically, I thought I was dying for months. The longer it went on, the most convinced I was, and the more it was perpetuated. When I finally got checked out, he confirmed my worst fear: that there was nothing physically wrong with me. My first reaction was frustration because that meant it was all in my head, but in the long run, it helped a ton. Knowing that it was in fact just anxiety attacks really helped keep them at bay and even allowed me to stifle them as they started. But also important, my doctor prescribed me medication. I opted for the type that you take when you have an attack rather than the type you take every day. I’ve had this medication for over a year know, and it helps a ton, even when I’m not taking it. When an attack starts to get bad, I start thinking about taking the medication, and knowing that I can fix the attack anytime I want is usually enough to quiet it down. So if you haven’t yet, definitely see a doctor.

But there are a lot of other coping mechanisms as well. Try to reduce your stress as much as possible. Easier than it sounds I know, but stress is usually one of the major causes. Try to get more sleep because being tired can make things worse (I fail miserably at this one most of the time, but I can tell it makes a difference on the rare occasion that I am rested).

When you feel yourself getting an attack, leave your current environment. If you’re inside, go outside. If you’re driving (my favorite time to get them), pull off somewhere and take a break or a quick walk through a store. Obviously, it’s going to be different for everyone, but I find that just a change of environment is enough to subdue the attack most of the time.

And if you don’t have medicine handy, my not best but helpful suggestion is to keep your mind occupied. My sleeping was a disaster for a long time, often resulting in me having and attack until 5 am or so and then just getting up without sleeping because trying to go to sleep gave my mind too much room to wander. So if I’m having trouble sleeping, I don’t try to, I read instead (or watch TV or whatever). Eventually, I’ll fall asleep. It may seem counter-productive to try to get to sleep earlier by doing an activity (even a fairly passive one), but it honestly helps because it keeps me focused until I’m tired. Video games or other engaging tasks can also help throughout the day because they require too much mental processing to allow your mind to go down the anxiety route. I definitely don’t recommend this approach as a long-term solution, but keeping busy is good for getting you through a rough period.

—mubi_merc

4. Force Yourself To Observe The World

Put your hand on something solid.

Count five things you can see.

Count four things you can hear.

Count three things you can smell.

Count two things you can touch.

Notice the taste in your mouth.

Get up and repeat in another room.

—mdxdx

5. Breathe It out

When I’m in a full out panic attack, I kinda just have to hug my knees and breathe it out. But overall, I find that exercising and yoga have been good outlets for my anxiety. Especially running.

—chanwillie

6. Before an Attack, Stop and Put It In Perspective

I don’t deal with my own failure well and will never stop beating myself up over mistakes unless I stop and use hard logic. Did the thing hurt anyone? Can I do anything to reverse the thing now? Will the thing matter a week or year from now? And so on. And if it’s really bad, I’ll imagine a character asking me things so it feels like someone else is reassuring me.

—MacabreLurker

7. Visualize

I mentally picture moving the scope from the neurons in my brain that are forming the stressful thoughts, to outside of my body, making sure to breathe deeply, name items in the room (the name game – if you see it, say it [in your head], check in with your skin – are you sweaty or hot? What would alleviate that? I ask if I’m thirsty, tired, or hungry. Then I shift my focus further outward to performing the task I identified as helping my physical body be comfortable. I maintain the present moment while I do the task, reminding myself to breathe in through my belly and deeply exhale. Also, breathing in a square is helpful – imagine a box, inhale at the corners, exhale the length of the line, repeat as needed. It’s super helpful at work! I’ll go outside if I can. Not a big trip, smoke break usually (maladaptive crutch, not advocating smoking!), just for ten minutes to deeply breathe and continue to be aware of my body sensations and keep playing the name game.

That’s how I triage high peak anxiety/panic. When that’s under control, I do one or both of these things. I assess from the stoicism angle – can you help or fix or change this? Yes? Do it. No? Let it go, what’s done is done and it is what it is. And then with that sharpened focus, I’ll either make a list on how to execute the solution to my problem (grocery list, to-do list, chores, make amends, work project), or I’ll journal. Just take a moment to write out what I feel and why I might feel that way. And I imagine writing it how I’d say it to me if I were confiding in myself. I say it all, as it is, plainly. That helps me remove any emotional shading of the scenario and it helps me identify my faults and points of action.

Then I’ll go back outside or pet my cat. More breathing, meditate on that forward-thinking plan or analysis journaled above.

I’ll set out to do it. And honestly, after a fairly big episode of stress, I always take at least half an hour to lay down, even if I don’t sleep. It’s just gently calibrating to your new mindset of your stressors/anxieties.

When all is said and done or delegated fairly over the week, I’ll call my mom or my dad and talk them through that wave. The initial physical panic, the ways I came out of it, how I soothed myself, and how I took action. That’s helpful for me, because it takes something I typically feel shame about (being an anxious person), and instead of hiding it and feeling badly for having gone through that, I explain my obstacle and my execution and subsequent relief. Always met with support and encouragement and empathy. But whoever is your go-to safe person to really open up to and who will make you feel good about it is the person I’d recommend.

