15 Ways to Calm Yourself Down

We all worry and get upset from time to time. It’s a normal part of life, right? But what happens when that anxiety or anger takes over, and you can’t calm down? Being able to calm yourself in the moment is often easier said than done.

That’s why having a few strategies you’re familiar with can help you when you’re feeling anxious or angry. Here are some helpful, actionable tips you can try the next time you need to calm down.

1. Breathe

“Breathing is the number one and most effective technique for reducing anger and anxiety quickly,” says Scott Dehorty, LCSW-C, of Delphi Behavioral Health.

When you’re anxious or angry, you tend to take quick, shallow breaths. Dehorty says this sends a message to your brain, causing a positive feedback loop reinforcing your fight-or-flight response. That’s why taking long, deep calming breaths disrupts that loop and helps you calm down.

There are various breathing techniques to help you calm down. One is three-part breathing. Three-part breathing requires you to take one deep breath in and then exhale fully while paying attention to your body.

Once you get comfortable with deep breathing, you can change the ratio of inhalation and exhalation to 1:2 (you slow down your exhalation so that it’s twice as long as your inhalation).

Practice these techniques while calm so you know how to do them when you’re anxious.

2. Admit that you’re anxious or angry

Allow yourself to say that you’re anxious or angry. When you label how you’re feeling and allow yourself to express it, the anxiety and anger you’re experiencing may decrease.

3. Challenge your thoughts

Part of being anxious or angry is having irrational thoughts that don’t necessarily make sense. These thoughts are often the “worse-case scenario.” You might find yourself caught in the “what if” cycle, which can cause you to sabotage a lot of things in your life.

When you experience one of these thoughts, stop and ask yourself the following questions:

  • Is this likely to happen?
  • Is this a rational thought?
  • Has this ever happened to me before?
  • What’s the worst that can happen? Can I handle that?

After you go through the questions, it’s time to reframe your thinking. Instead of “I can’t walk across that bridge. What if there’s an earthquake, and it falls into the water?” tell yourself: “There are people that walk across that bridge every day, and it has never fallen into the water.”

4. Release the anxiety or anger

Dehorty recommends getting the emotional energy out with exercise. “Go for a walk or run. in some physical activity serotonin to help you calm down and feel better.”

However, you should avoid physical activity that includes the expression of anger, such as punching walls or screaming.

“This has been shown to increase feelings of anger, as it reinforces the emotions because you end up feeling good as the result of being angry,” Dehorty explains.

5. Visualize yourself calm

This tip requires you to practice the breathing techniques you’ve learned. After taking a few deep breaths, close your eyes and picture yourself calm. See your body relaxed, and imagine yourself working through a stressful or anxiety-causing situation by staying calm and focused.

By creating a mental picture of what it looks like to stay calm, you can refer back to that image when you’re anxious.

6. Think it through

Have a mantra to use in critical situations. Just make sure it’s one that you find helpful. Dehorty says it can be, “Will this matter to me this time next week?” or “How important is this?” or “Am I going to allow this person/situation to steal my peace?”

This allows the thinking to shift focus, and you can “reality test” the situation.

“When we’re anxious or angry, we become hyper-focused on the cause, and rational thoughts leave our mind. These mantras give us an opportunity to allow rational thought to come back and lead to a better outcome,” Dehorty explains.

7. Listen to music

The next time you feel your anxiety level cranking up, grab some headphones and tune in to your favorite music. Listening to music can have a very calming effect on your body and mind.

8. Change your focus

Leave the situation, look in another direction, walk out of the room, or go outside.

Dehorty recommends this exercise so you have time for better decision making. “We don’t do our best thinking when anxious or angry; we engage in survival thinking. This is fine if our life is really in danger, but if it isn’t life threatening, we want our best thinking, not survival instincts,” he adds.

9. Relax your body

When you’re anxious or angry, it can feel like every muscle in your body is tense (and they probably are). Practicing progressive muscle relaxation can help you calm down and center yourself.

