My First-Aid Kit: 11 Tools to Navigate Anxiety & Panic Attacks

Hi, my name is Alex and almost every week, I enjoy an Anxiety Attack - an all consuming experience of “everything is fucked,” despite rationally knowing otherwise.

Sometimes, when I’m really lucky, it becomes a panic attack, which feels like dying.

Fortunately, I have ~15 years of tools and training to navigate these experiences. That doesn’t make them any more fun, but it does make them manageable. It gives me confidence that, even though it doesn’t feel like it, everything is going to be ok.

Everything is going to be ok.

Always has been.
Always will be.
Only way it can ever be.

Below are 11 tools I use to navigate acute panic and anxiety.
They’re not academic suggestions.
They’re my actual playbook when my brain puts me on my ass.

Bookmark this page and use it as a checklist, or steal it and modify to create your own.

When your brain goes to shit, be prepared.
Have this first aid kit ready so you can recovery as quickly and painlessly as possible.

1. Disconnect: Create Space to Recover

Stuck in a loop of of scrolling, app switching, looking for “the thing that’ll make it right?” It’s not on your phone, computer or YouTube.

I’ve literally thrown my phone across the room. Slammed my computer shut. Yelled “TURN THIS FUCKING SHIT OFF” to the 4 walls around me.

Break the grip of digital anxiety traps. Whatever it takes.

If you’re at a social event, excuse yourself. Postpone the meeting.* Ask for more time than you think you’ll need.

Create the space you need to recover without feeling in a rush.

Turn your phone off or put it on focus mode. Close your laptop. Turn off the TV. Turn on white noise or similar.

Distractions feed the wildfire of the anxious mind.

Let the fire burn out. Let the water grow still.

Only then can you see the unobstructed truth, that nothing is as bad as it feels right now.

Note: Be wise not to claim debilitation during routine discomfort. If you cry wolf, you will not get support when you need it. Even worse, if you believe your exaggerations, you’ll develop a self image that is fragile and weak. You will conform to this self image and feel fragile and weak. Life will be worse.

You are robust and strong. Part of that strength is recognizing worthy adversaries, taking losses gracefully and giving yourself the love you need.

Only you will know the actual severity of the episode. Act with integrity and without apology.

2. Write it Out

During an anxiety attack, my thinking becomes dogshit. I obsess over problems not worth solving. I create needlessly complex puzzles, trying to do it all, when it would be 10x easier to let most of it go. The trivial inflates. The essential gets obstructed.

Everything becomes 100x harder than it has to be.

Writing it out forces this rat’s next of unintelligible dogshit to be extruded as a single turd. It unties knots. Eliminates contrived problems and contradictions. It allows me to hear myself, so there’s at least one person on earth who knows what I’m going through - me.

Before that, nobody knows.

In writing, I can be both the client and therapist, sequentially. In my head, those forces become the hurricane of anxious hell, simultaneously.

Note: Audio journaling, or talking to yourself (recorded or not), is also super beneficial for extruding thought. I think 90% of therapy is just audio journaling with an accountability buddy. But I find writing to be more grounding and thorough. In writing, thoughts can be manipulated, annotated, responded to, etc.

There are no rules. Use both. Whatever works.

3. Rest. Truly Rest.

Few therapies are as effective for recovery as sleep and non-sleep deep rest (NSDR, more on this below).

I’ve taken naps in the car. Crossed my arms and put my head down on my laptop at coffee shops. Gotten in the fetal position fully clothed.

Whatever it takes.

15-45 minutes can save hours of suffering.

4. Nourish

With age, hunger and dehydration take an increasingly devastating toll on my body and mind.

The mind is a product of biology.

Short term, it can overcome suboptimal biological conditions. Long term, it cannot anymore than a hearty crop can overcome poisoned soil.

As a default, if we want positive psychological outcomes, we need to nourish the biological vehicle.

Nourishing also provides a great opportunity to practice gratitude amid the storm.

Caveat: It is important to eat with the intention of nourishing and giving the body and brain what they need to feel good and clean. This will affect both food choice and quantity. Eating for “comfort”, or, more accurately, escape/distraction, will likely result in eating foods that make you feel worse and quantities that you’ll regret.

Emotional eating only defers anxious tailspin until the consequences arrive. Use food and water to nourish and heal, not to numb and stuff.

5. Cleanse: Bathing & Hygiene

Shower. Shave. Wash your hair. Wash your face.

I don’t know the science, but it makes sense that cleansing the body helps cleanse the mind. It’s also an easy way to introduce movement, increase bloodflow/cell oxygenation and warm the body.

