If the thought alone of being anxious is enough to spark a fresh wave of panic in you, follow these essential tips to manage those feelings

Having a panic attack can be really scary, especially if you’re not expecting it. Heart palpitations, breathlessness, hyper-awareness – it’s not unusual for sufferers to say that they feel like they’re having a heart attack. As a result, you might find yourself nervous about the possibility of another attack, and suffering from ‘anticipatory anxiety’ – anxiety about your anxiety. Here are some practical ways to manage those feelings.

Understand your anxiety symptoms

When our brain becomes guarded against a perceived threat, it creates a physical stress response – even when it isn’t needed.

“When we are anxious, our physiology changes,” says therapist Devon McDonald. “We go into fight, flight, or freeze, so our breathing patterns change, our muscles can get tense, and we can feel nauseous as the blood rushes to the main muscle groups, and away from non-urgent tasks such as digestion. This can make us feel uncomfortable, and even more anxious as a result.”

That physical discomfort can work to create a negative feedback loop in our minds, where we might come to fear the attack itself, rather than what might have been the cause of the attack. Understanding symptoms can be particularly useful in dealing with anticipatory anxiety, because you’re worrying about the result of anxiety, not the cause of it.

Recognise increases in your anxiety levels

“I tend to ask clients to measure their anxiety on a scale of 0 to 10, where 0 is completely relaxed and 10 is, ‘I am going to have a panic attack,’” Devon tells me. “Being conscious of your anxiety levels can help you to understand why you may be feeling the way you do.”

Keep a note of when you start to feel anxious to see if there’s a pattern. It might be crowded places or a regular work deadline. Even events you’re looking forward to – like a friend’s party or a weekly brunch meeting – can become a struggle. You might only feel a little nervous to begin with, but then get more anxious because of your nerves, so it builds. Understanding what triggers you will help you address certain situations, rather than avoiding them.

Tell someone that you are feeling anxious

If you find yourself wanting to avoid a situation, share your anxiety with someone you trust, where possible. There’s no need to make a big announcement, simply whispering to a friend or a trusted colleague that your anxiety feels overwhelming can stop your mind from racing.

It won’t always feel comfortable to share in person, but try to message someone if you have to, or take some time out to call someone. Give your feelings validation, instead of trying to force them away.

Use breathing techniques

Breathing really can help when you feel overwhelmed by anxiety. Devon suggests the following technique: “Take a deep breath in and really open up the chest to fill up your lungs as much as possible. Hold at the top for the count of two, then breathe out very slowly with the aim of doubling the amount of time it took to breathe out as it did to breathe in. After a couple of good breaths like this, notice where you are holding tension in your body, and with the next breath out, consciously let go of that tension, and let it melt away from you.”

Try to stay grounded

Staying present when you’re anxious is really difficult, so it really helps to focus on something else. If you are in a safe place, try the 5-4-3-2-1 technique.

  • Name five things you can see.
  • Four things that you can touch.
  • Three things that you can hear.
  • Two things that you can smell.
  • One thing that you can taste.

The deliberate act of focusing on your surroundings can help stop the cycle of anxious thoughts when anticipatory anxiety begins to build.

Ask yourself logical questions

When we’re anxious, we can overthink things. One small worry about feeling anxious can lead to another and another, and then your fleeting negative thought is any number of potential disasters.

“If I have a panic attack, then this will happen, and then this, and then this.” Ask yourself some logical questions: what’s the worst thing that can happen? Has this ever happened before? Is there actual evidence to suggest that this will happen? Learning to challenge your anxious thoughts will give you a more reasoned response to your anticipatory anxiety.

Even if you can’t quash your anxiety, you can go a long way to stop being anxious about it. Recognising the physical symptoms and trusting yourself is a big part of that.