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Coping Skills for Anxiety and Panic Attacks

Table of Contents

What is anxiety disorder?

There are many types of anxiety disorders, but each one includes overwhelming worry and fear that interfere with day-to-day life.

Some of the most common anxiety disorders are generalized anxiety disorder, social anxiety disorder, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Anxiety can also manifest as a symptom of other mental health issues, such as schizophrenia and bipolar.

The symptoms of anxiety vary from person to person, but typically include:

  • Constant worry
  • Restlessness
  • Irritability
  • Sleep problems
  • Chronic muscle tension
  • Inability to focus
  • Panic attacks

The causes of anxiety vary from person to person. Traumatic situations from the past and present are frequently at play. This can include childhood family dynamics, unhealthy relationships, and interpersonal or mass violence.

Environmental stressors, drug abuse and withdrawal, and medical challenges can also fuel feelings of anxiety.

What is a panic attack?

A panic attack is defined as an acute episode of anxiety that comes on suddenly and is physiologically disabling. Symptoms of a panic attack include, but are not limited to:

  • Increased heart rate
  • Pounding heartbeat
  • Shortness of breath
  • Trembling/shaking
  • High blood pressure
  • Stomach cramping
  • Nausea
  • Dizziness
  • Light-headedness
  • Numbness
  • Tingling
  • Hot/cold flashes
  • Disassociation
  • Chest pain

This hyper-reaction is an adaptation that was necessary for survival throughout much of our evolution. When human beings lived with the looming threat of lions, tigers, and bears, the body developed an overdrive function to fight or flee from predators.

Modern panic attacks usually occur when stress has been built up over time. Reminders of past traumas, phobias, and overstimulation can all trigger the shift into panic mode.

De-escalating a Panic Attack

Whether you are experiencing a full-blown panic attack or sense one coming on, these five exercises are very effective at de-escalating the heightened state of arousal.

1. Alternate nostril breathing.

The alternate nostril breathing technique has been shown to slow heart rate, improve lung function, and decrease overall stress by improving brain function.

This exercise can be done anywhere, but it is best if you are in a safe and comfortable space. Remove your shoes and place your feet firmly on the ground.

Then close your eyes. If this is too overwhelming, choose an object in front of you to focus your gaze on. Take a deep breath into your diaphragm, lift your right hand to your nose, and exhale completely. Then, cover your right nostril with your thumb. Inhale deeply through your left nostril, then cover it with your index finger and release your thumb. Exhale through the right nostril. Inhale through the right nostril, then cover it and exhale through the left nostril. Continue alternating in this pattern until you feel calm and focused. Always complete the exercise with an exhale on the left side.

2. Relax your muscles.

Moving in an intentional way while breathing deeply allows you to regain control over your body and activate the parasympathetic nervous system, which is responsible for initiating relaxation.

Stretching is an excellent way to release the muscular tension that is created by anxiety. You can also isolate and dramatically contract specific muscle groups to create a sense of relief when released. Gently grazing your fingers across your skin can be incredibly soothing as well. If this isn’t effective due to numbness or disassociation, try engaging in a self-massage of the hands, feet, neck, shoulder, or other easily accessible body parts.

3. Connect to the five senses.

Connecting to the five senses helps you to ground in your body and the present moment. This helps the brain to process that there is no imminent threat to your safety and prevents disassociation.

Start by naming five things you can see out loud. These can be objects, colors, or shapes. Then, run your hand across the surfaces around you and name four textures that you can feel. Proceed to name three sounds you can hear.

By this point, you will feel slightly more focused and relaxed. Concentrate and try to name two things you can smell. If the air in your environment is particularly neutral, try smelling specific objects like your clothes or hair.

The final step is to identify one thing you can taste. You can concentrate on the flavor of your mouth if it happens to be identifiable or take the extra step to grab a snack. Focus on the flavor palette that is released as you chew.

4. Cold water.

If you are experiencing a panic attack that is far too overwhelming to engage in one of the exercises, try shocking your system with cold water.

This can be done through a cold shower, splashing cold water on your face, or dunking your head in a sink filled with water. The colder the water, the more effective it will be at lowering your heart rate and grounding you in the present moment.


After experiencing a panic attack, it is very important to engage in self-care to help your body recover from the intensity. It is very common to feel lethargic and drained after one of these acute episodes.

Restore your energy by drinking a tall glass of water and feeding yourself a healthy meal or snack. Keep yourself grounded and elevate your mood by moving your body in a healthy way, perhaps through dancing or exercise. Fresh air and sunshine is also very nourishing, so consider going for a walk. If you can, take a short nap and allow your body to digest the high levels of stress hormones that it has just released. If this is not possible, make sure to get to bed early in the evening.

When you have the time, it is important to journal about your experience and reflect on what triggered your panic attack. If this causes traumatic memories or overwhelming feelings to arise, talking things through with a trained professional is very beneficial.

Getting Help

Here at Dr. Messina and Associates, our compassionate team of professionals are qualified to help you at our Flower Mound, Texas, and Southlake, Texas, offices. Our Psychologists, Psychiatrists, and Counselors specialize in cognitive behavioral therapy (CBT), psychological testing, and medication management for a variety of emotional and behavioral health needs. All services are available in-person and online (telehealth). If you or a loved one are seeking help with mental health, we are here to help.


Picture of Dr. Michael Messina

Dr. Michael Messina

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