When Anxiety Feels Like a Crisis, Part 2: Coping with Panic Attacks
By Jennifer Mooney, LMHC
Have you found yourself skipping events with crowds, turning down social invitations, or even missing work because of anxiety? Maybe you put off medical appointments or arrange rides, so you don’t have to drive. If you have had a panic attack before, you may find yourself avoiding certain activities, situations, or settings like the ones mentioned here.
In some cases, it is not necessarily a specific situation that you are trying to avoid; it is the panic attack itself. The experience was so distressing that you are preoccupied with trying to detect and avoid any bodily sensation that resembles what you felt during the attack.
In a previous blog post, When Anxiety Feels Like a Crisis: Understanding Panic Attacks, we covered what is happening during a panic attack and what it feels like. Here, we will focus on what to do if panic attacks are interfering with your life.
Avoidance vs. Exposure: Which Helps?
It’s natural to want to avoid anything that triggers panic. While avoidance may provide temporary relief, it often reinforces the fear in the long-term. Panic attacks create a false sense of danger in safe environments. Avoiding situations sends a message to your brain that these places or feelings really are dangerous, which only strengthens the fear.
One of the most effective ways to manage panic attacks is through exposure: gradually and safely facing what you fear. This doesn’t mean jumping into your most feared scenario immediately, but taking small, manageable steps toward confronting anxiety triggers.
Practical Steps for Confronting the Fear
- Name your fear: By spending time reflecting on what exactly you fear. For example, if you find yourself avoiding crowds, is it because you are afraid that there are too many germs (“germs”), that there will be an emergency (“emergencies”), that people will be negatively judging you (“judgement”), or something else? Naming the fear helps you understand and address it directly.
- Challenge your thoughts: By identifying any distorted thinking that accompanies panic attacks and then actively work to reframe those thoughts to achieve a better perspective. Thoughts like “This shouldn’t be happening.” or “This will never end.” could be replaced with more realistic statements such as, “There is a biological reason for this panic, and it will pass. I can learn to breathe through it.” If catastrophic thoughts are a pattern, focus on all the possible neutral or positive outcomes, not just the worst-case scenarios.
- Plan gradual exposure: By starting with a scenario that will cause some anxiety but not a full panic attack, so you can see the activity through without abandoning it. For instance, to confront a fear of crowds, begin by watching a video of a crowd or imagining yourself in a public place. Next visit a quiet café or attend a small gathering. Slowly increase your exposure until you can comfortably handle a crowded market, a concert, or a sports event.
What To Do When a Panic Attack Hits
- Use breathing exercises to slow your breath; this is one of the best tools for calming panic. Experiment with several different techniques such as deep abdominal breathing or the exercise described in the blog post, Breathe Your Way to Calm. Practice regularly, so you’re ready to use it at the first sign of panic.
- Pair your breathing with soothing statements or mantras that you recite to yourself or read from a note card prepared in advance. Use the “challenge your thoughts” exercise above as inspiration for your personalized soothing phrases.
It may be reassuring to know that panic attacks are not uncommon. According to a 2016 study, nearly one in four people will experience a panic attack by age 75. There are tools and support to help.
Confronting your fears can be extremely hard and the process can feel overwhelming. If you would like support with these and other approaches for managing panic attacks, engaging in therapy at Behavioral Health Partners may help. Behavioral Health Partners is brought to you by Well-U, offering eligible individuals mental health services for stress, anxiety, depression, and ADHD. To schedule an intake appointment, give us a call at (585) 276-6900.
REFERENCES
American Psychological Association. (2022, June 28). Panic Disorder: Answers to your most important questions. https://www.apa.org/topics/anxiety/panic-disorder
Bourne, E. J. (2020). The anxiety and phobia workbook (7th ed.). New Harbinger Publications, Inc.
de Jonge, P., Roest, A. M., Lim, C. C., et al. (2016). Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys. Depression and Anxiety, 33(12), 1155–77. https://doi.org/10.1002/da.22572
Global Administrator | 10/31/2025