To do this, lie down on the floor with your arms out by your side. Make sure your feet aren’t crossed and your hands aren’t in fists. Start at your toes and tell yourself to release them. Slowly move up your body, telling yourself to release each part of your body until you get to your head.

10. Write it down

If you’re too angry or anxious to talk about it, grab a journal and write out your thoughts. Don’t worry about complete sentences or punctuation — just write. Writing helps you get negative thoughts out of your head.

You can take it one step further and make an action plan to continue staying calm once you’re done writing.

11. Get some fresh air

The temperature and air circulation in a room can increase your anxiety or anger. If you’re feeling tense and the space you’re in is hot and stuffy, this could trigger a panic attack.

Remove yourself from that environment as soon as possible and go outside — even if it’s just for a few minutes.

Not only will the fresh air help calm you down, but also the change of scenery can sometimes interrupt your anxious or angry thought process.

12. Fuel your body

If you’re hungry or not properly hydrated, many of these techniques won’t work. That’s why it’s important to slow down and get something to eat — even if it’s just a small snack.

13. Drop your shoulders

If your body is tense, there’s a good chance your posture will suffer. Sit up tall, take a deep breath, and drop your shoulders. To do this, you can focus on bringing your shoulder blades together and then down. This pulls your shoulders down. Take a few deep breaths. You can do this several times a day.

14. Have a centering object

When you’re anxious or angry, so much of your energy is being spent on irrational thoughts. When you’re calm, find a “centering object” such as a small stuffed animal, a polished rock you keep in your pocket, or a locket you wear around your neck.

Tell yourself that you’re going to touch this object when you’re experiencing anxiety or frustration. This centers you and helps calm your thoughts. For example, if you’re at work and your boss is making you anxious, gently rub the locket around your neck.

15. Identify pressure points to calm anger and anxiety

Going for a massage or getting acupuncture is a wonderful way to manage anxiety and anger. But it’s not always easy to find time in your day to make it happen. The good news is, you can do acupressure on yourself for instant anxiety relief.

This method involves putting pressure with your fingers or your hand at certain points of the body. The pressure releases the tension and relaxes your body.

One area to start with is the point where the inside of your wrist forms a crease with your hand. Press your thumb on this area for two minutes. This can help relieve tension.

10 Instant Ways to Calm Yourself Down

As a highly-sensitive person (as defined by Elaine Aron in her bestseller The Highly Sensitive Person), I’m easily overwhelmed, or over-aroused (not in a sexual way — not on antidepressants).

I have been compiling ways to calm down over the years. I learned some in Aron’s book, some as part of the mindfulness-based stress reduction (MBSR) program I participated in, and just recently picked up a slew of them in Lauren Brukner’s fantastic book, The Kids’ Guide to Staying Awesome and in Control. Brukner is an occupational therapist who helps kids who have sensory integration issues be able to keep it together in school. However, her calming techniques are brilliant for adults, too.

1. Hand Massage

I learned this one in both the MBSR program and in Brukner’s book. What’s great about it is that you can do it while attending a lecture, listening to your kids fight, or sitting at your desk working. No one will notice. Simply use the thumb of one hand and press around the palm of the other hand. It’s very soothing.

2. Palm Push

By pushing your palms together and holding for five to ten seconds, you give your body “proprioceptive input,” according to Brukner, which “lets your body know where it is in space.” I like this one because it reminds me of tree position in yoga, which is the last of the standing series postures in Bikram yoga. By then, I am quite happy to hold the tree position. The palm push is like a mini, portable tree position I can pull out any time to calm down.

3. Close Your Eyes

Aron says that 80 percent of sensory stimulation comes in through the eyes, so shutting them every now and then gives your brain a much-needed break. She also says that she has found that highly sensitive persons do better if they can stay in bed with their eyes closed for nine hours. They don’t have to be sleeping. Just lying in bed with our eyes closed allows for some chill time that we need before being bombarded with stimulation.

