Mental Health

Mandy Kloppers

How to cope with anxiety and panic attacks

Anxiety is a part of life although some people are able to handle it better than others. There are ways to deal with anxiety and panic attacks that make them less intense. Therapy will never be able to completely eradicate anxiety but it can help you feel less impacted by the worry and stress.

The amygdala – your ‘smoke alarm’

Anxiety is the body’s way of alerting us to danger but sometimes our brain’s alarm system activates when there is no real danger. In our brain, the amygdala acts as a smoke detector. When we start to feel anxious or panicky, our amygdala has activated our stress response and this is when we begin to feel something is wrong.

Anxiety is a modern-day affliction but it does not have to completely overwhelm us. Modern-day threats are very different from the threats we would have face thousands of years ago when we roamed the earth as cavemen. What hasn’t changed is the way our brain responds to danger or at least perceived danger. Our stress response is activated in exactly the same way whether a lion is chasing us or we are worrying about a looming deadline at work.

What to do about anxiety & panic attacks: Grounding techniques

It is impossible to feel calm when our stress response is activated. What we need to do initially, is teach our alarm system to shut down when we are not really in danger. Deep breathing provides instant relief. When we breathe deeply, we send a message to our brain that we are relaxed. This message is a contradiction to the way in which the body is preparing for fight, flight or freeze. The brain then reassesses and usually shuts down our threat response : How can I be in danger when my breathing is so slow?

1) The square method/ box breathing

There are four steps involved: Breathe in and count to four, hold your breath and count to four, breathe out slowly counting to four, and finally hold again for four. See the video below to help you. You can do this anywhere at any time to help you feel calmer.


Physical symptoms that appear from anxiety can make us feel even more anxious and panicky. When we learn how to manage our physical symptoms, we are one step closer to effectively dealing with anxiety and panic attacks.

2) Mindfulness

Mindfulness is a fantastic way to deal with anxiety. When we ignore the thoughts that lead to anxiety (such as, what if I am unable to do that?; or what if I fail? etc), and focus on our surroundings, it helps us to disengage from the cause of our worries.

We all tend to overthink and put a lot of effort into feeling safe. For some people feeling safe equates to feeling in control. In order to feel in control, you might be excessively neat, possess OCD tendencies or you may be obsessed with certain behaviours, such as going to the gym, writing excessive to-do lists, seeking reassurance regularly, avoiding situations and so on.

When you are distress intolerant, you will find all sorts of ways to feel safe to avoid feeling worried or ill-at-ease. The problem is with this approach is that it is only a short-term solution. Ultimately we can never have 100-percent certainty in life.

The trick is to learn to tolerate uncertainty

When you are mindful, your focus is on the present moment and the world around you. What can you see, smell, hear, taste and touch. Practise focusing your attention on the world around you instead of believing your fearful thoughts. We all experience intrusive thoughts and more often than not, they make us unnecessarily fearful and anxious. Always remember that thoughts aren’t facts and you can dismiss them.

Learning to tolerate uncertainty means accepting more uncertainty into your life. It may seem paradoxical but the more newness and uncertainty you can provide for yourself, the more confident you will become at handling life.

Think of adding uncertainty into your life as a gym work-out for your brain

3)Use muscle relaxation techniques

Muscle tension is a symptom of anxiety, and muscle relaxation techniques can help reduce tension and promote relaxation during an attack. Progressive muscle relaxation aims to release tension in one group of muscles at a time to relax the whole body.

Much like deep breathing, muscle relaxation techniques can help stop your panic attack in its tracks by controlling your body’s response as much as possible.


  • First, you may learn how to tense the muscles before releasing the tension.
  • Then, you will learn how to relax the muscles without tensing them first.
  • You may also learn how to relax specific sets of muscles, for example, in the shoulders, for practical use in everyday situations.
  • Finally, you may learn how to practice rapid relaxation, when you can identify any areas of tension and release it as needed.

To start relaxing your muscles at home, consciously relax one muscle at a time, starting with something simple like the fingers in your hand, and move your way up through your body.

Muscle relaxation techniques will be most effective when you’ve practiced them beforehand.

3) Remind yourself – Most worries don’t come true

When you look back, can you think of a time when you excessively worried about something that didn’t end up happening? If this has happened to you, it is evidence supporting the fact that many thoughts are inaccurate. Despite being inaccurate, your thoughts can create untold anxiety and distress.

