5 clinician-backed techniques for managing stress and panic attacks
Sometimes anxiety, depression, sleep problems, panic, and stress overtake people and cause them to struggle. Learning to cope is critical before these negative feelings become disruptive. Uncontrolled and unmanaged stress and anxiety also can contribute to health problems and upend the ability to consistently work, live life, and sustain meaningful relationships. But making it a priority to learn to cope safely can help.
Northwell Health shares five ways to manage stress and the onset of panic attacks.
Break the Loop. It’s highly unpleasant and difficult to experience stress, anxiety, or panic when they’re coupled with overthinking and ruminating. This can cause stressed people to come to extreme conclusions, all of which cause a strain—and a tough cycle to break. The first step? Understanding how to break the loop. Sometimes it’s helpful to have an external cue, such as a bracelet or a sticky note as reminders to use the next four options to break the loop.
Release the Energy. Behavioral health practitioners sometimes think of stress, anxiety, or panic as a form of energy that needs to be redirected. There are many science-backed ways to intentionally channel this energy. Different options work for different people. Some choose exercise. Walking, running, lifting weights, or playing a favorite sport can help create a pause, expend that energy, and develop clarity. Self-expression is helpful, too. That can include emoting, writing things down, or even yelling into a pillow. Some people find comfort in energetically cleaning, or cleaning out, their homes, and others choose what seem like extreme expressions of this stress by breaking or smashing things, but choose a safe venue to do so, like a “break room” for that catharsis.
Try mindfulness. In addition to eliminating or minimizing stress, anxiety, or panic energy, it can be useful and powerful to consciously direct attention onto something: This is called mindfulness, the ability to be completely present and aware of the current moment, thoughts, feelings, and surroundings, but without judging them. It’s a way of taking in a moment thoughtfully, but not reactively. Some types of mindfulness demand attention right away, like a fidget spinner or watching a captivating sporting event, but others require us to build attention, like becoming intensely interested in music, nature, a book, or art, and consciously noting and monitoring our feelings about them.
Change the Scene. Sometimes the most effective thing to do under stress is to “wash” the brain. One way to do this is simply by changing the scenery. Perhaps this means getting out of the house, taking a break from work, stepping outside for a few minutes, or going for a brief drive. This and the other exercises force the brain to tend to new stimuli and break the loop. This is different from distraction because intentionally altering the scene cognitively makes a bigger impact on the brain than turning to a smaller project for distraction.
Create a Reward. As people learn to cope, it’s also helpful to pay attention to what helps them do so and what positive changes they may be making to break the stress loop. When people successfully get through a bout of anxiety or panic without choosing something harmful, such as turning to chemicals or medications, it’s important to build in a reward. While this step may not reduce stress or panic in the moment, a minor indulgence after successfully remaining calm may serve as positive reinforcement and deter future panic attacks. This helps build mastery. Getting through a stressful ordeal without having a panic attack is a powerful key to self-confidence and helps manage future anxiety.
Xavier Jimenez, MD, is the director of consultation psychiatry, addiction medicine, and chronic pain at Northwell Health’s Long Island Jewish Medical Center.
This story was produced by Northwell Health and reviewed and distributed by Stacker.