4. Mindful Sighing

During the MBSR class, we would take a few mindful sighs when transitioning from one person speaking to another. Basically you breathe in to a count of five through your mouth, and then you let out a very loud sigh, the sound you hear your teenager make. I was always amazed at how powerful those small sighs were to adjust my energy level and focus.

5. Mindful Monkey Stretch

A couple of times during the MBSR class, we would stand in back of our chairs, move at least an arm’s length from each other in a circle, and do these exercises that I call mindful monkey stretches. We brought our hands, arms extended, in front of us, then brought the arms down. Next we brought our arms (still extended) to our sides, and then down. Next we brought our arms all the way past our heads and then swooped down, our head dangling between our knees, and hung there for a second. This exercise is extremely effective at releasing the tension we hold in different parts of our body. Our teacher said she does it before her lectures and it works to release the jitters.

6. Hug Yourself

Did you know that a ten-second hug a day can change biochemical and physiological forces in your body that can lower risk of heart disease, combat stress, fight fatigue, boost your immune system, and ease depression? You can begin by giving yourself a hug. By squeezing your belly and back at the same time, you are again giving yourself proprioceptive input (letting your body know where you are in space), which can help stabilize you.

7. Wall Push

Another great exercise to ground kids (and I add adults) with sensory integration issues, according to Brukner, is the wall push, where you simply push against the wall with flat palms and feet planted on the floor for five to ten seconds. If you’ve ever experienced an earthquake, you can appreciate why this gesture is calming … placing the weight of our body against a solid, immobile surface and feeling the pull of gravity is stabilizing, even on a subconscious level.

8. Superman Pose

If you do Bikram yoga, the superman pose is basically the full locust position (airplane position), except the arms and the hands are stretched out in front of you, not to the sides. “Lie on your belly on the floor,” explains Brukner. “Extend your arms in front of you, and hold them straight out. Extend your legs behind you and hold them straight out.” Hold that pose for ten seconds. It’s a great exercise if you are groggy, overexcited, distracted, or antsy.

9. Shake

Did you know that animals relieve their stress by shaking? Lots of animals like antelopes shake off their fear after being frozen in panic to escape a predator. In the MBSR program, we practiced shaking, for like 15 minutes at a time. I can’t say it looked all that pretty, but neurologically, I do believe it was beneficial.

10. Bubble Breath

My favorite exercise in Brukner’s book is the Bubble Breath, because it is so simple and calming. Brukner explains:

Breathe in for five seconds, out for five seconds.

Imagine you have a wand of bubbles. When you breathe out, be careful not to pop it.

Place one flat palm on your heart, one flat palm on your belly.

Breathe in through your nose and hold your breath for five seconds.

Breathe out a large “bubble” though pursed lips, blow out for five seconds.

Join ProjectBeyondBlue.com, the new depression community.

Photo by Laura LaRosa

Originally posted on Sanity Break at Everyday Health.

10 Instant Ways to Calm Yourself Down

Simple Ways to Calm Down During Times of Stress and Anxiety

September 13, 2019 5 min read Opinions expressed by Entrepreneur contributors are their own.

Living in states of anxiety and stress are the norms these days, evidenced by the rise in book sales on mental health. Entrepreneurs admit to being addicted to “the grind” and “the hustle” — some wear it as a badge of honor. It has created what Barnes and Noble calls “The Anxious Nation,” which is great for booksellers but not so great for the rest of us.

As an entrepreneur who, like many, juggle family, wellness and a personal life, I am guilty of arriving to everything “on two wheels,” at the minute the meeting begins and always striving to overachieve at everything I do, be it a project, an event, a workout and even the creative meals I serve my family for dinner. We hustle from Monday to Friday and when the weekend rears its head, we rejoice that the struggle of the five-day workweek is over — until the Sunday Scaries kick in. We accept the struggle as a necessary facet of modern life, but should we? What’s at the root of this lifestyle and how can we change it?

The answer lies within.

