Here’s everything you need to know about dealing with anxiety attacks

“Let it go, let it go. Can’t hold it back anymore.” Okay, to most wide-eyed children, Elsa from Disney’s Frozen is just this super-cool, kind of complicated snow queen with a great singing voice and a killer side braid. But if you really boil it down, the character is oh-so-relatable to the adult set, too. Think about it: She spends most of her life hiding from the outside world. She’s so worried about what might happen that she secludes herself from all of it. Beyond withdrawing from her family and friends, she avoids her problems instead of accepting or dealing with them. And not to get all clinical, but might it be possible that Elsa was suffering from some pretty intense anxiety while she was refusing to build a snowman with sweet Anna?

Sure, it’s a cheeky comparison, but in today’s ever-busy, always-working, rise-and-grind #hustleculture, all people are practically wired for anxiety. We may not have to worry about dudes trying to steal our castles and family fortune (probably), but the demands of life today are no joke, whether you’re a successful CEO, an analyst by day and yoga instructor by night, or a living-paycheck-to-paycheck recent grad trying to figure out WTF to do next. So, in the event your worries ever percolate into anxiety-attack territory, here’s what to do.

Anxiety attacks: 101

First things first, generalized anxiety is something many people experience from time to time. It’s a feeling of nervousness or worry about a particular event or situation, like an upcoming exam, a speaking engagement, or a mounting confrontation with a loved one (ugh). “The worry usually lasts for a limited period of time and can be directly linked to a particular situation,” says psychotherapist Sofia DiSanti, LCSW.

When enough of that anxiety builds, it’s more likely to bubble over into a full-blown anxiety attack. Think of it as a volcano that’s been dormant for a while, but then that lava gets flowing and the eruprtion oftentimes leaves a big ole mess in its wake. “An anxiety attack is colloquial terminology to describe an intense episode of anxiety, when anxious thoughts become more intensified and may also be accompanied with physical symptoms,” DiSanti says.

“An anxiety attack is colloquial terminology to describe an intense episode of anxiety, when anxious thoughts become more intensified and may also be accompanied with physical symptoms.” —Sofia DiSanti, LCSW

But though the two are often conflated, anxiety attacks aren’t the same as panic attacks. Anxiety attacks are directly related to a particular stress-inducing idea, whereas panic attacks have a fast-and-furious onset that feels most intense for about 10 minutes before deflating (though DiSanti says symptoms can persist for up to an hour). “Anxiety attacks, which are less disruptive in nature, can usually be linked to a specific feared or stressful situation, while panic attacks can occur seemingly out of nowhere,” DiSanti says.

Of course, anxiety attacks can be sneaky too, and what brings them on is incredibly individualized. Your running buddy may experience intense anxiety over an upcoming race, while your work wife may worry about an upcoming presentation, and your bestie may have trouble dealing with the fact that she’s in an unhappy relationship and needs to break it off.

“The most common stressors that lead to anxiety attacks are often related to work, money, relationship issues, adjustment issues—like moving or getting a new job—and chronic medical conditions,” says DiSanti. In some cases, anxiety attacks can also be linked to other diagnosable mental-health conditions, she says, such as post-traumatic stress disorder (PTSD) or obsessive-compulsive disorder (OCD). Furthermore, anxiety disorders can run in families, and research shows a strong genetic component. Think of this as more evidence you should eat your veggies, prioritize shut-eye, and opt for matcha over merlot, since DiSanti says poor self-care, like inconsistent eating, excessive drinking, and lack of quality sleep, can make a person more susceptible to anxiety attacks.

Common symptoms of anxiety attacks

1. 1.
   Restlessness
2. 2.
   Worry thoughts
3. 3.
   Irritability
4. 4.
   Heart palpitations
5. 5.
   Trembling
6. 6.
   Chest pain
7. 7.
   Nausea
8. 8.
   A sensation of shortness of breath
9. 9.
   Sweating
10. 10.
    Can be prolonged in length, and usually end after the perceived threat or anxiety-provoking event has passed

But what if you feel anxious, and these symptoms don’t align with what’s going on? “More persistent and intense anxiety, which may also come along with physical symptoms and notable interference with work, school, or relationships, can indicate an anxiety disorder such as generalized anxiety disorder, social anxiety disorder, or panic disorder,” DiSanti says. This can also make it difficult to tell if shortness of breath is from anxiety or another condition, for example. In any of these cases, seeing a licensed specialist is always your best bet.

Okay, so you’ve had an anxiety attack—now what?

If you have anxiety and/or symptoms of anxiety attacks, there are strategies to help you deal. Below find DiSanti’s best five tips for managing your condition so that attacks can be as few and far between as possible.

1. Engage in good self-care. Eat foods that make you feel good, and at consistent intervals, because not eating enough throughout the day can make you more susceptible to feelings of nervousness and irritability. Drink enough water, don’t over-caffeinate, avoid excessive alcohol use, and engage in joyful movement—whether that’s yoga, running, kickboxing, or anything else you actually enjoy. And, of course, get a good night’s sleep.

2. Be aware of your triggers. Do social situations make you overly anxious? Is that big deadline at work keeping you up at night? Are you afraid of making mistakes? Worried about the future? Anxious about how you’re perceived by others? Notice what makes you feel anxious so you can be prepared for your anxiety before it takes over.

3. Challenge and reframe your anxious thoughts. Is your anxiety reality-based? What would happen if the worst-case scenario were to come true? What is the most likely end result of the situation that’s making you anxious? Will this anxiety-provoking situation matter in a week, month, or year from now? What would a close friend say about your worry thoughts? You can also label your anxiety for what it is, without putting yourself down or getting frustrated about the very fact that you’re experiencing anxiety. “It’s just my anxiety, it can’t kill me.” Or, “I’ve felt anxious like this before, and I know I can get through it.”

4. Try some deep breathing exercises—and not just when you’re feeling anxious. Deep breathing, or diaphragmatic breathing, can help calm your body when you’re feeling overwhelmed. To try it, sit upright in a chair with your feet firmly planted on the ground, your shoulders relaxed, and your hands resting gently in your lap. Put one hand on your heart and the other on your stomach. As you breathe in, notice your stomach expanding, and as you breathe out, notice your stomach contracting. Try focusing on making your breath out longer than your breath in. Do this exercise for one minute every morning to train yourself to be able to access the soothing effects whenever you’re feeling more intense feelings of anxiety coming on.

5. See a pro.Speaking with a therapist about your anxiety can help. Anxiety may be an indicator of a larger issue, like an anxiety disorder, such as scopophobia. You can learn more about your triggers, how to more effectively manage your symptoms, and gain more insight into how anxiety impacts your daily life. In some cases, when the anxiety is more persistent and severe, medication can be extremely helpful in managing symptoms of anxiety. Remember, seeking help is a sign of self-awareness and strength, not weakness.

Ever wonder why anxiety feels worse at night? Plus, here’s how to make sure your meditation practice is squelching rather than stoking your worries.