Additionally, when you wash yourself, you touch your body. Which brings me to #6 -

6. Soothing Touch

When anxiety is really crippling, I often find myself craving to be held and told that everything is going to be ok.

If you have someone available that can give you this, that’s a blessing. If you don’t, it’s not a curse.

What I’ve found is that I can be the person who gives myself these gifts.

I can tell myself that it’s going to be ok, especially via my journal. I can fulfill my desire for touch via bathing/hygiene, stretching, massaging, curling into the fetal position and wrapping myself in a blanket.

Of all these tools, I suspect this one will make you most uncomfortable.

“Touch myself? Like a lonely loser? I’m not some pathetic [pejorative of choice].”

You don’t need to feel self conscious, pathetic or embarrassed about this.

• If you feel embarrassment, it is because you have internalized the future judgement of others (even if this is happening in private and they’ll never know). But you are the one dealing with this attack, not them. If they judge, that only tells you where they are uptight and lack confidence. That is their problem, let them have it. You have the right to take care of yourself.
  
  Unless they can go through this for you, their opinion is irrelevant.
  
  Heal yourself as you see fit.
• Even if you have someone in your life who can give you soothing touch, they may not be available at the moment of distress. Moreover, if this happens regularly, you may not want to become a burden on their life. This is part of what makes having a faulty brain so lonely and isolating. We don’t want to bother others with our shit.
  
  By being able to give ourselves more of what we need, we neither have to burden others, nor go without. By learning to love ourselves better, we become more able to love.

7. Sun and Air

Fresh air doesn’t just mean “the air outside.” It’s air that actually has more oxygen. Oxygen nourishes every cell of the body.

If you can’t go outside, crack a window.

If you can’t do that, turn on a fan. Even placebo fresh air can help.

Regarding the Sun -

We all know that it’s our lifetime supply of super-drug Vitamin D.

But further, my doctor tells me that sun exposure is correlated with nearly all positive biological/psychological outcomes, short of sunburn, skin cancer and heat stroke.

I also think that the sun’s warmth mimics the warm-hug-effect discussed above. Even bundling yourself up on a cold day can have this effect, not to mention the positive effects of cold exposure and contrasting warmth when you come back inside.

8. Let Someone Else Take the Wheel (Guided Meditation/Yoga Nidra/NSDR)

When I was 28, before any spiritual awakening, I found that 20 minutes of guided meditation during an anxiety attack was like being born again. I have no doubt that I could’ve gotten a lifetime prescription for Clonopin (anti-anxiety drug), but 10-20 minutes with the Calm app seemed to do the trick.

During an anxiety attack, I recognize that I am not the best operator of my mind.

Therefore, despite a decade of meditating regularly with various non-guided modalities, in moments of anxiety/panic, I release my white knuckle grip and let someone else take the wheel. My ego curls up in the backseat and accepts the ride. It relieves the pressure of making the “right” decision or doing the “right thing” when I’m in no condition to so.

My overactive survival drive has a chance to reset.

20 minutes later, the person that comes out is often different than the one that came in.

Buddhists say “with each exhale, I die. With each inhale, I am reborn.”

Ain’t that the truth.

Resource: Calm has guided meditations specifically for anxiety and panic. I’m sure other meditation apps do too. There are also plenty of free guided meditations on Youtube, as well as guided Yoga Nidra/NSDR, all of which have been scientifically observed to help with anxiety.

9. Stretch: Unstick the Body

It’s almost a trope that exercise is “the best treatment for depression.” I don’t disagree, but anxiety can occur independent of depression. I actually have an optimistic worldview and believe I have a great future ahead of me.

I still experience anxiety regularly.

So, while exercise may be of value in these moments and is a pillar of my life, let’s avoid platitudes and broad brush strokes.

I’ve found stretching and massaging knots and aches to be particularly soothing during moments of emotional distress. Something about releasing what’s stuck in the body has a deeply therapeautic effect on the mind.

Again, like showering, its an easy, low impact way to introduce bloodflow to the body, steady and deepen breathing and offer yourself soothing touch.

I’ve found that stretching in the warm sun can take me from an experience of psychological hell to near bliss. Results my vary, but I’m a fan.

10. Be Kind. Accept.

In some sense, an Anxiety attack is a bad trip. A bad trip is when your mind goes on a roller coaster ride, but you keep clinging to a version of reality that’s not there. You create suffering by demanding that reality return how you remember it or how you imagine it can be.

But things are as they are, not as you remember or imagine.

The attack is happening. You did not choose it.

It is a challenge. But whether you accept the graceful struggle or magnify it into needless suffering is up to you.

What are you holding onto that you can let go of? What are you fighting that you can accept? What’s essential? How can you make it easier? How can you make it effortless? Where is the beauty? What is there to be grateful for?