If we look around, we see an ocean full of “hustlers,” and “busy” people who are competitive and live in a dog-eat-dog world. We believe hustle should equal happiness, and we feel we need to be “busy” or in the act of “doing” to feel effective and satisfied. We speak quickly, we text back quickly and we order many things “to-go” in this world of hustle.

Related: 10 Ways Smart People Stay Calm

And we are hard on ourselves, usually unhappy with our bodies, or our performance results, and forget who it is that we are trying to please in the first place. Are we truly connecting with our hearts? Are we listening to our breaths? For most of us, no.

I began practicing yoga more seriously than “just for stretching” about 10 years ago, just after my first child was born. Through lessons from expert yogis who focus on breath work and meditation, I learned to look inward. When we look for self-help, we look outward – we look for self-help books, we reach out to therapists and even more prevalent now, we express our feelings over social media, and tell the world what we are going through, looking for validation, support and affirmation. We are dependent on others, and that’s okay, but in doing this, we have lost connection with ourselves – our hearts, our breath, our minds.

Try this one-minute breathing exercise.

A technique called “Box Breathing” is a great way to start and helpful for managing stress: inhale for a count of 4, exhale for a count of 4, pause at the bottom of the exhale for a count of 4, and repeat. This deep breathing exercise has been shown to be a powerful stress reliever and effective for improving concentration and is touted by everyone from athletes to Navy SEALS.

Related: 6 Ways To Calm Yourself Before Giving A Big Presentation or Talk

Practice getting in the right mindset.

While some days may be better than others, our mantras shouldn’t be “The struggle is real!” A couple of mental tactics that can help ease anxiety during the workday include expressing gratitude and resisting perfectionism. So for example, recognize the people and opportunities around you that are lucky to have, from the most simple things like good office coffee to more complex things like a great team and the ability for flexible hours or to work remotely.

With regards to perfectionism, acknowledge that mistakes can happen and use them as learning opportunities. Focus more on what you can control, such as your attitude, how hard you try and the way you treat people. Next time you walk into a meeting, open the door for someone, offer a genuine compliment, or simply listen to someone without looking at your phone. Or better yet, take the meeting outside and make it a “sweatwork” as exercise and fresh air are both stress reducers.

Related: 7 Strategies to Stay Cool, Calm and Collected During a Job Interview

In this “anxious nation” where time flies, we need to take a pause, breathe and look inward. My hope is that in the future, we will have a better connection to our hearts, and our obsession with “the struggle” will be replaced by feeling joy and gratitude, feeling more connected to ourselves, and ultimately, more alive. Because it’s the inhale and the exhale, our very own breaths, that keep us alive, right?

Q.U.E.E.N.

Girl, this is crazy… let me tell you

I can’t believe all of the things they say about me
Walk in the room they throwing shade left to right
They be like, “Ooh, she serving face”
And I just tell ’em cut me up and get down
They call us dirty cause we break all your rules down
And we just came to act a fool, is that all right? (Girl, that’s alright)
They be like, “Ooh, let them eat cake.”
But we eat wings and throw them bones on the ground

Am I a freak for dancing around?
Am I a freak for getting down?
I’m cutting up, don’t cut me down
Yeah I wanna be, wanna be Queen

Is it peculiar that she twerk in the mirror?
And am I weird to dance alone late at night?
And is it true we’re all insane?
And I just tell ’em, “No we ain’t” and get down
I heard this life is just a play with no rehearsal
I wonder will this be my final act tonight
And tell me what’s the price of fame?
Am I a sinner with my skirt on the ground?

Am I a freak for dancing around?
Am I a freak for getting down?
I’m cutting up, don’t cut me down
Yeah I wanna be, wanna be Queen

Hey brother can you save my soul from the devil?
Say is it weird to like the way she wear her tights?
And is it rude to wear my shades?
Am I a freak because I love watching Mary? (Maybe)
Hey sister am I good enough for your heaven?
Say will your God accept me in my black and white?
Will he approve the way I’m made?
Or should I reprogram, deprogram and get down?

