How To Stop A Panic Attack At Work, From Someone Who Has Been There

You are not helpless when a panic attack strikes at the office.
People can help manage a panic attack at work by reframing the narrative of their experience.
image_jungle via Getty Images
People can help manage a panic attack at work by reframing the narrative of their experience.

During the middle of an ordinary work day, I began to die. Or at least it felt like it, because I was having a panic attack. My throat closed up, my heart rate spiked, and my breathing quickened as I struggled to regain control of my body, sure that death was imminent.

It felt both silly and not silly that the fear of not getting enough air would panic me so much, I would cry about it in the privacy of a bathroom stall, then have to leave work early to go see a doctor, who would clear me as healthy. After the episode passed, I felt defective, wondering what caused the malfunction. I was getting enough air. My heartbeat was normal. My lungs were perfectly operational. But the panic attack destabilized my sense of what was normal.

It wasn’t the first time I experienced a sudden, intense fear for my life for no rational reason. The waves of panic first crashed over me in the months I was unemployed after a layoff. Even after I got a new job, it persisted. The anxiety settled into my bones and made a home there. I no longer trusted myself, so I no longer trusted my body, jumping to the worst conclusion each time a thought misfired in my mind: “You’re not getting enough air, your heart rate is too high, you’re dying, run, get out of the office.” While my co-workers were typing around me, getting work done, I was alone in a life-or-death match with my body.

These panic attacks cost me my time and productivity. I would disrupt my work under deadline to walk outside to a nearby garden and pace among trees until I could prove to myself that my body was fine. What is debilitating about panic attacks is that once you have one, you can develop a fear of them happening again. The shame isolated me and prevented me from asking for help. I did not want my boss or co-workers to see me as unreliable, so I kept these episodes of panic to myself.

It took trial and error, a good therapist, self-help books and time to retrain my brain to trust my body again. Making peace with myself is a process I am still refining, and it’s one panicked people everywhere can learn too, whether they experience panic on a clinical level or through an occasional sense of acute dread. Here are the expert-backed tips I learned that I would share with my anxious self and anyone who feels creeping panic at work.

1. Focus your breathing

Focused breathing centers our bodies when we are being hijacked by a surge of panic. Research has linked breathing to lower stress levels and reduced negative anxiety and emotions.

But being told to just breathe can be less helpful when you feel short of breath at your desk. Try long, slow breaths as you feel the symptoms of panic rise, said Maryland-based clinical psychologist Monique Reynolds of the Center for Anxiety and Behavior Change.

She recommended breathing in for a count of four, then breathing out for a count of six to slow your heart rate and breathing, which in turn activates the parasympathetic nervous system. During a panic attack, our body’s fight-or-flight response is turned on, releasing adrenaline and increasing heart rate and breathing to enable the body to fend off or flee a perceived threat. Breathing slowly tells the body we can let our guard down.

“We want to activate the brake system, the parasympathetic system,” Reynolds said. “A long slow breath is a really good way to do that. It cues our whole system that we are safe, there’s no danger here.”

2. Confront the panic head-on

Once we’re in the full throes of a panic attack, we may experience physical symptoms that accompany overwhelming sudden fear, like shaking, heart palpitations, chest pains, difficulty breathing, lightheadedness and paralyzing terror, according to the American Psychological Association.

These symptoms can be scary, but instead of shying away from the body’s discomfort, people should accept their circumstances to make the panic attack shorter. “Anxiety needs avoidance to really function,” Reynolds said. “The moment we start saying, ‘Oh, my God, this can’t happen now. I can’t have this panic attack. This is the worst time ever,’ then you’re in trouble.”

It may seem counterintuitive, but the quickest way to move through to the other side of a panic attack is to confront the feelings directly, she said. “If you know that typically you have a rapid heart rate, you might say to yourself, ‘Bring it on. I know my heart is going to pound, I’m going to feel dizzy for a second, my hands are going to sweat,’” she said. “Part of it is really educating yourself on what are your symptoms of panic.”

In his book When Panic Attacks, psychiatrist David Burns recalls how he lessened his fear of blood after he was forced to be surrounded by it in an emergency room as a student. “Instead of avoiding the thing you fear, you intentionally expose yourself to it and flood yourself with anxiety,” he writes. “You don’t fight the anxiety or try to control it, you just surrender to it. Eventually the anxiety burns itself out and you’re cured.”

3. Get logical

During a panic attack, we can stop thinking logically. Signals from deeper regions of the brain like the hypothalamus and brain stem, which are involved in defense responses, can take over instead of being moderated by the prefrontal cortex, which is responsible for decisionmaking. You can put the logical part of your brain back in the driver’s seat with a few techniques.

