How to keep your anxiety from spiraling out of control

Panic attacks can happen to anyone, and recognizing their symptoms is the first step.
anxious woman holding herself and looking off in the distance
Anxiety can strike any time, especially when your underlying stress levels are high. Diego Cervo/Deposit Photos

If you’re reading this, you’re probably stressed. Never fear: We’ve dug through the evidence to reveal what science really says about finding zen—and holding onto it through tough times. Want to try meditation? Take better baths? Stop anxiety in its tracks? Welcome to Calm Month.

For reasons we’d rather not dwell on, a lot of people have been feeling extremely anxious lately. In June 2020, four times as many people reported symptoms of anxiety disorder as the same period in 2019. Older folks and people of color have been especially hard hit. And this spike hits at a time when anxiety rates have already been trending quite high—in 2017, nearly one in five adults in the US had symptoms of anxiety.

Elevated stress levels can push your relationship with anxiety from an occasional nuisance to a constant struggle. . The best thing you can do is to go see a mental health professional—a therapist, a psychologist, a psychiatrist—and talk to them about how to handle these newfound feelings.

But if you can’t afford to go see someone, can’t do so safely during the pandemic, or simply feel that you’re not ready to seek treatment, here are some scientifically-sound suggestions for how to keep yourself from spiraling. Many of these are pulled from scientific research on panic attacks specifically, but the same principles apply to preventing general bouts of anxiety—and more long-term spirals into stressful thinking patterns.

Recognize that you’re anxious

This probably sounds obvious, but pretty much every resource on preventing anxiety attacks will give you the same advice for a reason: it’s surprisingly hard to recognize anxiety in the moment.

In The Anxiety and Phobia Workbook, psychologist and anxiety researcher Edmund Bourne has an excellent explanation for this:

“Because there is no immediate or apparent external danger in a panic attack, you may tend to invent or attribute danger to the intense bodily sensations you’re going through. In the absence of any real life-threatening situation, your mind may misinterpret what’s going on inside as being life-threatening.”

Anxiety triggers exactly the same physiological mechanisms that make up the classic fight-or-flight response: your heart rate jumps, your breathing increases, blood flow redirects to your newly tensed-up muscles, and you start sweating. This is how your autonomic nervous system keeps you out of harm’s way. A sudden surge of hormones, like adrenaline, blasts through your body and begins a cascade of changes that prepare you for danger.

Back in the early days of our species’ evolution, this would have enabled a person to run away from a predator, or possibly fight it off—in fact, it still does serve that purpose. But anxiety hijacks the same pathway to make us feel just as scared and amped-up in response to a psychological problem as we would when faced with a physical danger.

These attacks often come on without an obvious trigger, so physical symptoms can kick in before you even register that you’re particularly stressed. Your brain, meanwhile, is quick to interpret these hard-coded physiological responses as a sign that danger is afoot.

But shortness of breath, nausea, and heart palpitations are all very normal (if unpleasant) symptoms of anxiety. It only feels like there’s something more imminently troublesome going on. Unfortunately, that feeling can cause a sort of feedback loop. Anxiety makes you feel bad physically, and those physical symptoms feel like danger, so you become even more fearful and anxious, which only makes the symptoms worse.

Whether you experience sudden panic attacks or are simply having elevated background anxiety levels, The Anxiety and Phobia Workbook notes that “just recognizing your tendency to believe that harmless bodily symptoms are signs of imminent danger is the first step”

Breathe, and don’t fight the panic

It may seem counterintuitive, but the best technique to get past anxiety is to simply sit with it. Observe the sensations going on in your body. In her book Hope and Help for Your Nerves, physician Claire Weekes advises that you actually describe the feelings to yourself: “For example, you may say, ‘My hands sweat and tremble. They feel sore. …’ This may sound a little silly and you may smile. So much the better.”

Once you’ve catalogued those sensations, try a slow breathing exercise. There are plenty to choose from, whether it be box breathing or alternate nostril breathing or something in between.

It may be frustrating to be told to breathe through an experience that can be quite physically and emotionally distressing. But there actually seem to be physiological reasons that breathing exercises help to calm us down, and breathing dysfunctions themselves may contribute to the feeling of anxiety.

Conscious, slow, deep breaths cause sympathoinhibition, or inhibition of the sympathetic nervous system, which is exactly what gets over-excited when you’re anxious or stressed. It’s not clear exactly how this happens. One part of the theory is that stress can cause your cardiac and respiratory signals to get out of whack, and that slowing your breathing can help them synchronize again . Another piece is that the neurons involved in your sympathetic nervous system are inhibited directly by controlled breathing—so the act of focusing on your breath is actually calming your nerves, quite literally. This may be because of changes in your amygdala, the main area of your brain responsible for emotions like fear. Mindfulness and meditation also seem to soothe your amygdala in a similar way. Increased oxygen from your deeper breathing should additionally help your muscles to relax and restore your normal bodily functions.

Breathing and relaxation techniques even seem to help with chronic stress. In one double-blind trial, patients with hypertension were assigned randomly to either implement relaxation response training (deep abdominal breathing, praying, yoga, and so on) or to simply learn about controlling their blood pressure. About half of those assigned relaxation techniques were able to eliminate at least one blood pressure medication by the end of the trial, indicating that they’d brought their blood pressure down, versus about one-fifth in the control group.

No matter which technique you use, remember this: the peak of most anxiety attacks occurs within 10 minutes of onset. So even if you feel as if the panic is going to last forever, it’ll actually be over quite quickly.

Aside from breathing, Bourne recommends a few classic interventions:

Pay attention, practice, and take care of yourself

Managing anxiety is like trying to forge a new path in the woods. It’s easiest to go down the path you’ve always trodden, both metaphorically and neurologically. Your brain quite literally has connections between its cells, and the more time those connections spend firing in the same sequence, the stronger those connections get. To change your patterns of thinking, you have to get different neurons to fire instead—and that will take conscious effort at first.

Part of this change will involve thinking about what triggers your worst feelings of anxiety. Bourne suggests writing down the events and thoughts that lead up to sensations of panic. Eventually, some patterns might emerge. Understanding your triggers means you can avoid them, but more importantly it means you can identify in advance when something might make you feel anxious—and therefore, you can recognize early on when you’re experiencing anxiety.

Pairing this with self-soothing techniques, like exercising or journaling, will also help you manage the feelings themselves.

Self-awareness is the first step, and the more you think about overcoming your anxiety, the easier it will get. Eventually you’ll find that early physical symptoms of a panic attack don’t trigger more fear. Once you’re able to identify feelings of anxiety without experiencing them so intensely, you’ll have the tools you need to avoid spiraling into panic.