Do find a therapist with expertise in anxiety.
Finding a therapist with a focus in anxiety is your first line of defense against future attacks. Dedicate yourself to the practice of any homework exercises at home, so when you feel an attack coming on, you can easily engage in a set of tools that are well-rehearsed.
Don’t ignore your body.
Although bodily sensations of anxiety can sometimes seem overwhelming and heighten anxiety, body mindfulness is another key component in treating panic disorder. Practicing deep breathing and relaxation techniques at home regularly can help you utilize these tools more effectively when panic strikes in public. Even five minutes a day can lead to greater expertise in this area. Developing an awareness of how your body responds to stress (stiff, tightened muscles, rapid or shallow breathing, etc.) will help you learn how to ease these patterned responses.
Do try to identify and correct any distorted thinking patterns.
Recognize that your thoughts are likely to exaggerate fears when you’re feeling more anxious, and correcting these distorted thoughts can help ward off an attack even before it begins. Working with a clinician with a cognitive-behavioral focus can help you become more skilled at this.
Do develop a body mindfulness practice.
You may find that a regular practice like yoga or meditation can benefit you. Remember: it’s impossible to be relaxed and anxious at the same time. Engage in any relaxation techniques you may have practiced at home. Relaxing your breathing and your body overall can go a long way in reducing the symptoms associated with an attack.
Don’t skip any doses of your antidepressant medicines.
It’s essential not to skip any doses of antidepressant medicines (usually SSRIs) if it has been prescribed to you, as it must be taken daily in order to be effective. Don’t take yourself off of these medicines without discussing this with your prescribing doctor and therapist first.
Do carry a dose of short-term anxiety medicine with you.
If your doctor has prescribed short-term anxiety medicine (usually benzodiazepines), carrying a dose of this medicine with you at all times may prove beneficial. Although many people may fear developing a dependency to these medicines, often when a person with panic disorder carries a dose of medicine with them “just in case,” they may find that it leads to greater confidence- even when they choose not to take the medicine. Because panic disorder often leads to avoidance of places or situations that are associated with increased anxiety, knowing that relief from a panic attack is only a dose away can help reduce these behaviors.
Do “ground” yourself in your general surroundings.
During an attack, preoccupation with thoughts or somatic symptoms may worsen or prolong a sense of panic. Grounding, in essence, helps you bring gentle awareness back to your general surroundings. Examples of these techniques include bringing your attention to the ground underneath your feet, the wind on your face, or picking out a specific color in your immediate environment. These strategies can help you ground back into the here-and-now.
Don’t avoid feared places or situations.
Although avoidant behaviors are very common with panic disorder, your goal with the help of a trusted therapist should be to slowly reintroduce these activities back into your life. Although it may initially seem like a good way to cope, ongoing avoidance just reinforces the misconception that you are unsafe doing ordinary things, like going to parties or taking public transit. Breaking the cycle of avoidance will take dedicated practice, but over time these activities should become easier.
This article was written by Vanessa Ford, LCSW.