Narrate your experience. Addressing panic means giving it language, even if it is just you narrating what you’re going through in your head. This narration can help get your brain’s reasoning parts back online when you are not thinking straight during a panic attack.

“When you’re having a panic attack, your prefrontal cortex that has all that logical, sequential thought ― the reasoning, rational brain ― actually goes offline,” Reynolds said.

Narration can include talking yourself through an attack in multiple ways. You can become curious about your feelings instead of afraid of them. Noticing the world outside yourself or writing down how you feel can help accomplish that.

Take five. If you’re in the middle of a panic attack, unable to speak, one thing you can do to re-engage the rational brain is to focus on other sensations. Look around the room and find five things of a certain color, then listen for four different sounds, touch three textures, smell two things and taste one thing, Reynolds recommended. “The process of engaging your senses and focusing on sensory information pushes your brain back into engaging your prefrontal cortex,” she said.

Write it down. If panicking at work happens with any frequency or with known triggers, she recommended writing down self-coaching reminders on index cards to cue your logical side.

These statements should not be blanket reassurances like “You’re going to be fine” but positive statements you can believe in, such as “This feeling is uncomfortable, but it is not dangerous” or “I can handle difficulty,” Reynolds said.

Journaling how you feel before or after a panic attack can also help you notice what may be beneath those intense feelings of panic. Chloe Carmichael, a New York City–based clinical psychologist, recommended that people first confirm with a medical doctor that they are healthy and then use techniques like journaling to uncover the hidden emotions driving the panic.

“If you really do feel you’re having sudden, intense emergencies over your feelings, then it may be a sign you need to connect with your feelings more frequently so they don’t have to reach fever pitch to get your attention,” she said.

For people who avoid their emotions until they burst out in a panic attack, documenting what happened during the day can be a useful way to use language to calm down, feel in control and understand what prompts panicky fear. “In a very simple way, write down what was your high point and your low point of the day,” Carmichael said.

4. Connect with someone

During one frantic walk outside my office, I called my dad and felt my heart rate slow at the sound of his familiar voice. I no longer felt helpless, and knowing that support was a phone call away kept me going and enabled me to finish the workday.

Too many of us keep quiet about what is happening when we start to panic at work. A panic attack can be an isolating event, especially in a workplace where you may not feel comfortable sharing this vulnerability with your colleagues.

“There’s this sense of secrecy that tends to inflame the situation,” Reynolds said.

Seeking our support structures takes away secrecy’s isolating power and can put us back in control of our situations. “Instead of just being reactive, which is just running to the bathroom to catch your breath, you can be proactive by noticing in advance that you’re feeling on edge and could use some support,” Carmichael said. Texting or emailing friends or family members to see if they can chat during your lunch break or arranging to meet up with someone after work can be ways to call on your support, she said.

5. Identify your workplace triggers

After a panic attack, where it happened can become a source of dread. If the workplace becomes a place of panic-inducing stress, reflect on the triggers to see what can be changed about the situation.

“It’s really important to start using really descriptive language on what exactly about your office was so stressful that you ended up reacting this way,” Carmichael said. Ask yourself if it was your office environment or if the source is your field of work in general, social dynamics in your office or that you need to learn how to communicate more assertively about your workload, she said.

Even if you do not experience panic attacks specifically, knowing how you can address workplace stress is useful.

Unfortunately, addressing workplace stress and anxiety that you cannot avoid can be difficult. “It becomes a problem when the thing that your brain wants to avoid is also the thing that allows you to pay rent,” said Mary Poffenroth, a San Jose University researcher and lecturer on fear.

She said people can think about the central trigger for that workplace panic so they can talk with leadership on what can be adjusted. “Was it an individual person? Was it the overall culture? Was it a project? Was it a particular thing, like presenting?” she said. Then you can arrive at “some creative ways to deliver on what that need is but not do that thing that you know is going to send you into a tailspin.”

Panic happens to many of us

I am not the only person who has experienced embarrassing panic in a most inconvenient setting like an office, and I will not be the last. It’s estimated that 6 million American adults live with panic disorder, which comes with frequent attacks, and many more experience attacks less often. If you are huffing and pacing outside your office to get through the workday, if you need to take a break to call your parents to cope under a deadline, if you are slowly counting out breaths at your desk, know that there are many supportive people out there and that tools like the ones above can help.

If this is affecting your everyday life to the point that you can’t function, it’s worth seeing a mental health professional to get to the bottom of what’s going on. You deserve to be able to live a normal, productive life both in and out of the office.

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