What is an Anxiety Attack and What Should I Do If I Have One?

You may have heard someone at work or a social function say, “I feel like I’m having an anxiety attack.” Usually if you can say that, you aren’t actually having an anxiety attack.

You may be on the verge of an anxiety attack, but an actual anxiety attack is usually quite debilitating. The symptoms may come on suddenly, like a panic attack, or more gradually, but are no less distressing when severe, and may include:

• chest pains
• racing or pounding heart
• feeling faint, weak, or dizzy
• difficulty taking a deep breath, or rapid breathing
• feeling sweaty or having chills
• a sense of impending doom or terror

Some victims of anxiety attacks say it feels like they are having a heart attack. When experiencing these kinds of symptoms, a trip to the emergency room is a wise precaution, just to make sure something more serious is not happening.

Physical Processes of Anxiety

The human body is equipped with a remarkable defense mechanism—the sympathetic nervous system—that kicks on in moments of crisis. When we are under threat, we may have a split second to decide whether to defend (fight) or flee (flight). At that moment, the entire body prepares to go into action.

Imagine walking into a room and spotting a long snake in the shadows. Your pulse pounds, stress hormones flood your body, and in a fraction of a second you decide whether to kill it or run screaming from the room. This is your sympathetic nervous system on glorious display; ready to do whatever it takes to save you.

Now, suppose in the next moment, you realize the snake is actually a rope. Crisis averted, you take a deep breath, let out a sigh of relief, and begin to calm down. This is your parasympathetic nervous system switching on, calming your agitated system, counteracting the stress hormones, and helping you to relax.

Extended stress is damaging to the body, so normally we are wired only to be stressed when there is a good reason. Unfortunately, trauma can rewire the brain in such a way that our mind behaves as if we are always under threat.

This can make it very hard to calm down, and left unchecked over time, these patterns become entrenched, leaving us predisposed to anxiety. If this has gone on for more than six months, you may need a prescription for anti-anxiety medication to get it under control, at least at the beginning.

Anxiety Attack Triggers

Anxiety attacks usually require a trigger of some sort, but these triggers can be difficult if not impossible to see. If you have a strained relationship with a family member and have an anxiety attack right after learning he or she is coming to town, this is pretty easy to spot. If you are driving down the road, and have an anxiety attack for no apparent reason, that can be harder to diagnose.

Our bodies store trauma and if we are not in the habit of releasing it through physical activities like exercise or massage, and processing our negative feelings and thoughts, it can build up.

At some point, the body may say, “Um, I’m not carrying this for you anymore” and you may have an anxiety attack with no visible trigger, or you may actually have a fainting spell, also called a syncope event. Again, fainting spells and the like can be caused by other more serious conditions, so verification by a physician is a good idea.

What Can We Do?

The primary clinical intervention for recurring anxiety is pharmacological. Because the neural wiring of our predisposition for anxiety took decades, changing that wiring takes time, and managing symptoms during the transition often requires medication.

You can pursue this with your GP, but it is better to work with a psychiatrist when trying to find the right medication and dosage.

Besides medication, there are steps we can take ourselves to learn to manage our symptoms of anxiety.

Deep Breathing

If the anxiety is lower level or not as long term, it may more easily respond to non-pharmacological methods, like deep breathing and mindfulness, or exercise. In actual practice, engaging your parasympathetic nervous system should reduce anxiety (or anger).

We do this with diaphragmatic deep breathing; breathing in through the nose and out through the mouth with our diaphragm (pushing the stomach out on our in breath).

Imagine for a moment that you walked into a room in your basement and saw an animal coiled to spring. In an instant, your sympathetic nervous system kicks into action, cortisol floods your body, along with adrenalin and other chemicals, all geared to giving you the necessary reflex and energy to run away (flight) or defend yourself (fight).

Now, suppose in the next moment you realize the coiled animal is that old stuffed badger your weird Uncle Morty keeps forgetting to pick up. What’s the first thing you do?

Crisis averted, you take a deep breath and blow it out through your mouth. This literally signals your parasympathetic nervous system that it’s okay to stand down. No flight or fight necessary.

This is why deep breathing works, if we work at it long enough and persistently enough. Entrenched anxiety will not usually respond quickly to deep breathing.

If we are sitting there fidgeting, trying to slow our breathing, and thinking with ever greater anxiety, “It isn’t working!” it’s time to try something else. You have to let yourself off the hook for “doing it right.” If deep breathing helps you calm down, then do it. If it only contributes to your anxiety, let it go for now.

Mindfulness and Single Focus

Another useful tool for managing anxiety, and a good one to do along with your breathing, is mindfulness, which is essentially locating yourself in your body in the present.

