When anxiety arrives suddenly
Find support in the present, try comfortable breathing and return to situations in manageable steps.
Being told to ‘just relax’ rarely helps when you feel afraid. Start with simple actions without demanding that you calm down immediately.
A racing heart, trembling and breathlessness can accompany anxiety, but these sensations do not identify their cause. New or severe chest pain, severe breathing difficulty, fainting or concerns about your safety need medical help; call 112 in an emergency in Russia.
First, find support in the present
- If your surroundings are unsafe, move somewhere safe. If you feel dizzy, sit with support.
- Notice the support under your feet and behind your back. Name a few objects around you: their colour, shape and position.
- Try gentle breathing without taking excessively deep breaths. Do not breathe into a paper bag or force breath-holding when you feel short of air.
- You can ask someone you trust to stay with you. Seeking help does not diminish your efforts.
Return to feared situations gradually
Avoidance may bring short-term relief while gradually narrowing your everyday life. When you feel steadier, choose a safe situation and a small manageable step, such as a short walk, brief journey or conversation.
This does not mean staying in danger or pushing yourself to your limit. With recurring panic attacks or strong avoidance, plan these steps with a professional.
Take a little distance from a frightening thought
Once the acute wave has passed, name the thought: ‘I am afraid that…’. What might happen? What could I do if it did? Who could help? The aim is to see possible actions, rather than repeatedly imagine the worst.
If reflection makes the fear stronger, stop and return your attention to your surroundings or an everyday activity. Difficult experiences can be explored with a psychologist.
Practise slowing down when you feel calmer
A short pause, quiet walk, manageable yoga or attention to sensations can help you notice your pace. Try breathing exercises when you feel calmer; you do not need to learn every variation during intense anxiety.
Practice and notes
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Choose one comfortable breathing option
Sit with support or find another comfortable position. Breathe without effort; counting is a guide, not a target. You may keep your eyes open. Stop if you feel dizzy, in pain or more short of breath. If you have a respiratory condition, discuss these exercises with your doctor.
- A longer exhale: breathe in gently, for example for 2 counts, and out for 4 if comfortable. Do not force extra air in.
- Square breathing: about 4 counts each for inhaling, pausing, exhaling and pausing. Holds are optional: leave them out and return to natural breathing if uncomfortable.
- Even breathing: let the inhale and exhale be roughly equal in length. Try 30–60 seconds without holding your breath and notice how you feel.
- Alternate-nostril breathing: gently cover one nostril, breathe in softly and switch sides to breathe out. Then reverse sides. Skip this if your nose is blocked; holds are not needed.
- The 4–7–8 pattern: inhale for 4, hold for 7 and exhale for 8. Do not try to endure a long hold while anxious. For self-practice, you can choose even breathing without holds.
- Exhaling through gently pursed lips: breathe in softly through your nose and out through loosely pursed lips, as if whistling quietly. This guide does not offer the exercise as treatment for breathlessness or lung disease.
- Breathing with movement: from a comfortable position, gently lift your torso or arms as you inhale and release tension as you exhale. Avoid deep bends and breath-holding if dizzy.
- Observing the breath: rest a hand on your abdomen or chest and notice its natural movement. You do not need to fill particular parts of the body with air or make the movement large.
My plan for an anxious moment
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When to seek support
If episodes recur or anxiety interferes with leaving home, sleep or work, talk to a psychologist or doctor. These exercises do not diagnose a condition or replace assessment of new physical symptoms.
Discuss a consultation