What can I do to help with my anxiety so I don’t have anxiety attacks every time I’m in public?

Hello there!

I am sorry to hear about your challenges with anxiety and panic attacks. I will do my best to provide some information that I hope will be helpful for reducing some of the anxiety you are currently feeling. These panic attacks happen when you undergo an intense wave of anxiety or overwhelm wash over you. This is different than the normal anxiety we all feel at different times.  It sounds like being around people can ramp up those feelings, and social anxiety is a specific form of anxiety disorder that affects people. While it is probably pretty difficult to avoid people all together, I think there are some ways to work through the anxiety.

Social anxiety can range from mild or situational, such as when having to give a speech in front of others, to significant where any types of social interaction can provoke those feelings. It can be important to reflect on if certain situations tend to provoke more anxiousness over others (i.e. identifying your triggers). For example, is it all crowded spaces that make you anxious or only ones that are loud? Is it spaces in which you are forced or expected to interact with others or ones that you can keep to yourself? Having this awareness of what specifically sparks the anxiety can help you feel prepared when you know you have to face those situations. Avoiding these situations can often make the anxiety about them worse, even though it may feel easier in the moment. A better approach would be to recognize what things increase your anxiety, mentally prepare yourself for them and make a plan of attack for how you will get through it, and then proceed with doing it. When trying to prepare for these situations, when trying to decompress afterward, or if/when you are actively having a panic attack, you can practice what are called grounding techniques. These different strategies help you to relax and take control over the panic or anxiety when it becomes too much. Sometimes deep breathing may not help because it does not necessarily divert your attention away from the problem or give you an incompatible behavior to try. Here are a few techniques you can use:

• The 5-4-3-2-1 Method is where you engage your senses to bring awareness to your surroundings. Try finding 5 things you can see, 4 things you can hear, 3 things you can feel, 2 things you can smell, and 1 thing you can taste in your immediate vicinity. 
• Progressive muscle relaxation is where you tense up each part of your body then relax it. This can help draw awareness to the areas of your body that are holding tension, which can be a symptom of the stress we feel from anxiety. You can work your way up by starting with your feet, then your calves, then thighs, then abdominal region, hands, arms, and then whole body. 
• The categories exercise is when you think of different categories and try to name as many different things in that category as you can to help divert your thoughts to something else. Examples could be sports teams, countries in Europe, mammals, etc.

These can be done pretty discreetly if you feel the need to employ it during a social interaction or when out in public. You can also search for other grounding techniques online if you would like to explore this option more. I hope you find these helpful!

I also always recommend that people who find their life impeded by mental health challenges talk with a professional who can give you more specific, individualized support to help better manage the symptoms that you feel. Sometimes it can be more helpful to problem solve your specific challenges with someone. I hope that you start feeling better soon! Take care.

Cory Bedtke, LCSW