Breathe, take action, and seek solace in knowing it passes.

—Asaderbro

8. Try A Weighted Blanket

I found that weighted blankets helped me with anxiety.

—Luna_Lilliputian

9. Make Time For Meditation

I meditate before bed every night for about 20-30 minutes. I don’t have very serious anxiety, but the anxiety that I did have was pretty much gone in about a week. It could take more time for you if your anxiety is more serious, but I recommend it nonetheless. You’ll feel a lot more balanced and in control of your emotions and how you react to certain things.

Everyone does it a little bit differently, but this is what works best for me. I sit in an upright position with the bottom of my feet pressed together, my back up against a few pillows, and with my hands joined together in between my legs. Sit however you feel comfortable, but not in a position that you are likely to fall asleep in. Then I close my eyes. The important thing is not get caught up in a train of thought. Let thoughts pass through your mind but don’t latch onto them. If you find your mind veering away, re-center yourself. Accept everything about your present situation. Observe thoughts passing by from afar but don’t become involved in them. Eventually, you will find yourself in a meditative state that you can pull yourself out of at any point. I said I usually go for 20-30 minutes, but I don’t really keep track of time I kinda just stop when I feel satisfied.

—Capskadoo

10. Count To 10 In patterns

I count to 10, but not in order. Then I repeat the numbers in the same order. It forces me to think about what numbers I have already said and what numbers I need to say. The I have to remember and repeat them. It really forces me to think about something other than the problem at hand.

—UntoldMysteries

11. Focus on the out breath, not the in breath

I can’t say as I’ve had a full blown panic attack but I do have anxiety that can get pretty bad at times and make me feel panicky and short of breath. People always tell you to breathe deeply. What they fail to explain is that it’s the out breath that’s more important when you’re trying to calm down. You want your out breath to be at least twice as long as your in breath. try counting in for four and out for eight. I also find that it helps to imagine my breath coming up through my feet – for some reason that helps me “belly breathe” better and counteracts the inclination to take big gasping chest breaths, which is how I usually feel when I’m panicky.

—Sgw768

12. Remember to “ride the wave”

Healthy: I remember mindfulness techniques I’ve learned in therapy. Remaining in the moment and understanding what you’re feeling, why you’re feeling it, and what steps you can do to calm yourself And “ride the wave of emotion.”

—Apocalypse_Folk

13. Take Time To Regroup

Stop everything that you are doing and go somewhere you feel safe and comfortable. Do things that make you feel good (i.e. cooking, video games, sleeping) and take time for yourself. Don’t try and “push through” the anxiety. Take the time you need to regroup.

—MsQcontinuum

14. Create a mantra that works for you

For general anxiety, I have a mantra: “Everything is okay. You are still here. In the grand schemes of things, this is one moment. You will be fine.” I try to focus on one thing and let it take up all my attention, usually Netflix. Lately, though, I’ve turned to turning up my music really loud and letting loose.

I haven’t had a panic attack in a while, and I never got good at dealing with them. Normally I would just blow up my friend’s phones begging for them to talk to me so I could calm down and get ahold of myself.

—silentsilentsilent

15. Recite Your Favorite Poem Or Song Lyrics

Deep breaths and telling myself that my body is freaking out for absolutely no reason. It’s just chemicals going awry, and if I stay calm they’ll figure it out. If I’m driving, then I roll the window down and get some cool air flowing over me. I also recite the Lord’s Prayer, which helps me refocus my brain. If that doesn’t work, then I try to recite Psalm 23, which is a bit more difficult for me to remember. (This has worked wonders while in the dentist’s chair) Really, any bit of poetry or song lyrics will work.

One thing that has really helped is recognizing what my triggers are. Driving near semis or in the rain will send me into a full-blown attack, so I do my best to avoid those scenarios. I also have noticed that I start having them when the muscles in my left shoulder get too tense, which compresses the nerves, and are attached to the nerves in my arm and the ones that go across my chest. It induces that heart attack feeling, which we all know is not fun. It actually forced me to go through 6 weeks of physical therapy to repair initially. Now when I feel it getting bad I’ll get a massage and head straight to the chiro after. If I can’t get an appointment, then laying on a tennis ball against that nerve bundle brings some relief. It’s worked wonders, and my attacks have been limited greatly.

—tinkerschnitzel

16. 54321

54321! 5 things you can see 4 things you can hear 3 things you can feel 2 things you can smell 1 thing you can taste.

If that doesn’t work, then it’s a minute and a half of music (usually Blanche- City Lights).

This is all while breathing in through the nose, out through the mouth.

Keep repeating until it is fought off.

—SaltyPopcorn02

17. Give Your Anxiety Work To Do

Rock climbing. I was 40, fat, and convinced I was dying of a heart attack on a near daily basis. Started climbing and poof, no more panic attacks

My theory is that my anxiety ‘thermostat’ is just set too high. Climbing gives it a focus that can be resolved.

—pehvbot