Am I a freak for dancing around?
Am I a freak for getting down?
I’m cutting up, don’t cut me down
Yeah I wanna be, wanna be Queen

Even if it makes others uncomfortable
I will love who I am
Even if it makes others uncomfortable
I will love who I am

Ohh, shake ’til the break of dawn
Don’t mean to sing so tough, I can’t take it no more
Baby, me and tuxedo groove
Pharaohs and E. Badu
Crazy in the black and white
We got the drums so tight
Baby, here comes your freedom song
Too strong, we moving on
Baby, this melody will show you another way
Been ‘droids for far too long
Come home and sing your song
But you gotta testify, because the booty don’t lie
No, no, the booty don’t lie; oh no, the booty don’t lie

Yeah.. yeah, let’s flip it
I don’t think they understand what I’m trying to say
Haha, yeah, uh, I asked a question like this:

“Are we a lost generation of our people?
Add us to equations but they’ll never make us equal
She who writes the movie owns the script and the sequel
So why ain’t the stealing of my rights made illegal?
They keep us underground working hard for the greedy
But when it’s time pay they turn around and call us needy
My crown too heavy like the Queen Nefertiti
Gimme back my pyramid, I’m trying to free Kansas City
Mixing masterminds like your name Bernie Grundman
Well I’mma keep leading like a young Harriet Tubman
You can take my wings but I’m still gonna fly
And even when you edit me the booty don’t lie
Yeah, I’ma keep sangin’, I’mma keep writin’ songs
I’m tired of Marvin asking me “What’s Going On?”
March through the streets ‘cuz I’m willing and I’m able
Categorize me, I defy every label
And while you’re selling dope, we’re gonna keep selling hope
We rising up now, you gotta deal you gotta cope
Will you be electric sheep? Electric ladies, will you sleep?
Or will you preach?”

7 Signs You’re Having An Anxiety Attack Versus A Momentary Freak-Out

As someone who’s been diagnosed with both major depressive disorder and an anxiety order, I know all too well what it means to suffer an anxiety attack. Although I’m in the 36.9 percent of people who receive treatment and take medication daily for both of my disorders, it doesn’t guarantee that my depression won’t occasionally kick into high-gear or that I’ll never have anxiety attack. And, depending on what’s going on in my life, either outside struggles or internal ones, my anxiety attacks can pop up more than usual. Or I can go months without one. For example, just in the last couple weeks, I’ve suffered two major anxiety attacks. Before that, it had been a few months.

According to the Anxiety and Depression Association of American, anxiety disorders are the most common mental illness in the United States. Every year, 18.1 percent of the population, ages 18 and older, are affected — that’s roughly 40 million people. Although anxiety disorders are treatable, the majority of people skip treatment, with only a fraction, 36.9 percent, receiving treatment for their anxiety, despite the fact that those who have anxiety disorders are six times more likely to be hospitalized for psychiatric disorders, than those who don’t have anxiety disorders. Basically, treatment is absolutely key.

But the thing with anxiety is that it’s a legitimate disorder and not just some momentary freak-out. I have freak-outs all the time (I’m like a walking bundle of nerves), but there’s a clear difference between an anxiety attack and a freak-out. So before you label your next freak-out an anxiety attack, know the difference because an anxiety attack makes a freak-out look like a walk in the park. Here are seven signs experts say it’s an anxiety attack.

1. You Feel The Need To Escape

Andrew Zaeh for Bustle

Although an anxiety attack can come on out of nowhere, when it hits, you immediately feel the need to escape the space, the situation, and everything around you.

“You feel an overwhelming need to escape the situation you’re in as the only way to feel better,” psychologist, Dr. Greg Kushnick, tells Bustle. “Once you remove yourself, you feel the difference. For example, you’re in a movie theater and you begin to panic about how many people you have to squeeze by in order to reach the exit in the event of an emergency. You get to the lobby and automatically feel less anxious.”

2. You Feel Trapped

Ashley Batz/Bustle

“The anxiety you feel involves being trapped in a particular place, such as a meeting, a concert hall or a train,” says Dr. Kushnick.

