How to help prevent and cope with panic attacks

We can all experience anxiety at work or in social situations; but for some, this can become debilitating. Having (or even thinking you may be having) a panic attack at work can be really difficult. The fear of other people noticing what is happening to you can make the symptoms even worse. On top of this, not knowing or understanding what to do increases the fear response circle, so the fear of the fear can become the issue.

If you find yourself in this situation, grounding techniques can be helpful.

So, what is grounding, and how does it work?

Grounding is a way of keeping your thoughts - and therefore feelings - in the present. It helps you to ignore the thoughts that initially lead to your anxiety, and which could potentially escalate to a full blown panic attack.

Here are some examples of different types of grounding techniques that allow you to focus on the now and avoid intrusive negative thoughts.

Using external items

It may be that you are at your desk and are able to use a familiar object to help you. An example might be a family photograph: look carefully and begin to notice what is contained within the picture. Tell yourself about the image, sticking only to what you can see: “In front of me I have a photo of my partner on holiday; they are wearing blue Hawaiian shorts and a pale blue t-shirt; they are sitting on a wooden chair with a pink and orange spotted cushion”. Continue with this fact-stating until you feel the level of panic subside to a level that you feel comfortable with.

Another technique you can use anywhere is that of concentrating on your surroundings, noting the things that are near you. In the room I am currently in, for example, there are five chairs - three are grey, two are blue, and one is green. Think about the shape of each chair and the fabric it is covered in; notice the pattern or the texture. If you are sitting on one of these chairs, think about how it feels to be sitting on the chair: is it hard or soft? Cold or warm? Comfortable or uncomfortable? You can do this for any item you can see, and continue until your thoughts are just in the moment and concentrated on what you want them to be.

Using internal thoughts

You can use any method of thought-focusing; counting backwards, grouping items into categories, maybe the memory games you enjoyed as a child - whatever works for you.

Simple meditation techniques such as repeating a chosen word or mantra can also be helpful, thinking about where you are now, what time it is, what day of the week, season, year, how old you are, when your birthday is etc and repeating if necessary.

Using your body and mind

Be aware of your physical presence, such as in ‘progressive muscle relaxation’. This is an exercise in which you contract and relax muscles in a specific order.

Something as simple as breathing can also help. Make sure you are breathing out for twice as long as you breath in, much like a sigh. Imagine that you are breathing in calmness and breathing out your anxiety. Be aware of what this is for you - ask yourself what calmness and anxiety look and feel like, and use this to help you. Calmness is often pictured as a cool, gentle breeze, and anxiety as a red, hot, hard ball. As you breathe in, imagine the breeze entering your chest, and as you breathe out the breeze gently floats the anxiety ball away.

Another type of visualisation that can also help in this situation is by focusing your thoughts on a calming or happy internal image. Think of a place - real or imaginary - and begin to build a picture using all your senses. What does it look like? What does it feel like? What does it smell like? What does it sound like? Keep going until you can imagine you are actually there. Practise this until you are able to pull the image into your mind at will. It can be useful to create and practise your ‘calm place’ before you go to sleep.

There are many different techniques, and it is about finding one that works for you. It is important to try these over time rather than expecting any of these strategies to work straight away. Whilst you are developing these techniques, no doubt your familiar internal dialogue will continue. This is normal. You are not trying to stop this altogether, but to lessen the impact these thoughts have on you, and to help you recognise that these thoughts will pass.