You may feel like you are worried about a dozen things, all at the same time. If you take some time to notice how the thoughts are coming, however, you will find you are actually thinking of all those things one at a time in quick succession.

Our mind can only actually focus on one thing at a time. Because of this, if we can focus our mind on a single thing of our choosing, it interrupts our ability to entertain all those other anxious thoughts.

To do this, sit in a comfortable chair with your hands at your side. Notice where you are feeling tight or tense and see if you can relax it. Remind yourself you are HERE, NOW. The past is the past, it’s not happening now. The future is unwritten, it’s not happening now. All we have is now.

For right now, in this moment, we don’t have anywhere else to be, we don’t have anything else to do, we don’t have anyone we’re responsible for. Our worries, responsibilities, even our anxieties will all be waiting for us when we are finished here. We don’t have to take them up now.

You may notice a recurring sound in the room, or noises outside. Focus on that.  Be in this moment. You may come up with a centering word, like “Rest” or “Peace” and see that word in your mind, and say it quietly when distracting thoughts pop up.

Imagine you are floating comfortably in a river and stray thoughts are in packages that can float on by. There it is, and there it goes. No need to pick it up now.

Sometimes it can be helpful to pick up a smooth stone to hold in your hand. Notice the cool smoothness of it. Wonder what it’s made of, or what it looks like inside. Your brain can only think of one thing at a time. If you can focus on something like a stone or a centering word, your anxious thoughts will have to take a back seat.

Positive Affirmations

These are just simple phrases we repeat to ourselves as we breathe. For example, say you have a breathing pattern of four seconds on your in breath, hold for two, and then six seconds on your out breath. Now, choose a saying or Scripture that has meaning for you. A simple saying is “Lord Jesus Christ, have mercy on me.”

So, on your in breath, you think, “Lord Jesus Christ …” and on your out breath, “…have mercy on me.” The desert fathers used to pray this prayer a thousand times a day. Don’t beat yourself up if you can’t make that particular goal, but it will change you if you are persistent.

If you prefer Scripture, then pick one you like and split it up. So, for example, “The Lord is good…” on your in breath, “…and his steadfast love endures forever” on your out breath. If you struggle with self-worth, this can also be addressed in your positive affirmations. We are, after all, the image of God in the world.

An affirmation might look like this, “I am an amazing, unique expression …” on your in breath, and “… of the image of God upon the Earth” on your out breath. If our emotional structure is wired to make us feel one down, or worthless, or like we have no value, this may sound like nonsense at first. But if we can actually grasp, even a little, how astonishingly precious and valuable we are, it will begin to change us.

Other Things to Try

Kinesthetic Visualization

There is a somatic aspect to relocating anxiety, and anxious thoughts outside our bodies. If you are alone, you can vocalize as you slowly exhale a full breath, pushing your hands away from you, not unlike Bruce Lee’s finishing move after some of his martial arts sequences.

Your breath comes out sort of like a mild to moderate roar. As you breathe out like this, visualize your anxiety, anxious thoughts, negativity, or whatever as fine, grey sand or powder leaving your body through your mouth.

Do it at least three times and check in with yourself to see if there’s any improvement. Sometimes this combination of somatic action and intention can reduce our symptoms of anxiety.

Burden Stones

This is another form of kinesthetic visualization. Take a tall pot or other container, add a couple of handfuls of smooth stones keeping a few out, fill it most of the way with water. Take one of the extra stones in your hand and squeeze it.

As you squeeze, imagine your anxiety, anxious thought, negativity, or whatever as some kind of dark essence being pushed into the stone. When you are ready, breath out and release the stone into the water. In doing this, you combine action and intention and let your body know you mean to relocate your anxiety outside your body until you are free of it.

Final Thoughts

As important as anxiety is for our protection from danger, too much over time impedes our enjoyment of life, cutting desire off at the knees, crippling our will to work, to enjoy, to love.

We don’t have to be stuck with it. It doesn’t matter how smart you are, how tough you are, how self-sufficient you are, God never intended for us to go through these kinds of difficulties alone. We get to ask for help, and be creative in our attempts at healing, and try new things, and get medication, on the chance that it might help.

Have grace for yourself to be a work in progress and believe that change can happen. When a lying, negative voice says something that feels true, but you know is a lie, stuff the truth in its mouth. You can personify that part of you. Give it a name. Imagine stuffing the truth in its mouth.

“You’re worthless,” the voice says. “I’m an amazing, unique reflection of the image of God on the Earth,” you reply. Find your own words. Use them again and again. These truths can become the positive affirmations you use when you pray, meditate, or practice deep breathing.

Over time, it will become second nature to defy the lying voice, and you will gradually rewrite your neural pathways. This too will help you manage your anxiety, in concert with the professionals you choose to help you in your journey, as you move slowly and surely toward growth and health.