Regularly notice your thoughts (I like to call it my ‘mental diet’) and ask yourself whether the thought is helpful. More often than not it will not be helpful and one can choose to dismiss it. Acknowledge your thoughts without believing them or judging them.

Thoughts will keep on coming but you don’t have to pay attention to every thought you think


4) Dealing with panic attacks

Many clients tell me that panic attacks seem to come out of nowhere. It may feel like this is true but generally, panic attacks are the body’s way of manifesting psychological anxiety that isn’t being addressed. Many people suppress their anxiety without dealing with it effectively and eventually, the anxiety will force its way through in the form of a physical symptom (psychosomatic symptoms) such as:

  • Insomnia, sleep disorders
  • Bowel and digestive issues such as IBS
  • Functional neurological disorder
  • Headaches
  • Aches and pains, muscle tension
  • panic attacks
  • Fibromyalgia
  • tearfulness and irritability
  • rapid heartbeat, rapid pulse
  • shortness of breath

Some of the symptoms of panic, particularly chest pain, are similar to those experienced during a heart attack. It is therefore understandable that a person who is having a panic attack may think that they are in fact having a heart attack. It is worth remembering that heart disease is very rare in young people, who also happen to be the group most likely to experience panic disorder.

The fear of fainting 

It is very common for people to think that they are about to faint when they have a panic attack. When people faint they do so because their blood pressure is too low and not enough oxygen is getting to the brain. The most obvious consequence of fainting is that you fall over. Once you are lying down your heart is at the same level as the brain and no longer has to pump blood uphill. Also, your muscles relax releasing blood for your brain. As a result, your blood pressure quickly increases and you soon recover.


Fainting is another way your body protects you from harm.  Now, think about what happens during a panic attack: as soon as we become anxious our hearts beat much faster than usual, and our blood pressure increases.

This is exactly the opposite of what happens when we faint

It is very common to think that you may faint while panicking, but this does not happen.  There is one exception to this rule, which happens to people who have what we call a blood-injury phobia. These are people who have an extreme fear of blood, injuries, needles, and surgery. Most people are frightened of these things, but the phobia involves a much more extreme fear than usual. People with this type of phobia react differently to others when they encounter their fear in that their blood pressure drops. This probably occurs because if your blood pressure drops, you would bleed less and are more likely survive if you have been severely injured. There is a specific technique called applied tension that increases blood pressure and that can be taught to people who have this type of phobia. However, unless you have this rare problem (and you would know it if you did), remind yourself that you are less likely to faint while panicking than you are at any other time.


The fear of losing control 

For some people, the catastrophic fear is that they will lose control when they become very anxious. Often by this people mean that they will run around wildly, hurting themselves or others in the process while shouting obscenities. According to the NHS National electronic Library of Mental Health, there never has been a documented case of anybody doing anything ‘out of control’ in this way while experiencing a panic attack. If you have been worried that you may lose control, then it may be helpful to ask yourself, “Did I really do something completely out of control the last time I had a panic attack?”

The fear of losing control of bowels or bladder 

Another common fear is that we will lose control of our bowels or bladder while panicking. The feelings are common, yet in my clinical experience, nobody has reported ever actually losing control of their bowels – not unless they have an awful stomach bug. The question to ask yourself, again, is if it did not happen last time, why think that it will happen this time?

5) Panic involves a misinterpretation of the physical symptoms

Use grounding techniques to self-regulate and remind yourself that you are safe and your fears are unlikely to come true.

Picture your happy place

Guided imagery techniques can help reduce stress and anxiety. ResearchTrusted Source suggests that both spending time in nature and visualizing nature can help treat and manage anxiety.

What’s the most relaxing place in the world that you can think of? A sunny beach with gently rolling waves? A cabin in the mountains?

Picture yourself there and try to focus on the details as much as possible. Imagine digging your toes into the warm sand, or smelling the sharp scent of pine trees.

This place should be quiet, calm, and relaxing — no streets of New York or Hong Kong, no matter how much you love the cities in real life.

Here, learn about five visualization techniques that can help you meditate.

Learning how to deal with anxiety and panic attacks can be achieved. Learn to calm yourself with grounding techniques and don’t always trust your thoughts. Our thought lead us into dangerous territory when we care too much about what others think, when we catastrophize, criticise ourselves and spend too much time worrying about things that will most likely never happen.





Photo by Brett Jordan on Unsplash

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