7 ways to manage a panic attack

1) Learn what’s happening to your body

When it comes to panic attacks, knowledge is power. Although it won’t stop them from occurring, being aware of exactly what is happening to you physiologically and why can prevent your panic from escalating – plus it means you will be less likely to mistake it for a more serious health problem, such as a heart attack or a stroke.

2) Breathe

Like much advice given to people with anxiety, this may sound irritatingly obvious – but learning an effective breathing technique can be a gamechanger if you tend to experience attacks in public. During an attack you will often automatically take shallow, rapid breaths. Simple breathing exercises can help you to be conscious of filling your lungs, slowing your heart rate. Practise at home in calmer times so that you will feel empowered to try it during an attack.

3) Focus on relaxing your muscles

Telling someone who suffers panic attacks to relax can suggest you need a week by the beach. But progressive muscle relaxation is a practical method that teaches you to connect to sources of acute physical tension, so that when you are mid-attack you will be conscious of where you need to focus on relaxing.

4) Limit stimuli

When you feel an attack coming on, it is a good idea to limit the stimuli you are experiencing as much as you can. Try to find a dark, quiet space where you can practise your breathing and relaxation techniques. It may be harder to find a peaceful space in an office but try outside, or in the loos. When it is not possible – for example, when you are out – a good way to achieve the effect is to focus on a single thing or thought, such as a tangible object, like a ring, or a mantra you repeat to yourself while you ride out the attack.

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5) Keep a notebook

A notebook can be a valuable tool for dealing with the onset of a panic attack. Research has shown that treating intrusive thoughts as material objects that you can get rid of is an effective coping mechanism. When you begin catastrophising in the lead-up to an attack, write down the thoughts that are worrying you, then throw the page away.

6) Avoid caffeine at danger times, such as before a commute

Nobody likes to be told to give up their morning coffee, but caffeine can be a major trigger for anxiety. If crowds and tight spaces are a trigger for you, it’s a good idea to try cutting out coffee, or at least waiting until you are in the office to have your first of the day. Drink water on your trip instead, which will prevent dehydration – another possible trigger.

7) Use audio apps

Studies show that commuters in general suffer heightened levels of anxiety, but rush-hour journeys can be especially difficult if you get panic attacks. Combat external stressors by making the most of audio apps. This might mean a guided meditation, if that’s your thing, or an audio book – anything to ground you mentally and hold your focus. – Guardian