One of my greatest fears is having an anxiety attack on a plane. I can’t even imagine what that would be like, if I were on a 15-hour plane ride to whatever faraway country I plan to run off to next, and having an anxiety attack. And it’s not a fear of flying; it’s a fear of an anxiety attack creeping up on me and not being able to become un-trapped in that attack.

3. It’s A Familiar Feeling

Andrew Zaeh for Bustle

So. Familiar. It’s as though it’s sticking to a script and it’s refusing to waver or even add another plot to the storyline.

“The panic you feel reminds you of other recent anxiety attacks,” says Dr. Kushnick. “Panic attacks often have a pattern to them. They are predictable based on their location/context.”

4. You’re Aware Of How Irrational The Attack Is

Andrew Zaeh for Bustle

“You are fully aware of the irrational nature of the anxiety attack and therefore logic and reason don’t help you to feel better,” says Dr. Kushnick. “A freak-out involves really believing that there’s a threat.”

That might not make sense to someone who doesn’t suffer from anxiety attacks, but when an anxiety attack strikes, you’re actually aware how irrational it is, so no amount of trying to reason with your brain is going to make it go away. I once had an anxiety attack sitting on the couch, next to my mom, watching a movie. Logistically, it didn’t make sense. I was comfortable, I was safe, I was actually, for the most part feeling pretty OK about life — or as “OK” as a depressive can feel about life — and it hit. A freak-out can be rationalized. Your wallet, for example, is stolen and your bank account has been drained, so you freak-out. That makes sense; that’s justified. With an anxiety attack, there is sometimes no justification, well, except for the wiring in your head.

5. Anxiety Attacks Can Last For A Long Time

Andrew Zaeh for Bustle

While a momentary freak-out is just that: momentary, an anxiety attack can last and last and last. According to Dr. Kushnick, although most attacks are 15 to 20 minutes in length, some can last all day long. And, again, no amount of talking yourself out of it is going to undo the situation. You need to let it run its course, or if you’ve been prescribed something like Xanax, take one and hope it works. I’ve had anxiety attacks that have been so extreme that not even a Xanax can take the edge off — my mind just rejects any and all attempts at help.

6. Your Body Has A Physical Response

Fotolia

Sure, your heart can race and you can even become nauseous during a freak-out, but your body’s physical response to an anxiety attack is completely different. We’re talking about shaking, sweating, heart pain, dizziness, numbness, and even rashes — my body, in particular just loves to break out in a some hives during an anxiety attack. The physical pain can be so overwhelming and so intense that some people have even mistaken them for heart attacks and have gone to the ER, only to be told it’s an anxiety attack.

7. Depression May Follow

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“You can also tell if it’s an anxiety attack if you feel mild to moderate depression within about 24 hours of the event,” says Dr. Kushnick. And, because depression and anxiety go hand-in-hand for many people, according to the Anxiety and Depression Association of American, this can come as no surprise. It can also come as no surprise because the mental and physical stress than an anxiety attack inflicts on the body and mind, even if you don’t really understand just how extreme it is in the moment, can be truly exhausting, making us even extra vulnerable to depression.

Now that you know the difference, if you think you suffer from an anxiety disorder, then it’s time to get help. Don’t be in that large percentage of people who suffer in silence. While it may not be curable, it is treatable, with both medication and therapy.

Figuratively raise your hand if either of these sounds like something you’ve gone through:

You’re a bit of a worrier, but some days — when there are too many details up in the air, you’ve got a heap of work, your babysitter calls in sick, and your carefully constructed house of cards starts to wobble — you become completely overwhelmed. Everything feels equally urgent and yet you’re paralyzed. What’s gonna happen if you can’t figure it all out? At that moment, your breathing is really shallow and you can’t think. When your partner tells you not to worry, that it’ll all work out somehow, it’s all you can do not to punch him in the throat.

