An anxiety attack can be a frightening experience. You may feel like you can't breathe, that your heart is racing too quickly, your head is spinning and you can't control your thoughts. Anxiety attacks are often accompanied by or triggered by feelings of doom or fear, and it can feel like the anxiety will never end.
Even when it seems like you can't stop the spiral, you can: With the right tactics, you can learn how to control and prevent anxiety attacks. It's much more complex, however, than the "don't panic" and "just breathe" statements often given as advice for managing anxiety, licensed psychotherapist Haley Neidich says.
Note that you needn't be diagnosed with anxiety or another mental health condition to have an anxiety attack: Anyone can experience an anxiety attack even in the absence of a psychiatric diagnosis, and everyone can benefit from knowing how to control one in the case one occurs.
Also note that there's a difference between an anxiety attack and a panic attack. A panic attack is clearly defined by the Diagnostic and Statistical Manual of Psychiatric Disorders, while an anxiety attack is not.
One of the biggest differences between the two is that panic attacks often occur without warning and may be triggered by an external fear, such as a phobia you come into contact with, but panic attacks can occur without any triggers. Anxiety attacks, on the other hand, often build over time and are often triggered by an internal fear or feeling of doom.
The lack of diagnostic criteria doesn't make anxiety attacks invalid; it just means that symptoms are more open to interpretation and that there's an opportunity to uncover anxiety-inducing triggers.
With that, here's how to tell if you're having an anxiety attack and how to stop or control it.
Signs of an anxiety attack
If you haven't had an anxiety attack before, you may not even know what to look out for. Even if you do experience anxiety attacks regularly, the signs leading up to an anxiety attack can change, leaving you bewildered if one time feels different than the last.
"While many people can easily identify their triggers and early warning signs, it is something that can take time and support," Neidich explains. "Some people will experience anxiety attacks that seem to come out of nowhere and they may require professional support from a psychotherapist in order to help them identify the more subtle and underlying issues that are contributing."
That said, and although everyone experiences anxiety attacks differently, Neidich says a few omnipresent signs show up in most people.
"The most common early symptom is anxious thinking, particularly thinking rooted in 'what ifs' which typically lead people down a dark mental path," Neidich says. "This can happen slowly or quickly, depending on the external environment and vulnerability factors of an individual."
Racing thoughts and physiological symptoms like a racing heart, difficulty breathing and gastrointestinal disturbance are all telltale signs of an anxiety attack or severe anxiety in general, Neidich says.
"Anxiety attacks can be a terrifying experience as people often report feeling as if they are dying or having a heart attack during the episode," she says. "For this reason, many people who have experienced an anxiety attack will develop a fear of having another one, only compounding their underlying anxiety."
That's all the more reason that recognizing the early symptoms of an anxiety attack are key in preventing and controlling them, Neidich reiterates.
2 steps to stop an anxiety attack
It can be difficult to stop an anxiety attack entirely once it's started, but you can take some steps to control anxiety attacks, reduce the severity of symptoms and decrease their frequency. Neidich shares five tips for controlling and coping with anxiety attacks.
"Distraction is the No. 1 tool for managing an anxiety attack once it has gotten started," Neidich says. She adds that paying too much attention to your body -- like trying to breathe deeply, as is often recommended -- can make your symptoms worse.
Instead, Neidich says, "Once you've identified that an anxiety attack has started, it's time to distract yourself while you wait for it to pass. Put on a funny movie, grab a coloring book, go for a walk, listen to a podcast, put on your anxiety-soothing playlist or call a friend and tell them you need to talk about something else."
As you discover tools that work for you, keep a running list in the notepad on your phone, so if you find yourself unsure of what to do, you can simply scroll through that list. As for finding distraction tools, Neidich says that just about anything will work as long as it doesn't make your anxiety worse.
"Social media makes many people's anxiety worse, yet I just had someone mention to me that watching dance videos on TikTok helped them to get through an anxiety attack," Neidich says as an example. "We are all individuals and need to take the time to figure out what will improve our symptoms."
Aftercare is how you soothe yourself once the anxiety attack is abating, Neidich says. This can include tactics similar to distractions, such as taking a walk, journaling or calling someone. If you choose to call someone, Neidich says make sure it's someone who "knows not to ask you why you had the anxiety attack" (see the section below on building a support system for more on that).
"Once the peak of the anxiety attack has occurred," Neidich says, "using grounding techniques to feel more present in your body is a big part of aftercare."
Try these grounding techniques Neidich recommends:
- Hug a tree or touch other plant life
- Go for a slow walk
- Drink herbal tea
- Do a slow, relaxing yoga flow
- Write in a journal
- Listen to music
- Practice breathing techniques (only after anxiety begins to subside)
Neidich also offers a visualization exercise to help: Once your anxiety starts to dissipate, visualize yourself as a tree with roots growing into the ground as "a powerful way to begin to ground."
What about deep breathing?
The prevailing sentiment that meditation and deep breathing can or should be used to stop an anxiety attack can actually be harmful, Neidich says. Instead, those are effective tools for prevention.
"Meditation and deep breathing are typically poor skills to use once an anxiety attack has already started and can, in fact, make things much worse," she says. "Instead, people who have anxiety should be meditating twice per day in order to decrease their overall anxiety so that they can more effectively identify worsening anxiety symptoms."
Neidich notes that it's common for people to say "I know I should meditate" and then ignore meditation as a potential tool -- but "daily meditation has the potential impact of stopping anxiety attacks completely and the recommendation should be taken very seriously," she says.
It's true, meditation is known to reduce stress, anxiety, depression and emotional pain, as well as build resilience, or your ability to bounce back from stressful or painful situations.
Building a support system
A network of support people is essential to managing anxiety, Neidich says, but those support people must be effective in helping you cope -- that is, they should make you feel better, not worse.
Lean on people who can offer you the kind of support you personally need, like physical touch or an ear to listen to how you feel. Avoid anyone who asks you why you had an anxiety attack. After an anxiety attack or on the fringes of one, it's important to not talk about the cause behind it, Neidich says, pointing back to distraction techniques.
It's important to be clear on what you need from your loved ones in regard to anxiety, Neidich says -- it's a "huge part of a comprehensive anxiety-management plan."
"Be sure to talk ahead of time about what language is and is not helpful," Neidich says, noting that it's not someone else's responsibility to help you with your anxiety attack, but it is your responsibility to communicate your needs.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.