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How to Cope With Panic Attacks in Public

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It happens more often than I’d like. My anxiety is a thick cloud of smoke, poisoning the air I breathe. I sit in my classes, smoke filling my brain, my foot tapping a million miles a minute. My thoughts are far removed from the moment, my professor’s voice drowned out by the screaming from within the fire.

I wish I knew why it was like this.

I wish I could predict when it was coming, so I could avoid being out in public. So I wouldn’t have to face my classmates’ darting eyes as I frantically run from class. So I wouldn’t feel the burning tears run down my cheeks on the subway platform because the noise is overwhelming and I can no longer feel my hands.

I wish I could always cope in private, but often I don’t have that luxury, and I have to be prepared. My panic attacks are, for the most part, random. They sneak up on me when I least expect it, but it’s been like this for years. I’ve learned to expect the unexpected. I’ve learned ways to pull myself out of a panic state and return to the moment, even when I’m in public.

When I begin to panic, the first thing I do is try to breathe. This may sound simple, even dismissive, of something that is incredibly serious and complex, but sometimes it really works. I practice square breathing, also known as box breathing. Breathe in for four seconds, hold for four seconds, breathe out for four seconds, hold for four seconds, and repeat. I have found square breathing to be a miracle worker. About three-quarters of the time, it can pull me back into the moment and help me realize I am safe. As a bonus, it’s pretty subtle. No one really notices me doing it, especially in class, where everyone is focused on the lecture or the activity at hand. While I breathe, I sometimes have a mantra in my head. Recently it has been, “this will pass.” I like to remind myself that extreme states of emotion are always temporary. We can never be at a 10 forever, despite how it feels in the moment.

Another thing I have done is learned to pinpoint potential triggers. While my panic comes on at random, I have been able to recognize situations that exacerbate my anxiety and make it more likely for me to have a panic attack. For example, I tend to have panic attacks on trains. So, when I am planning to take a train, I bring fidgets for my hands like a clicking pen, headphones and something to write on. These are all things that help keep me calm and in the moment. If I can recognize a potential trigger, it is incredibly helpful for me to prepare in advance.

The last thing I do to help prevent and manage the panic attacks I have in public places is to consistently take my medications as prescribed. Medications aren’t for everyone, but for me, they have helped significantly reduce my anxiety symptoms. I know that when I am taking them, I am exponentially less likely to experience a panic attack in public. While it’s extremely difficult, it is crucial for me, and everyone, to remember not to be ashamed of these things. Anxiety and panic attacks are totally out of an individual’s control. No one asks to have panic attacks, and being embarrassed only makes the situation worse. At the end of the day, we can only make the best of the hand we are dealt.

Getty Images photo via golubovy

Originally published: April 29, 2019
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