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  • Natasha J. Thomas, MD

The Anxiety and Panic Series: Effective Strategies for Treating Anxiety (continued)

Welcome back to the second part of our anxiety management strategies list. Now, we'll review tips and resources for the management of panic attacks and panic disorder, specific phobia, agoraphobia, and anxiety due to substances or medical conditions. Follow the pink links to visit resource pages, and click here to review the symptoms of the various anxiety disorders.


Panic Attacks

Panic attacks can feel absolutely horrible but it's important to remember that they are not dangerous. Typically, they can be survived by healthy or unusual distractions. It's also important to figure out what triggers them, so you can help prevent them from becoming a regular occurrence.


  • At the onset of a panic attack, breathe!

  • Tell yourself you are ok and "ride the wave". Let the panic past through you without attempting to suppress it.

  • Engage your senses to distract yourself. You can touch something cold, put a piece of candy in your mouth, or describe the environment around you.

  • Do NOT tell yourself you're "going crazy." Instead, say, "It's a panic attack, it's going to pass soon."


Ann Borges of Buzzfeed has compiled a great list of other panic attack strategies. They all focus on engaging your senses in a way that removes your focus from the panicky feelings in your body (like a racing heart) and puts it on using your breath or becoming grounded in the environment around you. Check out the list here.

Panic Disorder

The main distinguishing factor between panic attacks and panic disorder is fear of panic attacks recurring, or coming back. Though all anxiety disorders improve with counseling, panic disorder is even more amenable to improvement through counseling than are the intermittent panic attacks. That's because panic disorder reflects habits of thought, that can be changed over time.


All of the tips above apply for panic attacks and panic disorder.

If you have recurrent worry that you will panic again, though, you should pursue Cognitive Behavior/al Therapy, referenced in the last blog post. Watch a brief description on CBT here.


Specific Phobia

Believe it or not, there are many, many different types of phobias. In fact, the website lists 100 phobias. I think that for as many people as there are in the world, we could potentially have that many things that cause irrational and intense fear. Common phobias, though, are fear of insects, snakes, bridges, flying, germs, tight spaces, and heights.


  • Identify your fear

  • Try to write down the history of that fear (how long ago did it start, was there a "trigger", does it get better sometimes)

  • Find a therapist or counselor to help you change the way you think about your fear objects, and to gradually, gently work toward facing them.



The development of agoraphobia can unfortunately shrink the world of those impacted by it. I have treated patients with the kind of agoraphobia that makes it scary for them to leave their homes, or even their bedrooms. I have always said that what I hate most about anxiety is that it makes your world small. Agoraphobia is the one type of anxiety that literally does that!


Start small. If you are working through agoraphobia, try to imagine what it would be like to leave home before you actually try it. The thought will be scary. See if you can use a coping strategy (like visualizing your outing going well, deep breathing, doing stretches, etc.) to mitigate the anxiety somewhat. Start with imagining yourself just leaving the front door to stand on your porch for a short period of time, then you may consider going to your street or sitting in the car. Do not try to go out until the thought of leaving home produces somewhat less anxiety. Once you start going out, you will have to have an armory of coping tools. This may require formal counseling with a therapist or psychiatrist, and is called Systematic Desensitization or Exposure Therapy


Anxiety from drugs, medicine or medical conditions

If you have anxiety from medicines, drugs or medical conditions, you will need medical care to fully address it. Please see your primary care physician for a physical exam and be honest with your doctor. If you are misusing a substance like caffeine or any prescription or illegal drugs, tell your doctor so they can help you get free of them. Your doctor will also do lab work to rule out a medical issue.


  • Decrease use of caffeine. Switch to decaf, drink half-decaf/half-caffeinated, or slowly taper off coffee, tea, soda, chocolate, energy drinks or whatever your source of caffeine is.

  • If you feel like your prescription medications are causing side effects of anxiety and panic, call your doctor.

  • If you have developed the use of a substance like marijuana, cocaine, LSD, ecstasy or alcohol, you may need help to stop.



Remember these other tips:

  • Visit a support group for your type of anxiety or start with the National Alliance on Mental Illness (NAMI) website for community resources.

  • Try a workbook to help manage anxiety. It may be a good first step, or complementary step, to help in counseling. Find a list of workbooks here.

  • Consider if animals can help you with anxiety. Would you be a good candidate for an Emotional Support Animal? Click here to find out.

  • Learn about the main types of therapy used for anxiety - CBT, Systematic Desensitization or Exposure Therapy, and Mindfulness.

  • Be sure to keep a good diet. See a registered dietician nutritionist for help!

  • Don't forget your faith. If you are raised in a particular faith tradition, don't isolate it from your attempts at anxiety recovery, unless you know it to be unhelpful.

  • Get physical activity regularly.

  • Reach out to family and friends.

Remember, the journey with anxiety may take some time to master, but it has an incredible power to teach you about the deepest parts of your mind and heart. Don't rush it, don't hate it! Embrace it!


Looking for the rest of The Anxiety and Panic Series? Just follow these links!

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