Mental Emergency Toolkit: Strategies to Try When Panic Takes Hold

Rebecca M. Hedrick, MD

Rebecca M. Hedrick, MD

Move Your Body

Often, strong emotions stimulate an action urge in the brain and the body.

"When we're feeling this huge amount of stress and we're overwhelmed, our bodies have flipped into the fight, flight or freeze response," Hedrick said. "It's as though there's some kind of tiger, and you've got to either fight it, run away from it or freeze so it can't see you."

Blood rushes into the limbs, the heart rate increases and blood moves out of the gut-priming the body to move. One way to manage this feeling is to go with it: run, walk briskly or engage in some other vigorous exercise that will help the body release some of this pent-up energy.

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Progressive Muscle Relaxation

Another evidence-based technique is called progressive muscle relaxation, Hedrick said. Begin in the hands or feet, and clench your muscles as tight as you can for several seconds, then release. Move from the feet to the legs, to the abdomen, and so forth until you've progressed through each of the major muscle groups.

"As you do this, pay attention to what this actually feels like," she said. "What do these tight, tight muscles feel like, and then what does it feel like when I let go of that tightness?"

This is a good technique to practice when trying to fall asleep, as well.

Read: Know the Hidden Symptoms of Stress

Take Cleansing Breaths

When struggling in a panicky moment, try taking a deep breath and then, when exhaling, make a loud sigh or "ah" sound a few times.

"When we're anxious, we start using our chest muscles to breathe," Hedrick said. "We're contracting those muscles and our stomach."

This takes space away from the lungs, which branch from the throat and shoulders down into the belly. When anxiety causes the body to contract and limits how much the lungs can expand, we must work harder to get the same amount of oxygen. Cleansing breaths can help relax the chest and let the lungs fill more completely. One way to practice is to put one hand on your chest and the other on your stomach, then try to allow only the hand on your stomach to move with each breath.

Read: Mental Health, A Key to the Heart

Create a Mental Health First Aid Kit

A small grab-bag of essentials can assist with tolerating emotional distress. Think of something small enough to be stashed in a glove box, desk drawer, purse or backpack. Consider items that will appeal to the senses to help ground you.

• Smell: Consider a vial of fragrance or essential oil that you find soothing or evokes happy feelings. A small candle, a small tin of coffee beans or loose tea, or a scented lotion also could do the trick.
• Taste: Mints, gum, hard candies or even popping candy are good options. Choose things you must consume slowly.
• Touch: Fidget toys, putty, a piece of fabric such as satin or velvet are good additions to a kit. You can also run your hands over your arms, massage your temples, or reach for a heat or cold pack.
• Sight: Photos of favorite places, sayings that bring you peace, or a list of favorite TV shows, movies or funny online clips are useful to have at the ready.
• Sound: Create playlists to help manage your moods. A queue of feel-good songs, nature sounds, energizing instrumentals or favorite stand-up routines can offer a sonic getaway. If you play an instrument, that is an excellent outlet in times of distress, Hedrick added.

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Practice and Prepare

In the Consultation Liaison Psychiatry program, Hedrick routinely sees patients who are in the hospital for serious medical issues, facing some of the most stressful circumstances of their lives.

"When I talk to them about learning new coping strategies while they're in the midst of a tough time, they often feel like it's more than they can manage," she said.

Hedrick advises patience.

"Coping strategies take practice," she explained. "It cannot fix everything this second, but it can help decrease your stress in the moment. And, with a few months of practicing, it will be even more powerful."

Start with a practice such as progressive muscle relaxation, or even a body scan-in which you just start with your scalp and check in with how each part of your body feels, all the way down to your toes. Practicing these techniques in times when you feel good or you're experiencing low-level distress will make you an expert in using them when a painful or challenging moment comes along.