Or:

You’re feeling fine, and then suddenly, for no apparent reason, your heart starts to race, it’s hard to take a deep breath, and weirdly, you feel both chilled and sweaty at the same time. Whoa, you need to sit down — you’re dizzy and want to puke. It’s a such a strong physical takeover of your body that you’re scared you’re actually dying! You’re about to call 911, but then you feel a little better and over the next 20 minutes or so, the feeling dissipates. You’re left exhausted, with a giant question mark — and the hope that it never, ever happens again.

So did you have a panic attack, an anxiety attack, or some hideous combo platter of both?

Short answer: If you have experienced something like the second scenario, that was likely a panic attack, which is a clinical term for a tsunami of intense, mostly physical symptoms, sometimes with no obvious cause. You are suddenly drowning in a deep ocean of fear, and then fairly quickly, the waters recede and you find you can stand again.

The first is what many people refer to in conversation as an “anxiety attack,” which isn’t something healthcare providers diagnose and has no official definition. So many people use the term, however, that it is generally understood to mean that you are feeling way more anxiety than you can handle — you feel “attacked” by it, because it’s all just too much.

How to Tell the Difference Between Panic Attacks and Anxiety Attacks

Panic attacks and anxiety attacks are really two distinct experiences, says Amanda Spray, Ph.D., Clinic Director of the Steven A. Cohen Military Family Center and a Clinical Assistant Professor in the Department of Psychiatry at NYU Langone Health in New York City. “The difference between the two is about the suddenness of the feelings — usually (but not always) people who get panic attacks will feel okay before it happens,” she says. The symptoms will then typically go away within 30 to 60 minutes.

In contrast, those who have anxiety attacks tend to carry around a low level of anxiety most of the time. The feeling of anxiousness ramps up during an attack and then eventually (anywhere from a few minutes to a few weeks) it settles back down to a normal-for-them level. Generally, panic attacks have more severe physical symptoms, whereas anxiety attacks are more of a “slow burn,” says Craig Sawchuk, Ph.D., a professor of psychology at the Mayo Clinic in Rochester, Minnesota,

So why the confusion? Because panic attacks and anxiety attacks overlap in a few ways, and some unlucky people experience both. Plus, people use the terms interchangeably.

“When people say ‘I’m having a panic attack,’ ‘I’m having an anxiety attack,’ or just ‘I’m freaking out,’ we know what they mean,” says Sawchuk. “The question is, at what point do either one meet clinical criteria?”

What Panic Attacks and Anxiety Attacks Have in Common

Both panic and anxiety attacks are “upregulating” states, meaning they move you to action. “They both activate the fight, flight, or freeze reaction in the body,” says Spray. That’s when your sympathetic nervous system triggers your brain to release of a bunch of hormones, including adrenaline and noradrenaline, that rev your body up. This alarm bell reaction is a good thing when we’re facing danger, as it spurs us to get to safety or otherwise protect ourselves.

The problem is both panic and anxiety attacks happen when you’re not truly at risk, says Sawchuk. They’re misfires of this alarm system when one or all of three things is going wrong:

  • The alarm goes off too loudly. With panic attacks, for instance, “your heart is pounding out of your chest, you’re sucking air, and you’re dripping with sweat,” says Sawchuk. With an anxiety attack, your brain might have thoughts pinballing around that feel dire, even though no one is going to die if you are, say, five minutes late to work.
  • It’s hard to turn the alarm off. With anxiety attacks, you can’t just snap out of feeling the way you do, and while panic attacks end on their own pretty quickly, they leave you spent.
  • It’s a false alarm. There is no actual danger in either scenario — it only feels like there is.

Some symptoms, such as shallow breathing and trouble thinking clearly, can happen in both panic and anxiety attacks; both can be amplified by worrying about them even more; and both of them can lead to behavioral changes, says Sawchuk. “If they start to happen with any frequency, the person might start to avoid certain activities that they associate with the attacks.”

