How can I better control my anxiety and panic attacks?

I have been having a lot of anxiety and panic attacks. I have been under a lot of stress and am no longer able to handle it like I could before. What should I do?
Asked by Cat


Thanks for getting in touch and putting your question out there- this is a really important query and I'm sure a lot of people could benefit from you asking it.

From your question, it sounds as though having anxiety and panic attacks is something you've experienced before, but due to current stress, this is harder to deal with now. This makes perfect sense, what the experience of anxiety is and then the escalation into a panic attack is an exacerbation of our fight or flight system. This system is an archaic way of 'keeping us safe', when we've perceived danger or been under threat then the body will activate this system to help us run away or fight the danger, via the sympathetic nervous system. This system is responsible for those anxiety symptoms, feeling overwhelmed physically, heart racing, shaky, short of breath, needing the toilet etc. These symptoms have a biological rationale to them- they are designed to get us ready to respond to a situation that may harm us.

Understanding this is very important in the management of anxiety, as our body is doing what it is designed to do, in effect, if you were a cave person- you'd be very much alive! But, despite this, the feelings are really uncomfortable, and maybe this old response isn't quite appropriate for the modern world, where our bodies' perception of dangers might be: whether or not the bus arrives, our social media interactions, whether we remembered our colleagues name correctly etc.

It can be really helpful to do some research about these symptoms and the body’s rationale for why they occur, for example, a racing heart gets blood around the body quicker to provide the oxygen it needs to move fast. This is a normal response to a perceived threat, whether or not it's life endangering or we perceive it to have negative consequences for us. 

When we understand this about anxiety we can reframe our thoughts around it, which can be helpful, for example- are there fears or worries about this anxiety, does it have other meanings for you?

For some people, when they experience a panic attack, they make sense of it in a catastrophic ways, for example- 'my heart might stop, I might die or pass out, vomit etc'. This is obviously very distressing. Making sense of anxiety in these catastrophic ways only leads to further release of stress hormones like cortisol and adrenaline, which perpetuates the cycle further, and can lead to more unexpected panic attacks down the line if we are experiencing chronic stress. 

Managing anxiety is quite a holistic approach, maintaining a regular exercise plan gives your body change to 'burn off' those stress hormones- as it would have done as cave people in true danger. 

Having a healthy psycho education understanding of what anxiety is and the importance of it 'keeping us safe'- and be able to recognize the symptoms for what they are during those periods. It's best to start doing this outside of intense stress, so you're better resourced in those tough times, and you can develop that healthy inner dialogue.

It can be beneficial to have an evidenced based approach when evaluating your experience, the sense you make of anxiety or the belief of what might happen during a panic attack- are they different things and what can that teach you? For example, does it always mean if you feel anxiety symptoms that these beliefs happen?

It can be helpful to write down some worries which may contribute to feelings of anxiety, especially if you've been under stress, are they things you can do anything about in the 'now' or can they be written down and returned to in a time limited way at your leisure. Writing down hypothetical worries as they happen, but then coming back to the present. Spending half an hour at a designated time to worry can also be a good way to manage anxiety. Spending a lot of time worrying which can contribute to anxiety because when we worry about 'the worst case scenario' it also activates the fight or flight system.

Practicing being more present is a good way to avoid the reflection of the past which may be activating or the worry of the future, practicing mindfulness is a way to do this. It offers space between ourselves and those thoughts, as if we are observers of them, witnessing them being in our consciousness, without judgment. 

I hope this answer has been helpful, please do contact me if you'd like some therapy regarding your experience. It can be really beneifical also to talk this through with someone you trust.

I wish you the best of luck.

Kind regards, Charlotte