How do you relax and let it pass?

You do not choose if your computer crashes. But you choose if you hit reset and let it go through the recovery process, or break it in half over your knee.

You have the opportunity to be kind to yourself. Kindness, isn’t mindless joy and cheeriness. It’s accepting someone where they are, as they are.

Give yourself kindness and accept.

11. Take Your Time. Trust the Process.

Ever made a bruise, cut or broken bone heal faster because you had other shit to do? This is similar.

You may not need to recover 110% to get back to life, but getting back to a functional baseline is going to take about as long as its going to take. Putting pressure on recovery to happen faster is like staring at a clock when you’re impatient. You slow time to a crawl.

Trust that your body and mind have some of the best regenerative technology in the universe.

So, relax. Take your time. Trust the process.

You’re going to be ok. Whoever/whatever is waiting for you will be ok.

Everything is going to be ok.

Always has been.
Always will be.
Only way it can ever be.

To Recap

1. Disconnect: Create Space to Recover
2. Write it Out
3. Rest. Truly Rest.
4. Nourish
5. Cleanse: Bathing & Hygiene
6. Soothing Touch
7. Sun and Air
8. Let Someone Else Take the Wheel (Guided Meditation/Yoga Nidra/NSDR)
9. Stretch: Unstick the Body
10. Be Kind. Accept.
11. Take Your Time. Trust the Process.

After Recovery. What Next?

What you do next will be personal and contextual.

You may want to resume your normal life, accepting what happened and releasing it from further consideration unless it becomes a more chronic issue.

You may want to post mortem to figure out the context and triggers that caused this event, so you can avoid, change or prepare for them in the future.

Most likely, there is a major disturbance in your life that you want to acknowledge and either fully accept or resolve. It is worth setting aside some time before you have another attack to really think this through.

This is Where Coaches and Therapists Enter the Discussion

The right coach or therapist can provide immense leverage. As Codie Sanchez says, “I believe in paying someone for their 10,000 hours.” But I’ve found this to be a nuanced issue. Not everyone’s 10,000 hours are created equally. Not everyone actually has the 10,000 hours they claim. Not everyone has the tools you particularly need - it’s not a one-size-fits-all profession. I have benefited tremendously from some, “graduated” from most, and completely spun my wheels with others.

So, sure, if you don’t already have one, look for a coach/therapist, but if you don’t have the resources/time, don’t make it another pressure to compound your anxiety. Like I said above, 90% of the value is in creating the space to extrude your thoughts and parse them. If you’re clear on the changes you need to make in to accept or improve your life, then get started and plug others in later.

The One Thing Not to Do

Don’t get stuck in the past. Don’t make the fact that you had an anxiety attack become kindling for the next anxiety attack. Accept. Release. Move on.

Be here now. What’s you intention now?

Proceed accordingly.

WAIT WAIT WAIT

It is an honor to serve you, but this shit ain’t free.

It doesn’t cost money, but it’s not free.

To write the above, it’s taken a decade of study and practice, thousands of dollars of professional help, years of diligent self-experimentation, endurance of countless painful episodes and the will to get full-frontal naked on the internet.

My intention is simple - to help as many people as I can with the resource available to me.

Therefore, here is what I ask of you -

1. Connect with Me. Show me that this was valuable to you by signing up for my email list/newsletter here. Knowing that you’re listening gives me the juice to keep giving my best. AS A THANK YOU I’ll send you a 1-page, actionable summary of this First-Aid Kit so you have easy access whenever you need it.
2. Pay it Forward. If you know at least one person suffering from anxiety or panic attacks and you think this may help, please forward to them. Share on Facebook, Tweets, post on Reddit, include in newsletters.
3. Speak Up - Any essential tools in your toolbox that I missed? Share them in comments. Questions/concerns? What’s unclear? How can I make this less hypothetical and more actionable? Tell me in the comments or tweet @TheXander?

Safe travels. See you soon. -AP

Special Thanks

• Dale Diaz, who coached me for 7 years in my 20s and was there for me on the single darkest night of my life. I use the tools he imparted to me every day of my life.
• Ram Dass who taught me “there are no mistakes in the system,” “it’s all grace.” His life and teachings are the north star of everything I understand to be true.
• Greg McKeown, whose books Essentialism and Effortless have been a bottomless well of comfort for me over the past few years. I look forward to creating a world where the essential few become increasingly effortless and the trivial many fall away.
• Countless meditation instructors, yoga teachers, fitness coaches that have pushed me and reshaped my mind and body over the past 10 years. Thank you for helping me shed the hurt, “tortured artist” of my childhood and discover one of the toughest motherfuckers I’ve ever met.
• Thank you.