The Symptoms of a Panic Attack

As similar as they may seem, there are some distinct differences between anxiety and panic attacks. A panic attack is an abrupt surge in intense fear or intense discomfort that reaches its peak within minutes, during which a person can experience:

  • palpitations
  • sweating
  • trembling or shaking
  • sensations of shortness of breath
  • feelings of choking
  • chest pain
  • nausea or GI upset
  • dizziness or lightheadedness
  • chills or heat
  • numbness or tingling
  • feeling of unreality or that the person is detached from themselves
  • fear of losing control or fear of dying.

The Symptoms of an Anxiety Attack

An anxiety attack means different things to different people, but symptoms of Generalized Anxiety Disorder include:

  • excessive and hard-to-control worry, often about many different everyday things (like finances, relationships, or work)
  • restlessness
  • difficulty concentrating
  • irritability
  • muscle tension
  • trouble sleeping

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Do I have an anxiety disorder?

Either panic attacks or anxiety attacks can rise to the level of disorders, depending on their frequency and severity. Say you have a panic attack when you ask a store clerk for another size. If you find yourself no longer shopping for clothes because you’re afraid of another attack or avoiding the mall altogether, that may signal a panic disorder.

A doctor may diagnose someone with a panic disorder if the attacks lead to a month or more of worrying about another attack or maladaptive changes in behavior, says Spray.

There are a several different anxiety disorders (including Generalized Anxiety Disorders, Obsessive Compulsive Disorder, and Social Anxiety Disorder) but what they all have in common is that the anxiety gets in the way of your life to a significant degree, says Sawchuk.

How do I treat or manage these attacks?

All the health and wellness practices we should probably all be doing can go a long way in managing panic and anxiety, says Sawchuk. These include getting the right amount of sleep for you, following a healthy diet, eating regularly to avoid blood sugar dips, and exercising. Meditation, mindfulness, and a solid social support system can also keep you on an even keel.

Cognitive behavioral therapy (CBT) has also been shown to help people manage both panic and anxiety. In CBT, you learn how to recognize the thoughts and triggers bring on these attacks, and how to think about them differently so they no longer amp you up, or if they do, you learn how to tolerate it. In the case of panic attacks, the CBT may involve exposure therapy in which the therapist carefully and gradually brings on the symptoms of a panic attack, says Sawchuk. Suppose you had a panic attack while running and felt like you were going to die; a therapist might have you do something to get your heart pounding again, to show you that a pounding heart does not equal certain death.

“It’s about retraining the brain and rewiring the alarm system to it’s not going off whenever those symptoms get stimulated,” he says. “You start to gain confidence, knowing that you can handle the symptoms and that they’re not dangerous. You can actually retrain your brain to become bored with these symptoms.”

And if therapy alone isn’t enough, “medication is always an option,” he adds. These usually start with SSRIs such as Prozac or SSNIs like Effexor, which you take daily. “These don’t work in the moment, but rather over time,” he says. Some doctors will prescribe benzodiazepines like Ativan, but only on a short-term basis, he adds.

What should I do if I’m having an attack?

Controlled breathing can help deescalate an attack or even nip it in the bud, says Spray. “It’s very helpful to have your exhale be longer than your inhale restore the balance of Co2 and oxygen in your body,” she says. Shallow breathing can throw these proportions off, so addressing this imbalance early on may help prevent the cascade of other symptoms, such as sweaty palms and racing heart.

Her favorite technique is called paced breathing. Here’s what to do:

  • Breathe in through your nose for a count of four.
  • Hold for a count of one.
  • Breathe out of your mouth for a count of six. “Purse your lips and pretend you’re blowing out a straw,” she says.
  • Hold for a count of one.
  • Repeat until you feel calmer.

The bottom line: If you are having trouble managing your anxiety or panic, let your primary care provider know. He or she can refer you to a therapist who can teach you the skills to dial them down.

Stephanie Dolgoff Deputy director, Health Newsroom, Hearst Lifestyle Group Stephanie, an award-winning journalist and New York Times bestselling author, has written and edited about health, fitness, and wellness for such publications as Good Housekeeping, Self, Glamour, Real Simple, Parenting, Cosmo and more.

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