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While each of the following tips may not work for everyone, they are meant to help you create an individualized plan for your own panic attacks. A good self-help book, such as The Anxiety & Phobia Workbook, can help you come up with more coping tools. The following suggestions are not a substitute for professional help. By working with professionals (a therapist and/or a psychiatrist), you can create an individual action plan for coping right now and recovering in the future.

Learn a breathing exercise

You may have heard that breathing exercises can stop a panic attack or, at least, reduce the symptoms.

If you wait until you are panicking to try a breathing exercise, however, you may find yourself making matters worse. Learn a simple breathing exercise when you are not in a highly anxious state and practice it every day, preferably twice a day (5 minutes in the morning, 5 minutes at night). Click here for a simple breathing exercise.

Some people find it difficult to learn a breathing exercise, or find that it increases anxiety. If that is the case for you, find a behavioral therapist to help you. If that's not an option, see if a friend will learn with you. Breathing exercises are good for everyone, so your friend will benefit. Create a safe environment where you can learn, talk about your fears, and start slowly (maybe only a minute at a time).

Once you have practiced a breathing exercise on a daily basis, you will find that it comes naturally to you to change your breathing during an attack. Additionally, regular practice may reduce overall stress and anxiety, thereby reducing panic attacks, too.

Learn a relaxation exercise

Relax during a panic attack? Impossible, you say. As with breathing, it is important to learn relaxation and practice regularly, so that it becomes natural to relax your muscles during an attack. Also, as with breathing, regular practice can reduce overall stress and anxiety. Quite simply, it's good for you. Click here for a simple relaxation exercise.

Again, if you have trouble learning a relaxation exercise, seek help from a professional. A behavioral therapist can help you learn relaxation and breathing. You may also find other forms of relaxation such as meditation helpful after you've learned the basics.

Create a telephone support list

This is the first of three lists (see the others below) you'll want to write. Keep one set at home in an obvious place (such as on the refrigerator) and keep one set in your purse or wallet.

The telephone support list is a list of names and telephone numbers of people who have given you permission in advance to call during a panic attack. Next to each person's contact information, write the times and days you may call. For example, your therapist might give you permission to call during certain hours. Also included on this list might be friends, family and support group members.

Ideally, you want a big list so that one person doesn't feel that he or she is your only support. That's one reason why joining a support group is a good idea -- you can be there for other people, as well as them being there for you. You know right now who you can ask to do this, so don't ask someone who doesn't understand, then be surprised when they aren't helpful. Keep seeking support (and if it's difficult in your community, then find support online and use instant messaging instead of the telephone).

At the top of your list should be the crisis hotline(s) for your area. A crisis hotline usually may be called 24 hours a day, whereas it's not always possible to find other support during late night hours. These hotlines are meant for any kind of emotional crisis, so don't feel you are burdening them if you are having trouble coping for any reason. Click here for instructions on finding a crisis hotline in your area. 

Create a list of distractions

It's often difficult to think of what to do once you start panicking, and sometimes it's something simple that is most helpful, such as taking a walk. Come up with a list of everything that's helped in the past during the early panic stages. Only you know what works for you (one person may find relief in a hot bath, whereas another person needs to be as active as possible).

Don't put activities on the list that you know don't work for you just because other people have suggested it. If there are activities you haven't tried during an attack, practice them at other times and see how they make you feel. Walking is a good example. If you find that walking reduces your anxiety, then there's a good chance it will be helpful during an attack (you may need to keep a plan of where you will walk next to your list of distractions).

Write a list of coping statements

What do you think about when you are having a panic attack? Write down a list of the thoughts that often run through your mind when you are beginning to panic and during the attack. An example might be, "I am going crazy." After you've created a comprehensive list of these types of thoughts, come up with coping statements that counter them. For example, "The feeling of going crazy is a symptom of a panic attack. I am not going crazy. These thoughts and feelings are temporary, and I can get through them."

About.com Depression Guide Nancy Schimelpfening has a great article on How to Cope With Negative Thoughts that will help you create counter-statements for the kinds of thoughts we often have when anxious or panicky. Use this list when you are beginning to have these kinds of thoughts and learn to repeat the coping statements to yourself. It's a good way to learn to rely on your own strength during difficult times.

Put together a comfort bag

Besides the lists and techniques mentioned above, you may find that other objects and tools help you through (or even avoid) panic attacks. For ideas on keeping these coping tools all in one place, see my article How to Put Together a Comfort Bag.

From Cathleen Henning Fenton,


http://panicdisorder.about.com/od/pdbasics/a/prepareforpanic.htm